Chapter 18: Wound management
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Anatomy and physiology
A pressure ulcer usually results from compromised circulation secondary to unrelieved pressure on the tissues, compressed between a bone and an external surface (Hess [48]). During the period of unrelieved pressure, the local tissues are deprived of blood flow, oxygen and nutrients, resulting in ischaemia (House and Johnson [49]).
Pressure ulcers are categorized according to the degree of tissue damage using the International Pressure Ulcer Classification System developed by the National Pressure Ulcer Advisory Panel, the European Pressure Ulcer Advisory Panel and the Pan Pacific Pressure Injury Alliance (Haesler [39]), illustrated in Figure 18.9. Pressure ulcers are categorized into six stages. Stages I–IV are attributed according to wound depth. Depth is unknown in the ‘unstageable’ and ‘suspected deep tissue injury’ categories.
Figure 18.9 The International National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel Pressure Ulcer Classification System.
Source: Reproduced from Haesler ([39]).
