Decubitus heel with necrosis of Achilles tendon

Decubitus heel with necrosis of Achilles tendon A decubitus is an ulcer of the skin and its underlying tissue layers, which occurrs due to increased local pressure during a longer time. When the pressure exceeds the capillary pressure, the tissue becomes hypoxic and ischemic, accumulating toxic metabolic products. Regular positioning of sick / weak persons, who can`t relieve the pressure themselves, is an important part of nursing, it prevents a decubitus. The picture shows a stage 4 decubitus: Muscles and tendons are already necrotic and destroyed. The other stages are:

Stage 1: Skin reddening, perhaps edema of the affected area

Stage 2: Epidermal damage, max. up to the corium, shallow ulcer or blisters

Stage 3: Damage of subcutaneous tissue, max. up to respective muscle fascia, open ulcer

Other pictures of this patient: VAC placement S/p debridement & VAC placement