Abstract

Worldwide pressure-sores are common health problem. It presents a difficult challenge because of the high rates of wound complications and recurrences. Pressure ulcers pose a considerable burden on health care resources and the community in terms of mortality and morbidity. In general, approximately 9% of all hospitalized patients develop pressure sore. Patients with neurosurgical (e.g. Head injury, Spinal cord injury) or neurological (e.g. Brain stroke) disorder are more prone to develop pressure sores. Up to 75% of all pressure sores are located around the pelvic girdle. It has now become an axiom that in addition to neuropathic factor and shearing forces, the single most important factor in the aetiology of pressure sores is ischemic necrosis resulting from sustained excessive pressure against bony prominences. Malnutrition, anaemia, infection and chronic illness can also contribute to their formation by the impairment of blood supply and delayed wound healing. Resultant necrosis at the skin level is usually small compared with that of the necrotic area over bone, which resembles an inverted cone. Sacral pressure sores are the common “sores” seen in patients confined to bed during medical and surgical emergencies where the patient is comatose and particularly common in patients with paraplegia in ICU. Most of these patients are found to have been nursed in supine position without timely and adequate change of posture because of ignorance and callousness. Different medical and surgical management of pressure sores will be discussed and contributing factors will be identified.

Key words: Pressure sore, Paraplegia