Pressure ulcers, also referred to as pressure sores, decubitus ulcers and bedsores, develop from sustained pressure placed on bony areas of the body, restricting blood supply to the skin and tissues. The decrease in blood supply causes damage and possibly death to the surrounding tissue. Bed-bound and wheelchair-dependent individuals have an increased risk of developing pressure ulcers. In addition to sustained pressure, moisture and friction on the skin increases the risk of developing bedsores.
Common Locations
Bony areas of the body are most at risk for developing pressure ulcers. Individuals confined to a wheelchair may experience pressure sores in locations that have constant contact with the chair, such as the tailbone, shoulders, elbows and lower legs. Bed-bound individuals tend to develop bedsores in areas such as the back of the head, ears, hips, the knees, ankles and heels.
Symptoms
Symptoms associated with pressure ulcers vary depending on the severity of the condition. Pressure sores are classified into four stages. Symptoms for the first stage include reddened skin that feels warm, spongy or firm, according to the Mayo Clinic. The area may also feel tender. Second stage symptoms include a loss of the outermost layer of skin and possibly a deeper layer of skin, and wounds may look like blisters or abrasions. The third stage of pressure ulcers includes deep damage to tissue under the layers of skin. The final stage includes damage to additional areas such as muscles and bones, and also damage that covers a large area of the body.
Treatments
The first step in treating pressure ulcers includes removing pressure from the area. Cleaning open wounds and removing dead tissue helps wounds heal. Dressings to the affected area help speed the healing process by keeping the wound moist while keeping the surrounding skin dry, according to the Mayo Clinic. Some wounds require surgery to remove dead tissues or to perform reconstruction of the area.
Complications
The most common complication associated with pressure ulcers is infection, which may occur in the tissue---called cellulitis---or in the blood---called sepsis. The bones and joints in the affected area may also develop infections. Severe infections involving the whole body, as with complications associated with cellulitis and sepsis, may become life-threatening.
Prevention
Pressure sores are completely preventable with proper care, such as making frequent weight shifts while sitting in a chair and turning at least every two hours when bed-bound. Using pillows to help support a prone body also assists in relieving pressure on bony areas such as the tailbone. Keeping the body dry and the skin moisturized decreases the likelihood of developing pressure ulcers, according to Medline Plus.
