The Pathogenesis of Decubitus Ulcers

Rudd, T. N.

doi:10.1111/j.1532-5415.1962.tb00242.x

Cited by 11 publications

(3 citation statements)

References 4 publications

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“…Clinically, it is a well-established fact that hypoproteinemia, which is a major endogenous factor, plays an important role in promoting the development and retarding the healing of PS (16)(17)(18)(19). However, there have been no experimental studies concerning the effects of endogenous factors on PS.…”

Section: Discussionmentioning

confidence: 99%

Effects of Malnutrition on Development of Experimental Pressure Sores

Takeda

Koyama

Izawa

et al. 1992

The Journal of Dermatology

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Using food-deprived rabbits we investigated the effects of nutritional deficiency on the development of pressure sores. The body weight of these animals was decreased significantly from normal. Organ weights of liver, heart, spleen, kidney, and testis were significantly decreased from normal as well. Protein deficiency in these animals was indicated by serum tests, as well as by histologic features of liver and testis and ultrastructural findings on fibroblasts. We produced lesions in malnourished as well as normal rabbits by exposing their skin to a balloon-produced compressive force of 120 +/- 10 mmHg for 4 hours. Biopsies were taken 1, 2, and 3 days after the pressure application. Histologic findings at each time were as follows: At day one, the degree of ischemic skin destruction in the malnourished animals was more severe than that in the normal ones, and thrombi were occasionally seen in the malnourished cases. At day two, proliferation of fibroblasts and macrophage infiltration were evidenced in the normal animals, whereas signs of collagen fiber degeneration as well as microthrombi were seen in the malnourished ones. At three days, epidermal cells covered the lesions in the case of normal animals; however, massive necrosis of the epidermis was still recognized in the malnourished rabbits. Thus, the healing process of pressure sores was strongly suppressed in the malnourished animals. This suppression was attributed to the reduction in fibroblast proliferation, capillary formation, macrophage infiltration, and also to the low level of epidermal cell proliferation.

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Section: Discussionmentioning

confidence: 99%

Effects of Malnutrition on Development of Experimental Pressure Sores

Takeda

Koyama

Izawa

et al. 1992

The Journal of Dermatology

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“…Alcohol removes essential fatty constituents from the skin, while rubbing may cause dryness, allergic inflammation, fissures, or desiccation and abrasion of the skin (4, 33). Witch hazel may also be harmful, in that it increases the incidence of sores (34).…”

Section: Therapymentioning

confidence: 99%

The Care of Decubitus Ulcers (Pressure Sores)

Michocki

Lamy

1976

J American Geriatrics Society

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Despite a large volume of literature particularly directed toward treatment, pressure sores (including decubitus ulcers) remain a difficult problem, especially in the nursing home environment. The treatment of pressure sores is somewhat controversial and quite diversified. Selection of a successful therapeutic modality must be preceded by correct evaluation, i.e., whether the sore is superficial or deep, open or closed. The treatment of superficial sores is conservative and directed toward cleanliness, relief of pressure, and exposure to air. Surgical debridement may be indicated. Proteolytic enzymes often are employed as adjunctive therapy, although there are some major drawbacks to their use. The plethora of therapeutic agents suggested for the treatment of deep pressure sores probably is related to the difficulties in achieving success. Surgical debridement is indicated, and proteolytic enzymes are widely used. Possible interactions. and factors leading to the inactivation of these enzymes are discussed, as is the use of various solutions, ointments, gold leaf, oxygen, dry heat, and other adjunctive devices. Of paramount importance in the management of pressure sores is the maintenance of cleanliness and dryness.

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“…The first known studies on PU risk factors were published in the mid‐20th century (Exton‐Smith & Sherwin, ; Husain, ; Rudd, ) and highlighted sustained pressure over time and shear and friction forces as key factors for PU development. They also identified other factors that can be described as coadjuvant or predisposing factors and may help to explain why the same tissue destruction is not always observed under identical patient conditions.…”

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confidence: 99%