[Infected pressure ulcers: evaluation and management].
Pressure ulcers in elderly individuals can cause significant morbidity and mortality and are a major economic burden to the health care system. Prevention should be the ultimate objective of pressure ulcer care, and it requires an understanding of the pathophysiology leading to pressure ulcers and the means of reducing both intrinsic and extrinsic risk factors. Clinical examination often underestimates the degree of deep-tissue involvement, and its findings are inadequate for the detection of associated osteomyelitis. Microbiological data, if obtained from deep-tissue biopsy, are useful for directing antimicrobial therapy, but they are insufficient as the sole criterion for the diagnosis of infection. Imaging studies, such as computed tomography and magnetic resonance imaging, are useful, but bone biopsy and histopathological evaluation remain the "gold standard" for the detection of osteomyelitis. The goals of treatment of pressure ulcers should be resolution of infection and promotion of wound healing. A combination of surgical debridement and medical interventions may be required. Systemic antimicrobial therapy should be used for patients with serious pressure ulcers infections, including those with spreading cellulitis, bacteremia or osteomyelitis.
Iori
Ido
I
Medicina Interna, Centro Emostasi e Trombosi, Stroke Unit, Azienda Ospedaliera ASMN di Reggio Emilia, Italy.
Pizzini
Attilia Maria
AM
Arioli
Dimitriy
D
Favali
Davide
D
Leone
Maria Cristina
MC
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D003646:Debridement; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D015994:Incidence; D054843:Negative-Pressure Wound Therapy; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D003668:Pressure Ulcer / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012874:Skin Diseases, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
D000900:Anti-Bacterial Agents