Decubitus ulcers. How to prevent them--and intervene should prevention fail

Decubitus ulcers can develop in any chronically ill patient who is immobilized. Elderly patients and patients with spinal cord injury are at particularly high risk. Prevention is best achieved by identification of susceptible patients, alleviation of causative and predisposing factors, and early detection of ischemic skin changes. Treatment should be determined by the depth of tissue involvement. Conservative therapy is effective for shallow ulcers, whereas surgery, including the use of flaps, is reserved for deeper, more extensive lesions.