[Pressure sores-A multilayered challenge]

Pressure sores occur when soft tissue of the skin, subcutaneous fat tissue or musculature is exposed to pressure or friction over a long period of time, which leads to local ischemia with subsequent necrosis. All areas of the skin lying over bones with only a thin layer of soft tissue are predilection sites. In older patients the risk factors for the development of a pressure sore must be systematically documented at admission and during the course of the disease. Accordingly, the necessary prophylactic procedures must be initiated. The classification of the European Pressure Ulcer Advisory Panel (EPUAP) is used to describe a pressure sore. For the differential diagnosis, incontinence-associated dermatitis and a manifest peripheral artery occlusive disease must be excluded. The treatment consists of positioning procedures and local and systemic supportive wound treatment. In cases of deep pressure sores, coverage by plastic surgery can effectively accelerate healing. The multiprofessional geriatric team has the appropriate prerequisites for comprehensive treatment of pressure sores.