Pressure ulcers, also known as bedsores or pressure sores, are injuries that occur on the skin and underlying tissues due to prolonged pressure on specific areas of the body where the skin becomes red, broken or ulcerated. These sores often develop when a person remains in one position for an extended period, restricting blood flow to certain areas.
What are the causes?
Pressure ulcers commonly affect individuals with limited mobility, such as those confined to a bed or wheelchair. The constant pressure on certain body parts, like the heels, hips, spine and tailbone, can lead to skin damage. Other contributing factors include moisture, friction, and shear forces where the layers of the skin are forced to slide over on another or over the deeper tissues, which increase the risk of developing these ulcers.
Who is at risk?
Pressure ulcers can affect anyone, but certain individuals face a higher risk. Those especially vulnerable include:
- People with mobility challenges requiring assistance to change positions.
- Individuals with persistently moist skin, such as those dealing with incontinence.
- Those with an inadequate diet and insufficient fluid intake.
- Individuals with impaired pain or sensation.
- People facing serious illnesses.
- Very young or elderly individuals.
- Those who have previously experienced pressure ulcers.
Stages of pressure ulcers
Pressure ulcers progress through different stages, ranging from mild to severe.
- Stage 1: The skin may appear red and irritated, signalling the initial damage.
- Stage 2: The outer layer of the skin breaks, forming a shallow open sore or blister.
- Stage 3: The injury extends into the deeper layers of skin, creating a crater-like wound.
- Stage 4: The ulcer reaches muscles, tendons, or even bones, posing a significant health risk.
Symptoms
Recognising the signs of pressure ulcers is vital for early intervention. Look for changes in skin colour, temperature, or texture. Early signs of damage include redness and discolouration. Regular skin checks are essential, especially for individuals with limited mobility. If you notice pain, discomfort or discolouration, please inform healthcare professional to prevent further damage.
Prevention
Preventing pressure ulcers involves a combination of strategies. Regular repositioning involves altering your posture regularly to ensure proper blood flow to your skin, promoting its health. You will need support from care givers or family members, if you cannot reposition yourself.
Treatment
The approach to treating pressure ulcers depends on the stage of the wound. Basic care includes keeping the area clean, dry and maintaining good hygiene. If skin is moist, there is a higher risk of break down and damage. Severe pressure ulcers may need dressings to promote healing and also relieving pressure on the affected area is crucial. Surgical intervention may be necessary in some severe cases to remove damaged tissue and promote healing.
Nutrition
Maintaining a well-balanced diet is crucial in preventing and managing pressure ulcers. Proper nutrition plays a significant role in supporting skin health and promoting healing. Additionally, staying well-hydrated is essential. Sufficient fluid intake helps keep the skin hydrated, enhancing its elasticity and resilience. Dehydration can contribute to skin dryness and make individuals more susceptible to pressure ulcers. For those at risk of pressure ulcers, consulting with a healthcare professional or a registered dietitian is advisable.
Equipment
There are range of mattresses which designed to alleviate pressure while you're in bed. If you face a substantial risk and experience restricted mobility in bed, an air mattress may be an option. In cases where leg movement is challenging, it is advisable to lift your heels off the bed surface, either through the placement of pillows under your legs or by using a specialized boot. It's important to note that utilizing an air mattress does not eliminate the necessity for repositioning.
Complications
Complications associated with pressure ulcers can be severe. Infections may spread to the bloodstream, leading to sepsis. In extreme cases, pressure ulcers can contribute to muscle and bone infections, posing a risk to overall health.
Caregiver Role
For individuals caring for those at risk of pressure ulcers, vigilance is crucial. Regularly repositioning the person, ensuring proper nutrition, and maintaining a clean and dry environment are essential tasks.
Conclusion
Pressure ulcers, while preventable, remain a significant concern for individuals with limited mobility. Education, proactive care, and early intervention are essential components of managing and preventing pressure sores. Effective communication with healthcare professionals is vital for timely intervention and treatment.