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Pathophysiology

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The Decubitus Ulcer in Clinical Practice

Abstract

Decubitus ulcers are the end result of an inadequate nutrient blood supply to the tissues. In discussing the pathophysiology of these lesions, it is important to distinguish between the cause, which is usually pressure on the skin, usually over bony prominences, and other factors that contribute to non-healing once the ulcer has formed. Numerous factors have been postulated to be important in the causation of decubitus ulcers (Table 1), and those factors that lead to a delay in healing have also been the subject of a number of studies. Factors that occlude capillary flow and those that delay healing overlap, of course, to some extent, but the pathophysiology of decubitus ulcers is usually blamed correctly on occlusion of capillary flow by pressures greater than mean capillary pressure (25 mmHg), along with shearing forces, infection, and a lack of cutaneous sensation [2–9]. Repetitive injury and prolonged pressure are especially important.

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Authors
  1. G. W. Cherry
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  2. T. J. Ryan
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Editor information

Editors and Affiliations

  1. Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA

    Lawrence Charles Parish M.D. (Clinical Professor of Dermatology and Cutaneous Biology and Director of the Jefferson Center for International Dermatology, Visiting Professor of Dermatology, Visiting Professor of Dermatology and Venoreology) (Clinical Professor of Dermatology and Cutaneous Biology and Director of the Jefferson Center for International Dermatology, Visiting Professor of Dermatology, Visiting Professor of Dermatology and Venoreology)

  2. Yonsei University College of Medicine, Seoul, Korea

    Lawrence Charles Parish M.D. (Clinical Professor of Dermatology and Cutaneous Biology and Director of the Jefferson Center for International Dermatology, Visiting Professor of Dermatology, Visiting Professor of Dermatology and Venoreology) (Clinical Professor of Dermatology and Cutaneous Biology and Director of the Jefferson Center for International Dermatology, Visiting Professor of Dermatology, Visiting Professor of Dermatology and Venoreology)

  3. Zagazig University, Zagazig, Egypt. 1819 J.F. Kennedy Boulevard, #465, 19103, Philadelphia, PA, USA

    Lawrence Charles Parish M.D. (Clinical Professor of Dermatology and Cutaneous Biology and Director of the Jefferson Center for International Dermatology, Visiting Professor of Dermatology, Visiting Professor of Dermatology and Venoreology) (Clinical Professor of Dermatology and Cutaneous Biology and Director of the Jefferson Center for International Dermatology, Visiting Professor of Dermatology, Visiting Professor of Dermatology and Venoreology)

  4. School of Medicine, University of Pennsylvania, 3501 Ryan Avenue, 19136, Philadelphia, PA, USA

    Joseph A. Witkowski M.D. (Clinical Professor of Dermatology, Professor of Dermatology) (Clinical Professor of Dermatology, Professor of Dermatology)

  5. Pennsylvania College of Podiatric Medicine, Philadelphia, Pennsylvania, 3501 Ryan Avenue, 19136, Philadelphia, PA, USA

    Joseph A. Witkowski M.D. (Clinical Professor of Dermatology, Professor of Dermatology) (Clinical Professor of Dermatology, Professor of Dermatology)

  6. University of Southern California School of Medicine, Los Angeles, California, 608 Sierra Madre Boulevard, 91108, San Marino, CA, USA

    John Thorne Crissey M.D. (Clinical Professor of Medicine (Dermatology) (Clinical Professor of Medicine (Dermatology)

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© 1997 Springer-Verlag Berlin Heidelberg

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Cherry, G.W., Ryan, T.J. (1997). Pathophysiology. In: Parish, L.C., Witkowski, J.A., Crissey, J.T. (eds) The Decubitus Ulcer in Clinical Practice. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60509-3_5

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  • DOI: https://doi.org/10.1007/978-3-642-60509-3_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64436-8

  • Online ISBN: 978-3-642-60509-3

  • eBook Packages: Springer Book Archive

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