Velozo Bruna Cristina, Hong Michelle Venâncio, Bernardo Larissa Cassiano, E Castro Meire Cristina Novelli, Contreras-Ruiz Jose, Abbade Luciana Patricia Fernandes
Department of Nursing, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Polanco Dermatological Center Los Cabos, Dr. Manuel Gea González General Hospital, Mexican Institute for Advanced Wound Care, Mexico.
An Bras Dermatol. 2025 Aug 18;100(5):501187. doi: 10.1016/j.abd.2025.501187.
Pressure injuries remain a significant challenge in healthcare services. They negatively impact these services by increasing workload, financial burden, and direct and indirect costs related to detection, prevention, treatment, and rehabilitation. It is of utmost importance that dermatologists and other healthcare professionals are knowledgeable about these lesions. The first part of this review discusses the history and terminology of pressure injuries, epidemiology in different settings, from adults to pediatric and neonatal patients; etiopathogenesis, demonstrating the current scheme of the vicious cycle of ischemia and tissue death; associated risk factors, both intrinsic and extrinsic; classification of all stages of pressure injuries with clinical images; and the main anatomical areas at risk in each position ‒ lateral, seated, supine, prone, and with medical devices. Differential diagnoses were detailed, including incontinence-associated dermatitis, and the "Kennedy terminal ulcer", providing support for proper evaluation and guidance on preventive measures and treatment, which will be further detailed in Part II of this review. The primary focus was to provide resources for healthcare professionals to holistically assess, prescribe, and monitor patients at risk for or with pressure injuries.
压力性损伤仍然是医疗服务中的一项重大挑战。它们通过增加工作量、经济负担以及与检测、预防、治疗和康复相关的直接和间接成本，对这些服务产生负面影响。皮肤科医生和其他医疗专业人员了解这些损伤至关重要。本综述的第一部分讨论了压力性损伤的历史和术语、不同环境下（从成人到儿科和新生儿患者）的流行病学；病因发病机制，展示了当前缺血和组织死亡恶性循环的模式；相关危险因素，包括内在因素和外在因素；压力性损伤各阶段的分类及临床图像；以及每个体位（侧卧、坐位、仰卧位、俯卧位和使用医疗设备时）的主要危险解剖区域。详细介绍了鉴别诊断，包括失禁相关性皮炎和“肯尼迪终末期溃疡”，为正确评估以及预防措施和治疗指导提供支持，这将在本综述的第二部分进一步详细阐述。主要重点是为医疗专业人员提供资源，以便全面评估、开处方和监测有压力性损伤风险或患有压力性损伤的患者。
