Pressure Injury and Infection Concept Map by

Pressure Injury stages

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stage 1

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Non-blanchable erythema of intact skin, which may darken in pigmentation. Early signs include blanchable erythema, changes in texture (hardness), warmth, or sensation. Purple/maroon discoloration indicates possible deep tissue damage.

stage 2

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Partial-thickness skin loss with exposed dermis. The wound is viable, pink/red, and moist, potentially appearing as an intact or ruptured serum-filled blister. No fat, deeper tissues, granulation tissue, or slough are present.

stage 3

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Full-thickness skin loss with visible adipose tissue, granulation tissue, and epibole. Slough/eschar may be present. Depth varies by location, with severe wounds in areas of high adiposity.

stage 4

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Full-thickness skin and tissue loss, including exposed or palpable fascia, muscle, tendon, ligament, cartilage, or bone in the ulcer. Slough and/or eschar would be visible. Depth would vary with location.

Inflammatory response

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Inflammation is the body's response to a sickness, injury, or foreign substance. Inflammation is a natural and vital process that helps the body to heal

How this affects different systems: integumentary and circulatory system

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This can affect the integumentary system, as the integumentary system is the body’s first line of defence against pathogens. Skin breakdown occurs when insufficient blood flow to the skin and underlying tissues, leading them to disintegrate.

Ulcer formation

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As dead tissue degrades, pressure ulcers or sores can develop, beginning with redness and escalating to open wounds.

Infection

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Once it develops, it is vulnerable to infection due to decreased blood flow, which restricts the body's capacity to resist microorganisms.

Tissue damage

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Pressure injuries can cause damage to deeper tissues such as muscle and bone, especially when left untreated.

Insufficient blood flow

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People with insufficient blood flow, such as those with peripheral arterial disease, have narrowed arteries.

Arteries

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Blood vessels that transport oxygen and nutrients throughout the body’s tissues.

Blood circulation

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Wounds heal more slowly when blood cannot circulate effectively.

Increased pressure:

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Increased pressure makes it more difficult for blood to flow and deliver adequate oxygen to tissues.

Poor circulation

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Poor circulation affects the supply of oxygen and nutrients, raising the risk that wounds may become chronic.

Integumentary:

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Circulatory:

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Acute inflammation:

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This is how the immune system reacts to a sudden injury or disease. Inflammatory cells migrate to the site of injury (such as a cut on your finger) or infection to initiate the healing process.

Chronic inflammation

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Chronic pain occurs when the body continues to send inflammatory cells even when there is no threat. Chronic inflammation causes mechanisms that might typically protect the body to harm it.

Redness

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Heat

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Swelling

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Pain

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Loss of function

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Body pain

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Chronic fatigue and insomnia

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Depression, anxiety and mood disorders

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Gastrointestinal complications

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Weight gain or weight loss

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Cellular death mechanisms:

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Apoptosis

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Apoptosis refers to the process of programmed cell death. It works in the early stages of development to get rid of unwelcoming cells, like those that are in between a developing hand's fingers. Adults use apoptosis to get rid of cells that are too damaged to be repaired.

Necrosis:

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The death of bodily tissue is called necrosis. It happens when the tissue receives insufficient blood flow. This may result from chemicals, radiation, or injuries. It is impossible to reverse necrosis.

Pyropotosis

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A proinflammatory mechanism of lytic cell death called Pyropotosis is caused by buildup of plasma membrane macropores made up of gasdermin-family proteins.

Autophagy

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To preserve intracellular homeostasis, cells use autophagy to break down and recycle proteins and organelles. Although autophagy generally protects cells, excessive autophagic flux or modification of autophagy processes typically results in cell death.

Key process of wound healing:

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Homeostasis:

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The initial phase of wound healing, known as haemostasis, can extend for up to two days. The blood arteries in the wound area tighten as soon as the body experiences a wound, lowering blood flow.

Inflammation:

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Reactive oxygen species are released by phagocytic cells and may persist for up to seven days in acute wounds and may last a lot longer in chronic wounds.

Proliferation:

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Aims to fill and cover the wound. As inflammatory cells die, wound healing moves on to the proliferative phase, which is defined by the creation of granulation tissue, angiogenesis, wound contraction, and epithelialization.

Maturation:

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Scar tissue production defines the last phase. It can take anywhere from months or years, depending on the wound's initial severity, location, and treatment procedures. During this time, the new tissue gradually gains strength and flexibility.