About Pressure Sores

Pressure sores are injuries to the skin, usually over a bony prominence, that are caused by unrelieved pressure.  You may also hear pressures sores referred to  as “bed sores”, “pressure ulcers”, and “decubitus ulcers.”  The injury can range from mild skin redness (called a stage 1 pressure sore) to severe tissue damage that can extend to the bone (referred to as a stage 4 pressure sore).  Some pressure sores appear black or brown which indicates they are covered with “eschar”, which is a thick, leathery area of necrotic or dead tissue.  The presence of this black or brown eschar can indicate that the wound is an advanced pressure sore that requires diligent medical treatment.

When unrelieved pressure is exerted to an area of skin,  the blood supply to the skin and nearby tissue is reduced.  The lack of necessary blood supply and oxygen can cause harm or death to the affected tissues.  Since pressure sores are caused by unrelieved pressure, they typically form on areas of the body where the bone is close to the skin, such as the heels, sacrum, tailbone (coccyx),  ankle, back, elbow, and hips, among others.  Pressure sores can also be caused by unrelieved pressure resulting from improperly used medical devices.  For instance, patients who are left on a bed pan for too long can develop pressure sores to their buttocks.  Pressure sores have also been known to develop from pressure caused by contact with medical tubing, improperly fitted medical boots, contact with bed rails, etc.

Because nursing home and hospital patients are often confined to a bed or wheelchair, they are often at high risk for developing pressure sores.   Patients require special nursing interventions to ensure that they are protected from developing these wounds, as it is generally no longer acceptable for hospitals and nursing homes to allow their patients to develop pressure sores, especially those which become advanced.  Unfortunately however, published studies have found a prevalence of pressure sores in hospital and nursing home settings in excess of 25%.*

Early recognition of pressure sores and risk factors associated with pressure sores is critical, because advanced pressure sores often become infected, and can lead to sepsis and even death.  Preventative measures can be taken to prevent the development of pressure sores.   These measures can include timely turning and repositioning, frequent skin inspections, use of proper pressure relieving devices for the bed and wheelchair, proper attention to the patient’s hydration and nutrition, and other nursing measures depending upon the individual patient’s needs.

 

More information:

• About pressure sore prevention
• About pressure sore stages
• About pressure sore treatment
• About pressure risk factors

 

 

*See these two studies:

• Cuddigan J, Ayello EA, Sussman C, eds.  Pressure ulcers in America: Prevalence, incidence, and implications for the future.  2001.  Reston, VA:  National Pressure Ulcer Advisory Panel.
• Horn SD, Bender SA, Fergusson MI, et al.  The National Pressure Ulcer Long-Term Care Study: Pressure ulcer development in long-term care residents.  J Am Geriatr Soc 2004; 52(3): 359-367.