Our contemporary understanding of the aetiology of pressure ulcers/pressure injuries. Issue 3 (11th August 2021)

• Record Type: Journal Article
• Authors: Gefen, Amit; Brienza, David M.; Cuddigan, Janet; Haesler, Emily; Kottner, Jan
• Is Part Of: International wound journal. Volume 19:Issue 3(2022)
• Page Start: 692
• Page End: 704
• Publication Date: 2021-08-11
• Subjects: aetiology -- pressure injury -- pressure ulcer -- risk; Wounds and injuries -- Treatment -- Periodicals; Wounds and injuries -- Periodicals; Wound healing -- Periodicals; 617.1005
• DOI: 10.1111/iwj.13667
• Languages: English
• ISSNs: 1742-4801

Abstract

Abstract: In 2019, the third and updated edition of the Clinical Practice Guideline (CPG) on Prevention and Treatment of Pressure Ulcers/Injuries has been published. In addition to this most up‐to‐date evidence‐based guidance for clinicians, related topics such as pressure ulcers (PUs)/pressure injuries (PIs) aetiology, classification, and future research needs were considered by the teams of experts. To elaborate on these topics, this is the third paper of a series of the CPG articles, which summarises the latest understanding of the aetiology of PUs/PIs with a special focus on the effects of soft tissue deformation. Sustained deformations of soft tissues cause initial cell death and tissue damage that ultimately may result in the formation of PUs/PIs. High tissue deformations result in cell damage on a microscopic level within just a few minutes, although it may take hours of sustained loading for the damage to become clinically visible. Superficial skin damage seems to be primarily caused by excessive shear strain/stress exposures, deeper PUs/PIs predominantly result from high pressures in combination with shear at the surface over bony prominences, or under stiff medical devices. Therefore, primary PU/PI prevention should aim for minimising deformations by either reducing the peak strain/stress values in tissues or decreasing the exposure time.