A sore spot in pediatrics: risk factors for pressure ulcers.

A retrospective, exploratory study was conducted as part of a performance improvement project examining pressure ulcer development in children. In 1 year, 69 children visited the hospital's wound clinic: 50 children had pressure ulcers, and 19 children had skin breakdown secondary to delayed operative wound healing. This article reviews findings from the 50 children with pressure ulcers. The primary diagnosis was myelodysplasia. Risk factors identified included (a) paralysis, (b) insensate areas, (c) high activity, and (d) immobility. The majority of the pressure ulcers occurred in the lower extremities, primarily the feet. As children get older or neurological condition deteriorates, sacral ulcers are seen particularly among wheelchair users. Pressure ulcers occur predominantly in the child's home environment.