The development of pressure ulcers due to tissue breakdown and cell necrosis is a significant secondary complication for many patients, including those with progressive neuromuscular disease, the elderly, and those with impaired mobility or paralysis. Tissue breakdown is referred to by many terms, including decubitus ulcers, pressure sores, ischemic sores, and bedsores. The term pressure ulcer is the most accurate nomenclature to describe both the cause and nature of chronic, nonhealing wounds due primarily to excessive applied pressure.

A consideration of the risk factors in pressure ulcer development is of vital importance because they contribute to the development of treatment and rehabilitation strategies. There are many factors that can lead to the development of pressure ulcers . These can be classified as extrinsic factors primarily related to the interface between the individual and the external environment and intrinsic factors related to the clinical and physiologic profile of the individual.

Changes in clinical status over time can alter intrinsic factors and can increase the risk for pressure ulcer development. For example, urinary incontinence will alter the microenvironment of the skin surface and make it more susceptible to maceration and breakdown. Changes in environmental factors, such as the seating system used, will alter external factors that affect pressure ulcer risk status.

Once a patient has a pressure ulcer , the determination of whether bacterial infection, underlying osteomyelitis, related abscess, or sinus tracts are hindering the healing process becomes important.

Different reasons to have pressure ulcers are:

• Ischemic ulcer
• Diabetic ulcer
• Venous stasis ulcer
• Dermatologic neoplasms
• Surgical wound dehiscence
• Abscess
• Abrasion

In our clinic with the physician's previous experience in general and vascular surgery and our home health services we can treat different pressure ulcers.