Also know as decubitus ulcer, pressure injury, pressure sore or bed sore
A pressure ulcer usually occurs in skin that covers a bony bulge such as heels, shoulders, hips, and upper buttocks.
Risk Factors for a Pressure Ulcer
- Reduced activity/Immobility
- Reduced feeling (sense of touch, pain)
- Chronic, complicated medical problems such as diabetes, obesity, smoking, poor circulation, and spinal cord injury
- Increased skin moisture from the inability to control your bowel and or bladder
- Poor nutrition, decline in the amount of proteins you eat.
- Older adults are more at risk for a pressure ulcer. So are patients who slide down in the bed. Sliding down causes friction that may tear delicate or already damaged skin.
Symptoms of a Pressure Ulcer
If you have a pressure ulcer, you may have burning, aching, or itching at the site. The injured skin may be red or bruised. It may have a purplish discoloration that continues even after moving.
A pressure ulcer may feel firm or mushy. It may be warm to the touch. Swelling and tenderness are common. A blister or shallow sore may develop. A clear or blood-tinged fluid may drain from the ulcer area. The wound may become deep and can extend down to the fatty tissue tissue, muscle or bone. Pressure ulcers are sometimes described using stages (Stage I, Stage II, etc.) based on how deeply the tissue is injured.
How is a Pressure Ulcer Cared For?
Treatment of a pressure ulcer may involve many health care professionals, including nurses, doctors, physical therapists, dietitians, and other specialized health care workers. This condition is not restricted to the elderly. Your doctor will review your medical history and set up a personal treatment plan. Many dressings are available to treat pressure ulcers. The doctor will decide which dressing is best for your wound. You also may need physical therapy to help promote healing. You and your care team will discuss how to decrease pressure at the area and how to prevent more ulcers from developing. A dietitian may work with you on a meal plan to meet your needs. Debridement is essential to promote wound healing. Its indications and benefit are described separately.
Case Study: From Nursing Home to Office Patient: Adapting Care for all Patient Populations
Case Study: Pressure Ulcer