Pressure Ulcer: An Updated Review for Healthcare Professionals

Almutairi, Mohammed Naif; Alghamdi, Mahfoudh Saad; Almutairi, Khalid Assaf Mohammed; Alotaibi, Ali Ali; Alhafi, Awadh Hamid; Alanazi, Muteb Marshad; Almutairi, Naief Qalit; Alrahimi, Ahmed Nijr Owaidh; Almutairi, Yousef Mesfer; Almntshre, Ali Abdullah; Saleh Aleidan, Eidan Abdullah; Saeed, Alqahtani Mohammed; Maashi, Majed Nasser Mohammad; Alotaibi, Sultan Mesfer; Albagami, Abdulrahman Saad Marzouq

doi:10.21608/ejchem.2025.412132.12156

Pressure Ulcer: An Updated Review for Healthcare Professionals

Document Type : Review Articles

Authors

Ministry of National Guard, Saudi Arabia

10.21608/ejchem.2025.412132.12156

Abstract

Background: Pressure injuries are preventable lesions of skin and soft tissues driven by sustained pressure and shear at bony prominences; device-related variants are increasingly recognized and cluster at the sacrum, ischium, and trochanter.

Aim: To synthesize current concepts on etiology, epidemiology, mechanisms, histopathology, evaluation, staging, management, prognosis, complications, and rehabilitation for healthcare professionals.

Methods: Narrative synthesis of frameworks and findings summarized in this review, including NPIAP/ICD-11 classification, risk instruments, and outcome reports.

Results: Immobility, moisture, malnutrition, anemia, and endothelial dysfunction are principal risks; shear magnifies deep tissue failure, and as little as two hours of uninterrupted loading can initiate injury. Histology progresses from papillary dermal vascular change to full-thickness necrosis; chronic ulcers harbor extracellular-matrix bacterial aggregates, whereas osteomyelitis beneath exposed sacral bone is uncommon and typically superficial. In the United States, about three million adults are affected annually; hospital-acquired pressure injury costs may exceed $26.8 billion, with incidences near 8.3 per 100 acutely ill patients and early onset within five days of admission. Healing at six months is >70% for stage 2, ~50% for stage 3, and ~30% for stage 4; sacral recurrence is common.

Conclusion: Standardized terminology, early risk stratification, dependable off-loading and microclimate control, prudent debridement and dressings, nutritional optimization, and multidisciplinary coordination reduce incidence, accelerate healing, and limit recurrence.

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