Many intrinsic and extrinsic factors contribute to PrU development.
› Extrinsic factors include pressure, friction, and shearing forces. The intensity and duration
of unrelieved pressure increases risk for PrU development. Other extrinsic risk factors
include inappropriate patient positioning, surgery, prolonged skin contact with moisture,
poor hygiene, external restraints to movement, poor lifting and handling, inappropriate
clothing, and longer duration of hospital stay. Smoking and use of certain types of
medications (e.g., sedatives, analgesics, and antihypertensives) that cause changes in
blood flow in the skin, as well as psychotropic drugs, corticosteroids, and NSAIDs
increase risk for PrU development. Potent vasopressor agents (e.g., norepinephrine,
vasopressin) may significantly increase the risk for PU development in critical care adult
populations