Final answer:
It include local tissue necrosis due to impaired blood flow, potential systemic infection, and the aging-related changes in the integumentary system leading to slower wound healing and thinning of the skin.
Step-by-step explanation:
The main contributor to skin changes, fatigue, and weight loss in a patient with a sacral pressure ulcer is likely the result of both the physiological response to the ulcer itself and the systemic effects it may cause. Pressure ulcers, also known as bedsores or decubitus ulcers, can lead to local tissue necrosis due to prolonged pressure that impairs blood flow to the area. When severe and untreated, these ulcers can become infected, which may contribute to systemic symptoms such as fatigue and weight loss due to increased metabolic demands and potential systemic infection (sepsis).
Furthermore, as part of the integumentary system changes associated with aging, patients with pressure ulcers may experience decreased mitosis in the stratum basale of the skin, leading to a thinner epidermis and slower wound healing. Additionally, the hypodermis can lose structure, contributing to further skin changes. These systemic symptoms can be exacerbated in patients with comorbid conditions like diabetes, where there is an increased risk of infection and delayed healing, influencing overall health and weight.
The lack of proper blood flow and oxygenation can cause skin changes, such as discoloration, breakdown, and ulceration. Additionally, the body's response to the pressure ulcer, including inflammation and the healing process, can contribute to fatigue. The body requires extra energy and resources to heal the damaged tissue, which can lead to weight loss.