Pressure ulcers also can become colonized by bacteria, resulting in cellulitis or bacteremia, especially in debilitated or immunocompromised patients. These scales relate the risk of pressure ulcer to impaired sensory perception, increased skin moisture, decreased physical activity, immobility, poor nutrition, and risk of friction and shearing force. Basic principles of pressure ulcer management include identification and therapy of known risk factors. For all stages of pressure ulcers, the first step is to reduce pressure. For stage II, III, or IV ulcers, necrotic tissue is eliminated by either medical or surgical debridement.
Necrotic tissue is a barrier to epithelialization and serves as a nidus for infection.
Most stage I and II pressure ulcers heal within 60 days with the usual optimal therapies. The choice of dressings and debridement techniques has little impact on this good prognosis.