What Are Pressure Ulcers?
Pressure ulcers — also referred to as decubitus ulcers and bed sores — are localized injuries to the skin and underlying tissue due to prolonged pressure. These most often develop on the skin from bony areas of the body, such as the shoulder blades, spine, tailbone, hips, ankles, and heels. The severity of pressure ulcers can vary greatly from closed wounds with discoloration and soreness all the way to open sores that can extend as far down as the cartilage or bone, causing a significant risk of infection.
Pressure ulcers are an especially common condition for the elderly and people who have limited mobility, including those who use wheelchairs or are bedridden from illness or other conditions.
What Causes Pressure Ulcers?
Pressure ulcers typically form after sitting or lying in one position for too long. This sustained pressure can limit blood flow to the skin in affected areas, depriving the tissues of essential nutrients and oxygen and resulting in damage over time. For those with fragile skin, friction from rubbing against clothing or bedding may also make an area of the body more susceptible to injury and bed sores.
Beyond immobility and staying in one position for prolonged periods of time, there are often additional factors at play that can increase the risk of developing pressure ulcers, including:
Medical Conditions Affecting Blood Flow
Skin fragility and the risk of tissue damage is increased by those with conditions such as diabetes, peripheral arterial disease, multiple sclerosis, Parkinson’s disease, and vascular diseases that negatively impact circulation in the body.
The health of skin and tissues starts from the inside-out and requires appropriate levels of fluids, calories, protein, and vitamins and minerals to stay healthy. When these needs are not being met, the health of the skin may be compromised and be more at-risk to break down.
Lack of Sensory Perception
If a person has a condition resulting in a loss of sensation or an inability to feel pain or discomfort, this can promote the development of pressure ulcers because a person would not feel the signals of discomfort and the need to change position.
How Long Does It Take to Get Pressure Ulcers?
Pressure ulcers often develop gradually as pressure points are put under constant duress, but it is possible for them to develop in a matter of hours. According to Johns Hopkins Medicine, a sore can develop if blood supply is cut off for more than 2 to 3 hours.
How to Prevent Pressure Ulcers
Preventing pressure ulcers may be a constant challenge for people with limited mobility. With a proactive approach, there are many strategies to mitigate the risk of these wounds developing.
- Do a daily check for signs of developing pressure ulcers and skin issues. This should be a head-to-toe analysis with a special focus on bony parts of the body, known pressure areas, or areas that are causing a person any level of discomfort.
- Early signs of pressure ulcers include skin redness, warm areas, spongy or hard skin, breakdown of the top layers of skin, or a visible sore. If any of these are found you should immediately contact your health-care provider to help prevent the sore from progressing.
- Regularly switching positions to shift pressure to another area is crucial. If a patient is bed-bound, they should shift every one to two hours (while awake) alternating between left and right sides and lying flat on the back. This may require the assistance of a care provider, which may also reduce the risk of friction and shear. If a person is in a wheelchair, they can readjust every 15-20 minutes by shifting from side to side or leaning forward.
- Wash the skin with a sponge or a soft cloth with non-irritating body washes. Especially with fragile skin, it is important to scrub gently to maintain the integrity of the skin.
- If a person is incontinent, regular cleaning and drying is required as moisture from urine or feces can be damaging to the skin if it persists.
- Wear smooth, comfortable clothes without thick seams, buttons, or zippers that press on your skin.
- Stay hydrated and ensure you have a healthy and balanced diet so your skin and tissues are receiving the nutrients they require to be healthy.
- Stop smoking. Since smoking can adversely affect blood circulation, it makes you more likely to get pressure ulcers.
How to Treat Pressure Ulcers
The treatment of pressure ulcers may vary depending on the severity of the wound; however, there are a few fundamental steps that are consistent throughout.
- Change what is causing the injury. Determine what the root problem is, such as lack of pressure relief and movement, malnutrition, abrasive clothing, etc. and take steps to improve the situation.
- If a pressure ulcer occurs, it is important to keep the wound clean and use a protective dressing to help promote healing and to prevent infection in the area.
- Never rub or slide on the affected area. Friction can worsen a wound, so movement and cleaning should be done with great care.
- In the most serious cases, surgery may be needed to remove damaged tissue and close the wound.
How Keystone Wound Care Can Help
Although it is a relatively common issue, pressure ulcers should be treated with diligence and concern so they do not escalate in severity.
Managing and treating pressure ulcers is a demanding task that requires frequent attention in order for the wound to properly heal. Consistent communication and nursing interventions are often needed to effectively treat the issue. The nurse practitioners at Keystone Wound Care are highly trained to assist patients dealing with pressure ulcers, and can help them get on the road to recovery from the comfort of their own home.