For others, they can be serious and lead to life-threatening complications, such as blood poisoning. Surgery to remove damaged tissue and close the wound is sometimes used in the most serious cases. Read more about the treatments for pressure ulcers. It can be difficult to completely prevent pressure ulcers, but there are some things you or your care team can do to reduce the risk.
If you're in a hospital or care home, your healthcare team should be aware of the risk of developing pressure ulcers. They should carry out a risk assessment, monitor your skin and use preventative measures, such as regular repositioning.
If you're recovering from illness or surgery at home, or you're caring for someone confined to bed or a wheelchair, ask your GP for an assessment of the risk of developing pressure ulcers. If you notice any damage, report it to your care team. If you are at home, contact your GP or community nurse. If you are in hospital or a nursing home, inform one of your nurses or carers.
If you are a smoker, giving up is one of the most effective ways of preventing pressure ulcers. Smoking reduces the levels of oxygen in your blood. It also weakens your immune system, which increases your risk of developing pressure ulcers.
Read about quitting smoking for further information and advice about giving up smoking. Home Illnesses and conditions Skin, hair and nails Pressure ulcers. Pressure ulcers See all parts of this guide Hide guide parts 1. About pressure ulcers 2. Symptoms of pressure ulcers 3. Causes of pressure ulcers 4. Diagnosing pressure ulcers 5. Treating pressure ulcers 6. Complications of pressure ulcers 7. Preventing pressure ulcers. About pressure ulcers Pressure ulcers are an injury that breaks down the skin and underlying tissue.
They are sometimes known as "bedsores" or "pressure sores". How pressure ulcers develop Pressure ulcers can develop when a large amount of pressure is applied to an area of skin over a short period of time. Who is affected? Treating and preventing pressure ulcers Treatment for pressure ulcers includes the use of dressings, creams and gels designed to speed up the healing process and relieve pressure.
These include: regularly changing a person's position using equipment to protect vulnerable parts of the body — such as specially designed mattresses and cushions Read about treating pressure ulcers and preventing pressure ulcers for more information.
Symptoms of pressure ulcers The parts of the body most at risk of developing pressure ulcers are those that are not covered by a large amount of body fat and are in direct contact with a supporting surface, such as a bed or a wheelchair. For example, if you are unable to get out of bed, you are at risk of developing pressure ulcers on your: shoulders or shoulder blades elbows back of your head rims of your ears knees, ankles, heels or toes spine tail bone the small bone at the bottom of your spine If you are a wheelchair user, you are at risk of developing pressure ulcers on: your buttocks the back of your arms and legs the back of your hip bone Severity of pressure ulcers Healthcare professionals use several grading systems to describe the severity of pressure ulcers.
Grade 1 A grade 1 pressure ulcer is the most superficial type of ulcer. Grade 2 In grade 2 pressure ulcers, some of the outer surface of the skin the epidermis or the deeper layer of skin the dermis is damaged, leading to skin loss.
Grade 3 In grade 3 pressure ulcers, skin loss occurs throughout the entire thickness of the skin. Grade 4 A grade 4 pressure ulcer is the most severe type of pressure ulcer. People with grade 4 pressure ulcers have a high risk of developing a life-threatening infection. Causes of pressure ulcers Pressure ulcers are caused by sustained pressure being placed on a particular part of the body.
Pressure ulcers can be caused by: pressure from a hard surface — such as a bed or wheelchair pressure that is placed on the skin through involuntary muscle movements — such as muscle spasms moisture — which can break down the outer layer of the skin epidermis The time it takes for a pressure ulcer to form will depend on: the amount of pressure how vulnerable a person's skin is to damage Grade 3 or 4 pressure ulcers can develop quickly.
Increased risk There are several factors that increase the risk of developing pressure ulcers. These include: with age, the skin loses some of its elasticity stretchiness , which makes it more vulnerable to damage reduced blood flow to the skin, due to the effects of ageing the amount of fat under the skin tends to decrease as people get older Incontinence Both urinary incontinence inability to control your bladder and bowel incontinence inability to control your bowels can cause certain areas of the skin to become moist and vulnerable to infection.
Mental health conditions People with severe mental health conditions such as schizophrenia a condition where people have problems telling the difference between reality and imagination or severe depression have an increased risk of pressure ulcers for a number of reasons. These include: their diet tends to be poor they often have other physical health conditions, such as diabetes or incontinence they may neglect their personal hygiene, making their skin more vulnerable to injury and infection.
Diagnosing pressure ulcers Pressure ulcers are easily diagnosed by looking at them. As part of the risk assessment process, the following will be considered: your general health your ability to move whether you have any problems that may affect your posture whether you have any symptoms that may indicate an infection your mental health whether you have had pressure ulcers in the past whether you have urinary incontinence or bowel incontinence your diet how well your blood circulation system is working As part of the risk assessment, you may be referred for blood and urine tests.
Self-assessment If you are thought to be at risk of developing pressure ulcers, but you are not staying in a hospital or care home, you may be advised to regularly check for early signs of the condition.
Treating pressure ulcers Treatment for pressure ulcers can vary, depending on the grade of the ulcer. Your care team Pressure ulcers are a complex health problem arising from many interrelated factors. Your MDT may include: a tissue viability nurse a nurse who specialises in wound care and prevention a social worker a physiotherpist an occupational therapist a dietitian medical and surgical experts with experience in pressure ulcer management Changing position It's important to avoid putting pressure on areas that are vulnerable to pressure ulcers or where pressure ulcers have already formed.
You may also be given training and advice about: correct sitting and lying positions how you can adjust your sitting and lying position how often you need to move or be moved how best to support your feet how to maintain good posture the special equipment you should use and how to use it Mattresses and cushions There are a range of special mattresses and cushions that can relieve pressure on vulnerable parts of the body.
Dressings Specially designed dressings and bandages can be used to protect pressure ulcers and speed up the healing process.
Examples of these types of dressings include: hydrocolloid dressings — these contain a special gel that encourages the growth of new skin cells in the ulcer, while keeping the surrounding healthy area of skin dry alginate dressings — these are made from seaweed and contain sodium and calcium, which are known to speed up the healing process Creams and ointments Topical preparations, such as creams and ointments, can be used to help speed up the healing process and prevent further tissue damage.
Antibiotics If you have a pressure ulcer, you will not routinely be prescribed antibiotics. Nutrition Certain dietary supplements, such as protein, zinc and vitamin C, have been shown to accelerate wound healing.
Debridement In some cases, it may be necessary to remove dead tissue from the ulcer to help stimulate the healing process. Some mechanical debridement techniques include: cleansing and pressure irrigation — where dead tissue is removed using high-pressure water jets ultrasound — dead tissue is removed using low-frequency energy waves laser — dead tissue is removed using focused beams of light surgical debridement — dead tissue is removed using surgical instruments, such as scalpels and forceps A local anaesthetic will be used to numb the area of skin and tissue around the ulcer so that debridement does not cause any pain or discomfort.
Maggot therapy Maggot therapy, also known as larvae therapy, is an alternative method of debridement. Surgery It's not always possible for a grade 3 or 4 pressure ulcer to heal.
There is a risk of a large number of possible complications occurring after surgery, including: infection tissue death of the implanted flap muscle weakness blisters small pockets of fluid that develop inside the skin recurrence of the pressure ulcers blood poisoning infection of the bone osteomyelitis internal bleeding abscesses painful collections of pus that develop inside the body deep vein thrombosis a blood clot that develops inside the veins of the leg Despite the risks, surgery is often a necessity to prevent life-threatening complications, such as blood poisoning and gangrene the decay or death of living tissue.
Complications of pressure ulcers Even with the best possible medical care, complications can arise from grade 3 or grade 4 pressure ulcers and can occasionally be life-threatening.
These complications are discussed below. Cellulitis Infection can spread from the site of the pressure ulcer to a deeper layer of skin. Read more information about cellulitis. Blood poisoning If a person with a weak immune system has a pressure ulcer that becomes infected, there is a risk that the infection will spread into their blood and other organs.
Bone and joint infection Infection can also spread from a pressure ulcer into underlying joints septic arthritis and bones osteomyelitis. Necrotising fasciitis Necrotising fasciitis, commonly known as "flesh-eating" bacteria, is a serious skin infection that causes rapid tissue death. It can lead to heart attack or stroke. Learn about risk factors, symptoms…. Obesity is a condition in which you have too much body fat for your height.
Morbid obesity is when the excess body fat becomes a danger to your…. Viruses, bacteria, fungi, and parasites can all cause skin infections. Infections can range from mild to severe. Learn what to do if you have a skin…. Candida fungal skin infection is most common in armpits, the groin, and between digits. The infection causes rashes and other skin symptoms. Many people have experienced an occasional skin rash or unexplained mark.
Some conditions that cause skin rashes are very contagious. Learn about some…. Read about the four types of skin ulcers, how to treat them, and when you need to see a doctor.
Skin ulcers are not always serious but have a high…. Health Conditions Discover Plan Connect. What are the symptoms of a decubitus ulcer? Stages of decubitus ulcers. What causes a decubitus ulcer? Diagnosing a decubitus ulcer. Treating a decubitus ulcer.
Preventing pressure sores If you are confined to a bed or chair for any period of time, it's important to be aware of the risk of pressure sores. Position changes to prevent pressure sores If you use a wheelchair shift position within your chair about every 15 minutes. Daily skin care to prevent pressure sores Ways to prevent pressure injuries include: Checking the skin at least daily for redness or signs of discolouration.
Keeping the skin at the right moisture level, as damage is more likely to occur if skin is either too dry or too moist. Using moisturising products to keep skin supple and prevent dryness.
Never massaging bony areas because the skin is too delicate. Diet and lifestyle changes to avoid pressure sores Changes to avoid pressure sores include: Make sure you eat a healthy and nutritious diet. Be aware of using good hygiene practices. Maintain activity levels, where appropriate. Make sure you quit smoking.
Warning signs of pressure sores Daily checks are needed to look for early warning signs including: red, purple or blue torn or swollen skin, especially over bony areas signs of infection, such as skin warmth, swelling, cracks, calluses, and wrinkles.
Treatment for pressure sores There are a variety of treatments available to manage pressure sores and promote healing, depending on the severity of the pressure sore. These include: regular position changes special mattresses and beds that reduce pressure being aware of the importance of maintaining healthy diet and nutrition dressings to keep the sore moist and the surrounding skin dry.
There is no advantage of one type of dressing over another. J Wound Ostomy Continence Nurs. Adv Skin Wound Care , Mar;33 3 Meta-analysis of effect of foam dressing and hydrocolloid dressing on bedsore management. Chinese Nurs Res. Dressings and topical agents for treating pressure ulcers. Cochrane Database Syst Rev.
0コメント