The treatment of decubitus ulcers [Terapia delle ulcere da decubito]

Bad sores are a frequent problem among the elderly, with an incidence of 1.8% in the 55 to 75 years age group. They are classified in 4 stages according to the depth of tissue damage. The main pathogenetic factor is constant pressure on the skin, but shearing forces, friction and maceration are also important. Immobility, nutritional status, and age related factors seem to be significant risk factor. Preventive care include use of assessment tools to identify high risk patients frequent repositioning, air or foam mattresses capable of reducing pressure over the areas of prominent bones below critical values, as well as careful attention to optimizing the overall patient condition. Treatment of bed sores may be general, local and even surgical and should be based on careful evaluation of the patient's general condition. Bad sores in stage I and II are usually given local medication therapy. Surgery is preferable, when it is possible, for lesions in stages III and IV.