Modern Approaches to Pressure Ulcer Risk Assessment, Prevention, and Nursing Care Algorithms in Immobilized Patients

Background: Pressure ulcers (decubitus ulcers) represent a major healthcare challenge in bedridden and critically ill patients, leading to prolonged hospitalization, increased risk of sepsis, and reduced quality of life. Effective nursing care relies on structured risk assessment, advanced dynamic surfaces, and standardized wound care protocols. Objective: This study evaluates current evidence regarding: (1) pressure ulcer risk stratification using validated scales (Braden and Norton); (2) the clinical efficacy of modern pressure-relieving devices (alternating air mattresses and gel-infused overlays); (3) standardized nursing algorithms for Stage I and Stage II pressure ulcer management; and (4) postural rotation schedules combined with advanced dermatological skin hygiene. Methods: A systematic literature search was conducted across PubMed/MEDLINE, Scopus, and clinical nursing practice guidelines for studies published between 2020 and 2026 focusing on pressure injury prevention, repositioning kinetics, and topical wound management. Results: Clinical integration of the Braden Scale enables early identification of high-risk patients. Dynamic alternating pressure air mattresses (APAM) reduce interface tissue pressure below capillary occlusion thresholds (32 mmHg), superior to static foam or standard surfaces. Implementing a strict 2-hour 30-degree lateral tilt rotation schedule significantly reduces tissue ischemia over bony prominences. Early-stage (Stage I–II) intervention using modern hydrocolloid and foam dressings combined with pH-balanced skin barrier sprays accelerates re-epithelialization and minimizes bacterial bioburden. Conclusion: A multi-faceted nursing intervention framework—combining standardized risk assessment, dynamic pressure redistribution technology, scheduled repositioning, and advanced local wound barrier protection—effectively minimizes pressure ulcer incidence and halts early-stage tissue breakdown.