Trauma and thrombosis in the pathogenesis of pressure ulcers

Lowthian, Peter

doi:10.1016/j.clindermatol.2004.10.001

Cited by 20 publications

(19 citation statements)

References 14 publications

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“…Lowthian (2005) pointed out that not only the duration of one period of pressure but also the frequency of repeated periods of pressure are of importance, as the affected tissue will need sufficient restitution after each period of pressure in order to avoid tissue damage. Bouten et al (2003) presented computer models simulating the consequences of mechanical stimulation on skin and underlying tissue and stated that pressure directed towards the skin surface is not representative of mechanical conditions in the underlying tissue.…”

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

“…Maklebust and Sieggreen (1996) defined shearing forces as mechanical forces that shear different types of tissue parallel to each other and are typically caused by non-perpendicular pressure. Lowthian (2005) mentioned consequences such as stretching, and, possibly also, rupture of the blood vessels, and stated that especially deep tissue is affected by shearing forces. One example is a human patient lying in bed with the head elevated, whereby bone tissue is sheared in one direction as a result of the body weight, whereas the skin surface is fixed by the bed linen and remains stationary.…”

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

“…Bouten et al (2003) described several possible ischaemic mechanisms, for example, localized ischaemia due to the occlusion of the blood vessels, which impeded the flow of interstitial fluid and lymphoid drainage resulting in the loss of nutritional supply and clustering of waste products in the tissue leading to increased cell death and necrosis. However, both Bouten et al (2003) and Lowthian (2005) stated that these ischaemic mechanisms may not be equally relevant for different types of tissue, and may not fully explain the development of pressure ulcers. In relation to pressure ulcers near bony prominences, Lowthian (2005) suggested that pressure combined with shearing forces will result in stretching and pressure directed towards the surrounding tissue leading to capillary rupture in the area subjected to maximal pressure and thrombosis (obstruction of blood flow) that will subsequently lead to ischaemia.…”

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

“…However, both Bouten et al (2003) and Lowthian (2005) stated that these ischaemic mechanisms may not be equally relevant for different types of tissue, and may not fully explain the development of pressure ulcers. In relation to pressure ulcers near bony prominences, Lowthian (2005) suggested that pressure combined with shearing forces will result in stretching and pressure directed towards the surrounding tissue leading to capillary rupture in the area subjected to maximal pressure and thrombosis (obstruction of blood flow) that will subsequently lead to ischaemia.…”

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

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Decubital shoulder ulcers in sows: a review of classification, pain and welfare consequences

Herskin

Bonde

Jørgensen

et al. 2011

Animal

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Decubital shoulder ulcers are lesions on the shoulders of sows kept in production systems, reported to have a relatively high prevalence, and to some extent be comparable with human pressure ulcers. In sows, the ulcers are caused by pressure inflicted by the flooring, leading to oxygen deficiency in the skin and the underlying tissue. This paper reviews existing knowledge about decubital shoulder ulcers in sows, focusing on the pathogenesis, classification and consequences in terms of pain and animal welfare. On the basis of available human as well as animal literature, we describe the primary causal factors, underlying mechanisms, suggested direction of progression as well as temporal development. We review suggested scales for the classification of decubital shoulder ulcers, and argue that none of these are useful for the classification of decubital shoulder ulcers in live sows. The knowledge of the welfare consequences of decubital shoulder ulcers is limited. On the basis of the tissue structures that are involved, we assume that the development and presence of decubital shoulder ulcers in sows are a painful and prolonged condition. It is concluded that the extent of the welfare problem related to decubital shoulder ulcers cannot be fully determined until a valid ante-mortem classification system is available, and knowledge about the duration of the condition (including the various stages), as well as the possible consequences in terms of pain or discomfort have been established.

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Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

Section: Description and Definition Of Decubital Shoulder Ulcersmentioning

confidence: 99%

See 2 more Smart Citations

Decubital shoulder ulcers in sows: a review of classification, pain and welfare consequences

Herskin

Bonde

Jørgensen

et al. 2011

Animal

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show abstract

“…Any decubitus ulcer staging system is necessarily a compromise between an adequate description of the ulcers and a brief, unambiguous, yet simple guide that can be used by hard‐pressed and inexperienced bedside nurses 3 . Until the pathogenesis of these lesions is sorted out and the variety of lesions involved is clarified, we cannot hope to have a really reliable staging system 4–7 …”

Section: Introductionmentioning

confidence: 99%