Iatrogenic pressure sores: primum non nocere

Abstract

An iatrogenic wound can be defined as a wound that is attained during or as a result of medical treatment provided by a health care giver. A study by Lee et al. reported that the most common iatrogenic injuries that are referred to plastic surgeons are extravasation injuries, followed by cast-induced injuries and vasopressor-induced necrosis 1. Pressure sores can also be identified within the iatrogenic wound spectrum, as a majority of such wounds occur during treatment in a medical facility and is regarded as a serious complication of hospitalisation 2. Stationary positioning and the subsequent altered tissue perfusion along with a compromised nutritional status are among the main factors that lead to decubitus ulcers, and universal precautions are taken in order to minimise the risk 3. Several iatrogenic wounds have been referred to us, mainly unconventional pressure sores in patients undergoing medical treatment in different branches. We believe that the main reason behind the occurrence of these wounds in the wards is the lack of attention given to areas distant to the area of primary pathology. One dramatic case of an iatrogenic pressure sore was a 61-year-old male patient who presented with circumferential penile necrosis following the rigorous taping of an external urinary catheter after colon surgery (Figure 1). However, the necrosis was superficial, and the patient was treated with debridement followed by skin grafting. Another unusual case of an iatrogenic pressure sore was a 42-year-old female patient who presented with a linear ulcer in her left popliteal area due to thromboembolic sock compression following gastric surgery (Figure 2). Her wounds were also treated with debridement and local wound care.