Pressure Sores

Pressure sores (also known as bedsores, pressure ulcers or decubitus ulcers) is a medical condition in which localized damage to skin and tissues is caused by pressure, stress or friction.

Pressure sores are mainly developed on the skin covering bony areas. Elbows, tailbone, back of the head, heels, very rarely knee-heads and knuckles, buttocks, rims of ears, hipbones or tailbones and skin covering bony area in other parts of the body that is subjected to pressure and shear etc. are the areas at risk.

What are the Signs and Symptoms?

1. In its earliest stage, the pressure sore infected skin area appears red or purple or black in color (discoloration of skin) and may itch or hurt. The skin may feel spongy to tough.
2. Loss of upper layer of skin.
3. Necrosis of the infected area.
4. In its most advanced stage, the damage reaches to the deepest level including bones, joints and tendon.

What are the Causes?

As mentioned above, pressure sores are mainly caused due to application of constant pressure on our body. People who can move around or change their position when they sleep, sit or press against any hard surface to avoid any possible harm to their body are at lowest risk, whereas those who are immobilized because of some reason or other (such as paralysis, physical condition, any type of deformity that keeps them in same position (sit/lie) for a longer duration) and cannot keep moving/changing their positions in bed or chair, such people are at highest risk of acquiring pressure sores.

Physical conditions as mentioned above, improperly designed chair/bed that causes unwelcome pressure on the bony part of our body and specially for those people who cannot feel/adjust against such unwelcome pressure caused due to their physical condition (a paralyzed person will not understand if the part of the bed under his legs is having something protruding and is putting pressure on his/her legs), pressing of body parts against hard surfaces (some people maybe required to work in such conditions), friction and shear are the main causes of pressure sores.

What Causes Pressure Sores

Most of the cases of pressure sores are caused due to constant pressure on the skin over a period of time. Other conditions such malnutrition, deteriorated physical and poor mental condition, ignorance towards body care, activities which require staying in one particular position (such as sitting or lying) for an exceptionally longer duration throughout the day etc. can also lead to the development of pressure sores.

Pressure Sores are Categorized into Following Four Stages

Stage I: This is the earliest stage in development of pressure sores. This stage starts with discoloration of the skin (reddish, purple, blue or black casting of the skin). The affected skin area feels warmer than the surrounding skin, spongy to touch and may pain or itch sometimes. In this stage, the sores are recoverable if proper care is taken.

Stage II: As the pressure sores mature, loss of skin either in the uppermost layer or the deepest layer of the skin occurs. The pressure sores in this stage appear similar to blisters with the reddened cells connecting the affected area to the tissues of surrounding skin.

Stage III: Skin is damaged at a deeper level and it bears wounds indicating destruction of the skin. The damage has extended to the tissue underneath the skin.

Stage IV: In this stage, the damage is done to the tissues, tendons and joints or bones. This is the most advanced stage of pressure sores and very serious as the wounds in this stage are extremely hard to heal and are open to any type of infection.

Who’s at Risk of Developing Pressure Sores?

People who are bedridden due to chronic illness, people who have lost sensitivity for pain due to damage to nervous system or spinal cord etc., those who are suffering from malnutrition and in weak physical condition and those whose food intake does not include proper balanced diet etc. are at risk of developing pressure sores.

You should be careful about your skin and consult your doctor as soon as you discover any damage to the skin (feels spongy) and has red/pink/black etc. discoloration. You should also examine your skin if it has lost sensation.

Treatment

Your doctor may advise you to undergo some tests such as blood test, biopsy, stool culture etc. before concluding if you have developed pressure sores and confirm which stage it has reached.

The treatment for pressure sores may vary from very simple to a complicated surgical/medication course. In its earlier stages (I and II), it is comparatively easy to treat the wounds than in the advanced stages (III and IV).

For the treatment of stages I and II, your doctor may prescribe you some type of ointment, medication etc. and also suggest you change positions often, use cushion or some type of support to relieve the pressure on the existing wounds and help them heal faster, cleaning of the wounds and dressing, follow healthy diet to help your wounds heal faster. Your doctor may also remove the dead/damaged skin and tissues from the wounds to prevent any unwanted infection and to help the wound heal quickly.

Surgical repairing is used for the treatment of pressure sores in stages III and IV. The damaged tissues/skin cells are removed along with the diseased bones. Along with the surgery, your doctor may also advise a strict and heavy medication to help your wounds heal faster.

Prevention Tips

1. Skin inspection of skin area on tailbone, hipbone, back of head, elbows, buttocks etc. may help keep track of any wound that can lead to pressure sore and treat it before it’s too late.
2. Keep changing your posture/position continuously to avoid constant pressure on the skin.
3. Follow healthy/nutritional diet.
4. Use cushion whenever possible/needed.