A Conceptual Schema for the Study of the Etiology of Pressure Sores

&NA; Studies related to the treatment of pressure sores have appeared in the literature. Questions remain regarding both the etiology and treatment. This article presents a conceptual schema within which current knowledge can be organized and examined and further study facilitated. The critical determinants of pressure sores are primarily the intensity and duration of pressure. A second critical concept, the tolerance of the tissue for pressure, is also discussed. Conditions contributing to prolonged and intense pressure are included within the concepts of mobility, activity, and sensory perception. Tissue tolerance for pressure is influenced by both extrinsic and intrinsic factors. Extrinsic factors such as moisture, friction, and shear impinge on the skin and underlying tissues, while the multiple influences of nutrition, the physiologic effects of stress, aging and alterations in cellular respiration are intrinsic factors which influence the architecture and integrity of the skin and supporting structures. The schema provides broad categories capable of organizing existing knowledge and new findings.

[1]  J. Delisa,et al.  Pressure ulcers. What to do if preventive management fails. , 1985, Postgraduate medicine.

[2]  L. By,et al.  Skin stress and blood flow in sitting paraplegic patients. , 1984, Archives of physical medicine and rehabilitation.

[3]  M. Powers,et al.  Health beliefs, adjustment to illness, and control of hypertension. , 1984, Research in nursing & health.

[4]  A. Z. el Ghatit,et al.  Smoking, spasticity and pressure sores in spinal cord injured patients. , 1983, American journal of physical medicine.

[5]  Natow Ab.  Nutrition in prevention and treatment of decubitus ulcers. , 1983 .

[6]  T A Krouskop,et al.  A synthesis of the factors that contribute to pressure sore formation. , 1983, Medical hypotheses.

[7]  N W Levin,et al.  Psychosocial Factors Affecting Adherence to Medical Regimens in a Group of Hemodialysis Patients , 1982, Medical care.

[8]  S. A. Kvorning,et al.  Medical Aspects of the Decubitus Ulcer , 1982, International journal of dermatology.

[9]  J. Hallal,et al.  The Relationship of Health Beliefs, Health Locus of Control, and Self Concept to the Practice of Breast Self‐Examination in Adult Women , 1982, Nursing research.

[10]  E. Cheraskin,et al.  Vitamin C and human wound healing , 1982 .

[11]  K. Andreoli.  Self‐Concept and Health Beliefs in Compliant and Noncompliant Hypertensive Patients , 1981, Nursing research.

[12]  R. Daniel,et al.  Etiologic factors in pressure sores: an experimental model. , 1981, Archives of physical medicine and rehabilitation.

[13]  J. Reuler,et al.  The pressure sore: pathophysiology and principles of management. , 1981, Annals of internal medicine.

[14]  L M Vistnes,et al.  Differential Response of Skin and Muscle in the Experimental Production of Pressure Sores , 1980, Plastic and reconstructive surgery.

[15]  Anderson Tp,et al.  Psychosocial factors associated with pressure sores. , 1979 .

[16]  WALTER 0. SEILER,et al.  Skin Oxygen Tension As a Function of Imposed Skin Pressure: Implication for Decubitus Ulcer Formation , 1979, Journal of the American Geriatrics Society.

[17]  T. Ryan,et al.  BLOOD SUPPLY AND DECUBITUS ULCERS , 1979, International journal of dermatology.

[18]  F. Finseth,et al.  NICOTINE AND ITS EFFECT ON WOUND HEALING , 1978, Plastic and reconstructive surgery.

[19]  Manley Mt.  Incidence, contributory factors and costs of pressure sores. , 1978 .

[20]  S. Fisher,et al.  Wheelchair cushion effect on skin temperature. , 1978, Archives of physical medicine and rehabilitation.

[21]  J. George,et al.  Pressure Sores and the Spinal Cord Injury Patient , 1977 .

[22]  K. Berecek,et al.  Etiology of decubitus ulcers. , 1975, The Nursing clinics of North America.

[23]  M. Becker,et al.  Sociobehavioral Determinants of Compliance with Health and Medical Care Recommendations , 1975, Medical care.

[24]  M. Becker,et al.  The Health Belief Model: Origins and Correlates in Psychological Theory* , 1974 .

[25]  T. Taylor,et al.  Ascorbic acid supplementation in the treatment of pressure-sores. , 1974, Lancet.

[26]  Dinsdale Sm,et al.  Decubitus ulcers: role of pressure and friction in causation. , 1974, Archives of physical medicine and rehabilitation.

[27]  J. Kirscht,et al.  A new approach to explaining sick-role behavior in low-income populations. , 1974, American journal of public health.

[28]  A. Prasad,et al.  Effect of zinc deficiency on nucleic acids, collagen, and noncollagenous protein of the connective tissue. , 1973, The Journal of laboratory and clinical medicine.

[29]  D. Gosnell,et al.  An Assessment Tool to Identify Pressure Sores , 1973, Nursing research.

[30]  T. Hallböök,et al.  Serum-zinc and healing of venous leg ulcers. , 1972, Lancet.

[31]  R. G. Burr,et al.  Leucocyte ascorbic acid and pressure sores in paraplegia , 1972, British Journal of Nutrition.

[32]  Moolten Se.  Bedsores in the chronically ill patient. , 1972 .

[33]  A. Williams.  A STUDY OF FACTORS CONTRIBUTING TO SKIN BREAKDOWN , 1972, Nursing research.

[34]  J. Vasile,et al.  Prognostic factors in decubitus ulcers of the aged. , 1972, Geriatrics.

[35]  K. Rajan,et al.  The role of ascorbic acid in the pathogenesis and treatment of pressure sores , 1971, Paraplegia.

[36]  J. D. Thornburgh,et al.  The Management of Pressure and Other External Factors in the Prevention of Ischemic Ulcers , 1970 .

[37]  W. Pories,et al.  Acceleration of wound healing in man with zinc sulphate given by mouth. , 1967, Lancet.

[38]  Stathers Gm.  PORPHYRIN-BINDING EFFECT OF CHOLESTYRAMINE , 1966 .

[39]  I. Weinbren.  SPONTANEOUS PERIODIC ŒDEMA: A New Syndrome , 1963 .

[40]  O. Lindan,et al.  Etiology of decubitus ulcers: an experimental study. , 1961, Archives of physical medicine and rehabilitation.

[41]  M. Kosiak,et al.  Etiology and pathology of ischemic ulcers. , 1959, Archives of physical medicine and rehabilitation.

[42]  P. Testas,et al.  [Pathogenesis of bedsores]. , 1958, La Presse medicale.

[43]  S M REICHEL,et al.  Shearing force as a factor in decubitus ulcers in paraplegics. , 1958, Journal of the American Medical Association.

[44]  T. Husain,et al.  An experimental study of some pressure effects on tissues, with reference to the bed-sore problem. , 1953, The Journal of pathology and bacteriology.

[45]  Chester M. Jones,et al.  Vitamin C and wound healing. 1. Experimental wounds in guinea pigs. , 1942 .

[46]  B. Brooks,et al.  EFFECTS OF PRESSURE ON TISSUES , 1940 .

[47]  A. Natow.  Nutrition in prevention and treatment of decubitus ulcers. , 1983, Topics in clinical nursing.

[48]  M. Seashore.  Clinical, Biochemical, and Nutritional Aspects of Trace Elements , 1983, The Yale Journal of Biology and Medicine.

[49]  T. Elliott.  Pressure ulcerations. , 1982, American family physician.

[50]  G V Cochran,et al.  Interstitial fluid flow as a factor in decubitus ulcer formation. , 1981, Journal of biomechanics.

[51]  R. Richardson,et al.  Prevalence and incidence of pressure sores in acute spinal cord injuries , 1981, Paraplegia.

[52]  L. Hart,et al.  The relationship of health beliefs and knowledge to exercise compliance in patients after coronary bypass. , 1980, Heart & lung : the journal of critical care.

[53]  M. Andberg,et al.  Psychosocial factors associated with pressure sores. , 1979, Archives of physical medicine and rehabilitation.

[54]  N. Lassen,et al.  On the pathogenesis of bedsores. Skin blood flow cessation by external pressure on the back. , 1979, Scandinavian journal of plastic and reconstructive surgery.

[55]  M. Manley.  Incidence, contributory factors and costs of pressure sores. , 1978, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[56]  M. Irwin,et al.  A conspectus of research on vitamin C requirements of man. , 1976, The Journal of nutrition.

[57]  B. Môle.  [Decubitus ulcer]. , 1975, L'Infirmiere francaise.

[58]  K. Haeger,et al.  Oral zinc sulphate in the treatment of venous leg ulcers. , 1972, VASA. Zeitschrift fur Gefasskrankheiten.

[59]  S. Moolten.  Bedsores in the chronically ill patient. , 1972, Archives of physical medicine and rehabilitation.

[60]  S. Kegeles.  WHY PEOPLE SEEK DENTAL CARE: A TEST OF A CONCEPTUAL FORMULATION. , 1963, Journal of health and human behavior.