Pressure sores
Can you explain what is meant by a pressure sore?
Pressure sores are areas of skin damaged by a lack of blood flow due to pressure.
Pressure that reduces or cuts off blood flow from the skin can occur from a bed, chair or wheelchair, cast, splint or other hard object.
If blood flow is cut off for more than one or two hours, the skin dies, beginning with its outer layer. The dead skin breaks down and forms an open sore or ulcer.
Pressure sores can develop in people of all ages who are bed-bound, chair-bound or unable to reposition themselves.
While they are more common among older people, those who are paralysed, comatose, very weak, sedated or restrained are also at increased risk.
Pressure sores tend to occur over bony projections such as the hip bones, tailbone, heels, ankles and elbows.
Factors that can contribute to the development of pressure sores include: pressure, traction, friction, moisture and inadequate nutrition.
How serious are they?
Pressure sores can be life threatening if they are untreated or if underlying health conditions prevent them from healing.
Treating a pressure sore is much more difficult than preventing one.
The main goals of treatment are to relieve pressure on the sores, keep them clean and free of infection, and provide adequate nutrition.
I'm looking after my elderly mother-in-law who is more or less bed-bound. How best can I prevent her developing pressure sores?
People who cannot move themselves need to be repositioned very frequently.
The skin must be kept clean and dry because moisture increases the risk of developing pressure sores.
Dry skin is less likely to stick to fabrics and cause friction or traction.
For people confined to bed, sheets should be changed frequently to make sure they are clean and dry.
Bony projections (such as heels and elbows) should be protected.
However, donut-shaped devices and sheepskins should be avoided as they only shift pressure or friction from one vulnerable site to another.
Special pressure-relieving beds, mattresses and seat cushions can be used to reduce pressure in people who are bed- or wheelchair-bound.
Consult your public health nurse or occupational therapist to advise on the management regimes and equipment needed to help prevent pressure ulcers developing.
However, no device can eliminate pressure completely nor are they a substitute for frequent repositioning.
Because shifting position is necessary to keep the blood flowing to the skin, over-sedation should be avoided and activity encouraged.
