This 5 cm decubitus ulcer was debrided to help with healing in a 54-year-old chronically debilitated intensive care unit patient.
Decubitus ulcers are caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of sustained and constant pressure. Pressure ulcers typically occur in chronically debilitated patients who are unable to change position in bed. Ulceration most frequently occurs over bony prominences with 95% of all decubitus ulcers occurring on the lower body and 65% in the pelvic area. Pressure ulcers are graded according to a four-stage system. Stage I: Lesion appears as an area of persistent non-blanchable redness. Stage II: Superficial ulcer involving the epidermis and/or dermis. Stage III: Ulcer extends to and/or through subcutaneous fat. Stage IV: Ulcer involves muscle, tendon, bone, or joint capsule.