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    Jill Storch

    “Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. The Guidelines provide comprehensive guidance on the actions needed to prevent pressure injury.”
    These guidelines do not provide the clinician with the pathological cause of pressure injuries/ulcers in the decubitus zones of the body.
    As wounds which are necrosis based, the important background to understanding these wounds is in a knowledge of the histological structure of the skin/subcutaneous tissue complex and the Angiosome Concept, which describes the modern understanding of the blood supply to the skin.
    When these are comprehended, the mechanical effects of vascular injury (i.e. pressure, shear and friction) over the architecture of the blood vessels which supply the cells that form the skin/subcutaneous tissue complex, and particularly the capillaries in the dermal and sub-dermal tissues, can be explained. This is the basis of why offloading and interface dressings (i.e. Mepiplex) can work to minimise the degree of compressive forces caused by pressure over bony processes.

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