This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 10. Dermatologic Disorders Chapter 122. Pressure sores occur most often in patients with diminished or absent sensation or who are debilitated, emaciated, paralyzed, or long bedridden.
Pressure sores can also affect muscle and bone.
Disuse atrophy, malnutrition, anemia, and infection contribute. In a paralyzed patient, loss of vasomotor control leads to lowered tone in the vascular bed and lowered circulatory rate. Spasticity, especially in patients with spinal cord injuries, can place a shearing force on the blood vessels to further compromise circulation. The force and duration of pressure directly determine the extent of the ulcer. The best treatment is prevention by relief of pressure on sensitive areas.