Submit Manuscript | http://medcraveonline.com Introduction A Pressure Ulcer (PU) is defned by the National Pressure Ulcer Advisory Panel (NPUAP) as a ‘‘localized injury to the skin and/ or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. 1 Pus represent a signifcant healthcare problem and play a critical role in the patients’ quality of life and their treatments affect the patients’ lives emotionally, mentally, physically and socially. 2 The staging system of PU was defned by Shea in 1975 and provides a name to the amount of anatomical tissue loss. The original defnitions were confusing to many clinicians and lead to inaccurate staging of ulcers associated or due to perineal dermatitis and those due to deep tissue injury. In 2007, the proposed defnitions were refned by the NPUAP and described in details with input from an on-line evaluation of their face validity, accuracy clarity, succinctness, utility, and discrimination. 1,3 Method The following electronic databases were searched to identify literature relevant to this study: PubMed, Ovid (MEDLINE, Psych INFO, and Global Health), and Cumulative Index of Nursing and Allied Health Literature (CINAHL). Search terms (keywords) used were pediatric, pressure ulcers, skin integrity, risk factors, assessment, incidence and prevalence, physical disabilities, assistive technology, adaptive seating interventions, and prevention. Seventy four potential relevant research studies were identifed and screened for the literature review. Research studies were selected and included in the literature review if they were written in the English language and published between 1976 and 2013 in peer-reviewed journals. Based on these criteria, 55 studies out of the 74 were identifed and reviewed and 19 studies were excluded. Furthermore, studies were screened again for more detailed evaluation and were included if they involved methods of pressure ulcers assessments, prevention, and intervention in different populations (pediatrics, adult, geriatrics). Studies were excluded if they included only one pressure ulcers measurement method and did not compare between different methods. This yielded a total of 32 studies that were included in the literature review and 23 studies were excluded. Results PUs in pediatrics has not received adequate attention compared to other populations. The anatomical sites of PU differ between the adult and pediatric population. While the sacrum is the most common site for PU in adults, the occipital region in children less than 36 months, the sacral region, and the calcaneous are the primary sites identifed in the research. 4,5 PUs occurs less frequently in the pediatrics than adults. 6–9 In 2004, a survey of 513 adult and pediatric inpatients at a tertiary care hospital, PU prevalence was found to be 29.2% in J Pediatr Neonatal Care. 2018;8(5):245‒248. 245 © 2018 Sarsak. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Review of pressure ulcers management in pediatrics: assessment, prevention, and intervention Volume 8 Issue 5 - 2018 Hassan Izzeddin Sarsak Department of Occupational Therapy, Batterjee Medical College, Saudi Arabia Correspondence: Hassan Izzeddin Sarsak , PhD, OT, Department of Occupational Therapy, Batterjee Medical College, Jeddah, KSA, Saudi Arabia, Email h.sarsak@ju.edu.jo, hassan.sarsak@bmc.edu.sa, sarsakhassan@gmail.com Received: October 15, 2018 | Published: October 24, 2018 Abstract Objective: This study did a thorough review of the literature and investigated the current evidence-based guidelines and information available for the incidence and prevalence, the identification of risk factors, which risk scales are valid and reliable, and examined the effectiveness and applicability of the different intervention and prevention options for the management of Pressure Ulcers (PUs) and skin breakdown in pediatric population in comparison to those found in adults literature. Results: PUs in the pediatric population has been poorly documented and has not received adequate attention in the literature compared to those in the adult population. The chronically ill children and the pediatric patient population with chronic conditions and severe neurological and sensory motor impairments such as cerebral palsy, spine bifida and Spinal Cord Injury (SCI), are at significant risk for the development of PUs. A comprehensive and thorough pediatric skin care program should emphasize the need for accurate, continuous assessment, including specific and detailed documentation of tissue damage. Early assessment and detection are essential because early stage PUs is far easier and less costly to treat. Currently, there are 10 published pediatric pressure ulcer risk assessment scales. Of these scales, only the Braden Q Scale, the Neonatal Skin Risk Assessment Scale (NSRAS), and the Glamorgan Scale have been tested for sensitivity and specificity. Conclusion: Most of the current evidence-based guidelines for prevention and management of pediatric PUs have been relatively limited and are largely modifications of adult practice guidelines. Healthcare professionals should keep in mind that pediatric patients are not just small adults, but deserve unique consideration in their medical and surgical care. Therefore, further future research studies and well designed randomized clinical trials (RCTs) are needed to examine the efficacy, effectiveness, the applicability, and safety of the available prevention and treatment options for the management of PUs and skin breakdown in pediatric population. Keywords: pressure ulcer, pediatric, assessment, management, prevention, intervention Journal of Pediatrics and Neonatal Care Review Article Open Access