What is Pressure Ulcer?
You may know pressure ulcers by their most common name pressure sores. They occur when you lie down or sit in one position too long and the weight of your body against the surface of the bed or chair cuts off the blood supply. You can get them if you are on bed rest or in a wheelchair. Your doctor can talk about the "stage" of your pressure sores. The stages are based on the depth of the sores, which can affect your treatment. If caught early, these sores are most likely to heal in a few days, with little discomfort or pain. Without treatment, they can get worse. You will know they are better when the sore gets smaller and pink tissue appears on the sides.
A pressure ulcer is also known as bedsores, pressure sore, or decubitus ulcers. It is an open wound on your skin. Pressure sores often occur on the skin overlying bony areas. The following are the most common places for a pressure ulcer:
- Hips
- Back
- Ankles
- Buttocks
This condition is common among people who:
- Are older have reduced mobility
- Spending long periods in bed or a wheelchair
- Cannot move certain parts of the body without help
- You have fragile skin
The condition is treatable, but deep chronic ulcers can be difficult to treat. The specific prognosis depends on several factors, including the underlying medical conditions, as well as the stage of the ulcer.
Pressure ulcers develop in four stages:
- The skin feels warm to the touch. There may be a color change, such as redness, and the area may itch.
- A painful open sore or blister occurs, surrounded by discolored skin.
- The lesion takes on a crater-like appearance due to tissue damage below the surface of the skin.
- There are severe skin and tissue damage, possibly with an infection. Muscles, bones, and tendons would likely be noticeable.
- An infected sore takes longer to heal. The infection can spread to other parts of the body and cause significant damage.
Causes
Anyone who stays in one position for a long time is at risk of developing pressure sores. They often form in people who need help to change positions. A person who develops a pressure ulcer can:
- Spending a lot of time sitting in a chair or lying in bed
- Wearing a prosthesis or surgical device
- Wear ill-fitting shoes or clothing with elastic bands
- These sores form when tissues and blood vessels are compressed and then deformed
- This can result in a loss of circulation, which can lead to tissue death and infection. Sores can result from significant pressure for a short period of low pressure for a longer period
Diagnosis
Medical staff can take samples of the tissue and fluid from the pressure ulcer to look for bacteria or cancer. They may also do blood cultures, bone scans, or other tests, depending on the severity of the ulcer. Also, they will assess the condition of the ulcer based on:
- The size of the pressure ulcer and the depth of the crater
- What type of tissue is affected by the ulcer: skin, bone, or muscle
- The color of the ulcer and the surrounding skin
- The death of tissue caused by the ulcer
- The presence of infection, bleeding, or a bad smell
Risk factors
The following can increase the chances of sores developing:
- Not being able to move without help
- Advanced age, as the skin becomes thinner and more fragile
- Incontinence, which raises the risk of skin injury and infection
- Low or high body mass index, or BMI, both of which can increase pressure
- A low body weight, which leads to less padding around the bones
- A condition, such as diabetes, that reduces the sensation of pain
- Prolonged wound healing, as can also happen with diabetes
- Poor blood circulation
- Reduced mental awareness
Treatment
Depending on the stage of the ulcer, treatment may include some or all of the following:
- Clean the ulcer and put a dressing on the wound
- Meticulous wound care with frequent dressing changes
- Reduce pressure in the area by repositioning and using support surfaces
- Antibacterial drugs to treat the infection
- Pain relievers to relieve discomfort
- Debridement surgery to remove dead ulcer tissue
- For a quicker recovery, change your diet and drink more water