Pressure Ulcer: An Updated Review for Healthcare Professionals

Background: Pressure injuries are preventable lesions of skin and soft tissues driven by sustained pressure and shear at bony prominences; device-related variants are increasingly recognized and cluster at the sacrum, ischium, and trochanter. Aim: To synthesize current concepts on etiology, epidemiology, mechanisms, histopathology, evaluation, staging, management, prognosis, complications, and rehabilitation for healthcare professionals.Methods: Narrative synthesis of frameworks and findings summarized in this review, including NPIAP/ICD-11 classification, risk instruments, and outcome reports. Results: Immobility, moisture, malnutrition, anemia, and endothelial dysfunction are principal risks; shear magnifies deep tissue failure, and as little as two hours of uninterrupted loading can initiate injury. Histology progresses from papillary dermal vascular change to full-thickness necrosis; chronic ulcers harbor extracellular-matrix bacterial aggregates, whereas osteomyelitis beneath exposed sacral bone is uncommon and typically superficial. In the United States, about three million adults are affected annually; hospital-acquired pressure injury costs may exceed $26.8 billion, with incidences near 8.3 per 100 acutely ill patients and early onset within five days of admission. Healing at six months is >70% for stage 2, ~50% for stage 3, and ~30% for stage 4; sacral recurrence is common. Conclusion: Standardized terminology, early risk stratification, dependable off-loading and microclimate control, prudent debridement and dressings, nutritional optimization, and multidisciplinary coordination reduce incidence, accelerate healing, and limit recurrence.