PRESURE ULCERS 

Pressure ulcers  can be defined as any damage to the area of skin and underlying tissue caused by the prolonged pressure on a hard plane, not necessarily intense, and independent of position.
Prevention is a priority mainly based on methods that quantify risk factors that help predict tissue involvement because 95% of ulcers are preventable.


RISK FACTORS

Pathophysiological

• Skin lesions
• Oxygen transport disorders
• Nutritional deficits
• Immunological disorders
• Disturbances of consciousness
• Motor deficit
• Sensory deficit
• Removal altercations

Derivatives of treatment:

• Immobility imposed by treatment
• Immunosuppressive treatment: radiotherapy, chemotherapy
• Drilling for diagnostic or treatment

Situational

• Poor hygiene
• Wrinkling
• Rubbing objects
• Immobility by pain, fatigue

Environment

• Lack or misuse prevention material
• Professional motivation due to lack of training and / or specific information
• Work overload
• Lack of uniform criteria in planning cures
• Lack of health education for caregivers and patients
• Deterioration of the image of the disease.

Neuropathic Ulcers:

• Presence of distal pulses.
• Small injuries.
• Cellulites, abscess.
• Rapid progression, painless.
• Location: digital support areas
• Joints metatarsicafalángicas 
• Plantar area

Venous Ulcers:

• Hyperpigmentation
• Appear from the distal malleolus to the distal third of calf
• Can develop rapidly
• Shallow, irregular edges and bleeding, oozing plentiful
• Pigmented dermatitis around.
• Lipodermatosclerosis
• Distal pulses +

Arterial ulcers

• Develop much in the fingers
• Shallow
• Related to diabetes
• Weak distal pulses
• They tend to hurt more
• Deep, neurotic little granulation, exuding no sharp edges.

I think that the best for the pressure ulcer is the prevention. We must to explain to the patient how prevent it. The skin must be clean and there are very important the postural changes. a good nutrition is necessary too.

The job of the nurses is very important in these patients because we must do a lot of palliative treatment.

We must explain the risk factors to the patient for prevent if it is possible.

I think that our job is necessary to prevent the infection, pain, the loss of function, and even death.

1. Martínez Cuervo F., Pareras Galofré E.. La efectividad de los ácidos grasos hiperoxigenados en el cuidado de la piel perilesional, la prevención de las úlceras por presión, vasculares y de pie diabético. Gerokomos  [revista en la Internet]. 2009  Mar [citado  2013  Abr  28] ;  20(1): 41-46. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2009000100006&lng=es.  http://dx.doi.org/10.4321/S1134-928X2009000100006.
2. Gloria Hoffmann Wold. Basic Geriatric Nursing. 5^th ed. Milwaukee, Wisconsin:Elsevier; 2012
3. Medeiros Adriana Bessa Fernandes, Lopes Consuelo Helena Aires de Freitas, Jorge Maria Salete Bessa. Análise da prevenção e tratamento das úlceras por pressão propostos por enfermeiros. Rev. esc. enferm. USP  [serial on the Internet]. 2009  Mar [cited  2013  Apr  28] ;  43(1): 223-228. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342009000100029&lng=en.  http://dx.doi.org/10.1590/S0080-62342009000100029.