Infection and pressure sores.

Pressure sores cause considerable morbidity and prolonged hospitalization in debilitated patients. Healing of pressure sores may be delayed if they are infected, although response to appropriate topical therapy is satisfactory. However, some pressure sores that appear uninfected may have associated infection of deeper tissues and require specific diagnosis and treatment to close the sores. Two hundred sixty-seven debilitated patients, mostly with spinal cord injury, are reviewed. Included in this group are 49 patients with pressure sores that did not appear to be infected but were associated with deep infections. Diagnosis of nonhealing sores associated with deep infection requires clinical suspicion and a variety of laboratory tests, such as sinograms, radionuclide studies, computed tomography, and biopsy. Treatment usually requires a combination of appropriate antibiotics and surgery. Prevention of pressure sores and infection by offering specialized care for nonambulatory patients should be the ultimate goal.