Pressure Ulcer: Causes, Treatment and Remedies
You may know pressure ulcers by their most common name, pressure sores. They occur when you lie down or sit in one position too long and the weight of your body against the surface of the bed or chair cuts off the blood supply. You can get them if you are on bed rest or in a wheelchair.
Pressure sores(Bedsores) can be staged based on their depth. When caught early, they can heal in a few days with minimal discomfort. Without treatment, they can worsen. Signs of improvement include the sore becoming smaller and pink tissue appearing on the sides.
A pressure ulcer is also known as bedsores, pressure sore, or decubitus ulcers. It is an open wound on your skin. Pressure sores often occur on the skin overlying bony areas. The following are the most common places for a pressure ulcer:
- Hips
- Back
- Ankles
- Buttocks
This condition is common among people who:
- Are older have reduced mobility
- Spending long periods in bed or a wheelchair
- Cannot move certain parts of the body without help
- You have fragile skin
The condition is treatable, but deep chronic ulcers can be difficult to treat. The specific prognosis depends on several factors, including the underlying medical conditions, as well as the stage of the ulcer.
Alternate Terms for Bedsores
The other names is Bedsores You may also hear these terms:
- Decubitus ulcers.
- Pressure injuries.
- Pressure sores.
- Pressure ulcers.
- Pressure wounds.
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Get A Second OpinionStages of Pressure Ulcer(Bedsores)
Pressure ulcers, also known as bedsores or decubitus ulcers, develop in stages based on the severity of tissue damage. The stages are as follows:
- Stage 1: Non-Blanchable Erythema
- Skin is intact but appears red or purple and does not blanch (turn white) when pressure is applied.
- The area may be painful, firm, soft, warmer, or cooler than the surrounding skin.
- Stage 2: Partial Thickness Loss of Skin
- The ulcer presents as a shallow wound with a pink or red wound bed.
- There may be an open, intact blister or an abrasion.
- The skin is no longer intact, but the damage is limited to the epidermis or dermis.
- Stage 3: Full Thickness Skin Loss
- There is a deeper wound involving full loss of skin layers.
- Fat may be visible, but bone, tendon, or muscle is not exposed.
- The wound may have slough or necrotic tissue.
- Stage 4: Full Thickness Tissue Loss
- Severe tissue damage extends through all layers of the skin, exposing muscle, tendon, or bone.
- There may be large amounts of necrotic tissue or eschar.
- The wound is deep and may involve significant tissue loss, with extensive destruction.
- Stage 5: Unstageable Pressure Ulcer
- The wound is covered with slough or eschar, making it impossible to determine the depth or stage.
- Once the slough or eschar is removed, the ulcer may be staged accordingly.
- Stage 6: Deep Tissue Pressure Injury (DTPI)
- The skin may appear intact, but there is deep tissue damage, often beneath the skin.
- The area may appear purple or maroon, and the skin may feel warm or mushy, indicating underlying tissue injury.
Proper treatment and care are crucial to prevent the progression of pressure ulcers and promote healing.
Pressure Ulcer Symptoms(Bedsores)
- Redness: Persistent red or discolored skin, especially over bony areas, that doesn’t fade when pressure is relieved.
- Pain: Tenderness or pain in the affected area, which may worsen with pressure.
- Swelling: Swelling or increased warmth around the area.
- Blisters: Fluid-filled blisters or sores on the skin.
- Open Wounds: Open or broken skin that may appear as a shallow sore or deep wound.
- Drainage: Discharge of fluid or pus from the ulcer.
- Odor: Foul-smelling odor from the wound, which may indicate infection.
Early detection and treatment are crucial to prevent complications and promote healing
Causes of Pressure Ulcer
Anyone who stays in one position for a long time is at risk of developing pressure sores. They often form in people who need help to change positions. A person who develops a pressure ulcer can:
- Spending a lot of time sitting in a chair or lying in bed
- Wearing a prosthesis or surgical device
- Wear ill-fitting shoes or clothing with elastic bands
- These sores form when tissues and blood vessels are compressed and then deformed
- This can result in a loss of circulation, which can lead to tissue death and infection. Sores can result from significant pressure for a short period of low pressure for a longer period
Diagnosis of Pressure Ulcer
Medical staff can take samples of the tissue and fluid from the pressure ulcer to look for bacteria or cancer. They may also do blood cultures, bone scans, or other tests, depending on the severity of the ulcer. Also, they will assess the condition of the ulcer based on:
- The size of the pressure ulcer and the depth of the crater
- What type of tissue is affected by the ulcer: skin, bone, or muscle
- The color of the ulcer and the surrounding skin
- The death of tissue caused by the ulcer
- The presence of infection, bleeding, or a bad smell
Risk factors of Pressure Ulcer
The following can increase the chances of sores developing:
- Not being able to move without help
- Advanced age, as the skin becomes thinner and more fragile
- Incontinence, which raises the risk of skin injury and infection
- Low or high body mass index, or BMI, both of which can increase pressure
- A low body weight, which leads to less padding around the bones
- A condition, such as diabetes, that reduces the sensation of pain
- Prolonged wound healing, as can also happen with diabetes
- Poor blood circulation
- Reduced mental awareness
Pressure Ulcer Assessment
- Inspect the affected area for signs of damage (redness, blistering, or skin breakdown).
- Stage the ulcer (Stage 1 to Stage 4) based on severity, considering size, depth, wound bed condition, and drainage type.
- Assess pain levels and the patient's comfort.
- Evaluate risk factors like immobility, poor nutrition, and incontinence.
- Check for signs of infection.
- Consider the patient's nutritional status and medical history.
- Perform regular reassessment to guide treatment and prevent further damage.
Pressure Ulcer Treatment
Depending on the stage of the ulcer, treatment may include some are all of the following:
- Relieving Pressure: Regularly repositioning the patient to reduce pressure on affected areas. Use specialized cushions or mattresses to distribute pressure evenly.
- Cleaning the Wound: Gently clean the ulcer with saline solution or a mild antiseptic to avoid irritation.
- Dressing the Wound: Apply appropriate dressings (hydrocolloid, hydrogel, or alginate) to keep the ulcer moist, promote healing, and prevent infection.
- Infection Control: If an infection is present, pressure ulcer medication such as antibiotics (topical or oral) may be prescribed.
- Debridement: Removal of necrotic tissue to promote healing, either through surgical, mechanical, enzymatic, or autolytic methods.
- Pain Management: Use pain relief medications to reduce discomfort during cleaning, repositioning, or dressing changes.
- Nutritional Support: Ensure adequate protein and calorie intake to support healing. Supplements like vitamin C and zinc may also be recommended.
- Improve Mobility: Encourage physical therapy to enhance mobility and promote blood flow.
- Management of Underlying Conditions: Control any existing conditions like diabetes or circulatory issues to facilitate healing.
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Book an AppointmentHow Can Prevention for Bedsores be Achieved?
- Change the person's position every two hours
- The use of support elements such as pillows or foam pads reduces pressure on pressure points
- Keep skin clean and dry and apply moisturizing lotions made especially for fragile skin
- Provide the person with nutritious and balanced meals and 8-10 glasses of water a day
- Pain relievers to relieve discomfort
- Help the person do daily range-of-motion exercise
- Clean carefully after urination or defecation and apply a cream formulated for fragile skin if necessary
Home Remedies for Pressure Ulcer
Home remedies for Bedsores include:
- Relieve Pressure: Reposition every 2 hours and use special cushions.
- Maintain Hygiene: Clean and dry the area with mild soap and warm water.
- Use Aloe Vera or Coconut Oil: Helps soothe and moisturize skin.
- Apply Honey: Medical-grade honey can reduce infection and promote healing.
- Increase Vitamin C and Zinc Intake: Supports skin repair.
- Stay Hydrated and Eat Well: A healthy diet aids healing.
- Avoid Smoking: Smoking slows down healing.
