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Úlcera por pressão

Last reviewed: 20 Aug 2025
Last updated: 03 Aug 2021

Summary

Definition

History and exam

Principales factores de diagnóstico

  • presença de fatores de risco
  • uso de superfície de apoio que não oferece alívio da pressão
  • alterações de pele localizadas em áreas sujeitas a pressão
  • ferida superficial aberta ou perda de tecido em áreas sujeitas a pressão
  • ferida com espessura total em áreas sujeitas a pressão, com ou sem descolamento (tunelização)
  • ferida com espessura total, com envolvimento de tecidos importantes, em áreas sujeitas a pressão, com ou sem descolamento (tunelização)
  • dor localizada e aumento da temperatura na área em torno da ferida
  • aumento do exsudato e/ou odor fétido
Todos los datos

Factores de riesgo

  • imobilidade
  • deficiência sensorial
  • idade avançada
  • cirurgia
  • internação em unidade de terapia intensiva
  • desnutrição
  • história prévia de úlcera por pressão
  • fatores ambientais
  • incontinência fecal ou urinária
  • diabetes
  • doença vascular periférica
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • diagnóstico clínico
Todos los datos

Pruebas diagnósticas que deben considerarse

  • swab de ferida
  • Velocidade de hemossedimentação (VHS)
  • leucócitos
  • glicose sérica
  • biópsia de tecido profundo
  • RNM
Todos los datos

Algoritmo de tratamiento

Agudo

todos os pacientes

Colaboradores

Autores

Dan R. Berlowitz, MD

Professor; Department of Public Health

University of Massachusetts-Lowell

Lowell

MA

Divulgaciones

DRB declares that he has no competing interests. DRB is the author of a number of references cited in this topic.

Agradecimientos

Dr Dan R. Berlowitz would like to gratefully acknowledge Dr Madhuri Reddy and Dr Stephen Thomas, the previous contributors to this topic.

Divulgaciones

MR is the author of a number of references cited in this topic. ST declares that he has no competing interests.

Revisores por pares

Jane Deng, MD

Assistant Professor of Medicine

David Geffen School of Medicine at UCLA

Los Angeles

CA

Divulgaciones

JD declares that she has no competing interests.

Keith Harding, FRCGP, FRCP, FRCS

Sub Dean of Innovation & Engagement

Head of Section of Wound Healing

School of Medicine

Cardiff University

Cardiff

UK

Divulgaciones

KH has worked in the area of wound healing for many years and has helped establish and sustain a section of wound healing in a university medical school. The school is entirely self-funded and receives funding from a wide range of commercial concerns in addition to the NHS and grant-giving bodies. The funding is provided to the University rather than to KH personally, and this funding is used to provide sustainability for a wide range of individuals employed within this section.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Qaseem A, Humphrey LL, Forciea MA, et al; Clinical Guidelines Committee of the American College of Physicians. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2015 Mar 3;162(5):370-9.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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  • Guías de práctica clínica

    • Prevention and management of pressure ulcers
    • Prevention and treatment of pressure ulcers/injuries: clinical practice guideline
    Más Guías de práctica clínica
  • Patient information

    Úlceras de pressão

    More Patient information
  • Calculators

    Escala de Norton para a estratificação do risco de ferida por pressão

    More Calculators
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