Description

Pressure ulcers are injuries of the skin and the tissue below the skin, due to the pressure on the skin for a long time. Bedsores most often arise in the skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone. Pressure sores are also called pressure sores, pressure injuries and pressure sores.

The people who are at higher risk for pressure ulcers have medical conditions that prevent them from change of position or movement. Or they spend most of their time in a bed or a chair.

Pressure sores can arise for hours or days. Most of the sores heal with treatment, but some may never heal completely. You can take steps to put an end to decubitus ulcers and help them heal.

Symptoms

The symptoms of pressure sores are:

  • Changes in skin color or texture.
  • The swelling.
  • Pus-like drainage.
  • An area of skin that feels colder or warmer to the touch than other areas.
  • Pain areas.

Pressure ulcers are classified into several stages, based on its depth, the degree of severity, and other features. The degree of the skin and damage in the tissues of the ranges of inflamed, intact skin to a deep injury of the muscles and the bones.

The common sites of pressure ulcers

For people who use wheelchairs, decubitus ulcers often occur on the skin in these areas:

  • The tailbone or buttocks.
  • Shoulders and the spine.
  • The backs of the arms and legs where they rest against a chair.

For people who need to stay in bed, pressure ulcers can occur in the:

  • Behind or to the sides of the head.
  • The shoulder blades.
  • Of the hip, lower back or tailbone.
  • The heels, ankles and the skin behind the knees.

When to see a doctor

If you notice warning signs of a pressure ulcer, change your position to relieve the pressure on the area. If the area does not improve in 24 to 48 hours, contact your health care professional.

Seek medical attention immediately if you notice signs of infection. These include fever, drainage of a pain or a pain that has a bad smell, as well as the warmth, or swelling around the sore.

Causes

The pressure against the skin that limits the flow of blood to the skin that cause pressure ulcers. The limited movement can make the skin prone to damage and the cause of bedsores.

The three main things that lead to pressure sores are:

  • Pressure. The constant pressure in any part of the body can decrease blood flow to the tissues. The flow of blood is essential for carrying oxygen and other nutrients to the tissues. Without these key nutrients, the skin and surrounding tissues are damaged and may die with time. The limited movement can make the skin prone to the damage that the pressure of the causes. For people with limited mobility, pressure tends to occur in areas that are not well padded with muscle or fat, and they are spread over a bone. These areas include the spine, the coccyx, the shoulders, the hips, heels, and elbows.
  • Friction. Friction occurs when the skin rubs against clothes or bed linen. You can make the skin fragile, more vulnerable to injury, especially if the skin is wet.
  • Shear. Shear occurs when two surfaces move in the opposite direction. For example, when the bed is raised to the head, a person can slide down in the bed. As the coccyx moves down, the skin on the bone can stay in place, pulling in the opposite direction.

Risk factors

Your risk of pressure ulcers is greater if you have difficulty moving and you can't easily change the position seated or in bed. The risk factors include:

  • Immobility. This could be due to ill-health, spinal cord injury or other cause.
  • Incontinence. The skin becomes more vulnerable to prolonged exposure to urine and feces.
  • The lack of sensory perception. Spinal cord injuries, neurological disorders and other conditions that can cause you to lose sensation. If you can't feel pain or discomfort, not to be aware of the warning signs and the need of change of position.
  • Poor nutrition and hydration. The people need a sufficient amount of fluids, calories, protein, vitamins and minerals each day to keep your skin healthy and stop the decomposition of the tissues.
  • Medical conditions that affect the flow of blood. Health problems that can affect the flow of blood can increase the risk of tissue damage, such as pressure ulcers. Examples of these types of medical conditions include diabetes and vascular disease.
  • Age. If you have more than 70 years, is more likely to be affected by pressure ulcers.

Complications

Complications of pressure sores are:

  • The cellulite. Cellulitis is an infection of the skin and attached soft tissues. It can cause heat and swelling of the affected area. The skin can change color or look swollen. People with nerve damage, often do not feel pain in the area of cellulite affects.
  • Bone and joint infections. An infection of a pressure ulcer, can be buried in the joints and the bones. Joint infections, such as septic arthritis, it can damage the cartilage and tissue. Bone infection, also called osteomyelitis, can reduce the function of joints and limbs.
  • Cancer. An ulcer of Marjolin is long-term, nonhealing wound that can become a type of squamous cell carcinoma.
  • Sepsis. Rarely, an ulcer in the skin leads to sepsis, which is a life-threatening complication of an infection.

Some complications can be life-threatening.

Prevention

You can help stop the sores with these steps:

  • Frequently change position to avoid stress on the skin.
  • Take good care of your skin.
  • Eat and drink regularly.
  • Stop smoking.
  • Manage stress.
  • The daily exercise.

Tips for the repositioning of the

Consider these recommendations in relation to changes of position in bed or in a chair:

  • Change your weight often. Ask for help to change position every two hours.
  • Lift yourself up, if possible. If you have enough upper body strength, doing push-ups in a wheelchair. Lift your body off the seat by pushing on the arms of the chair.
  • Find in a specialty of the wheelchair. Some wheelchairs allow you to tilt, which can relieve the pressure.
  • Select cushions or a mattress that relieves pressure. The use of cushions or a special mattress to help relieve pressure and help to ensure that your body is well-positioned. Do not use ring cushions. You can focus the pressure on the surrounding tissue.
  • Adjust the height of the bed. If possible, do not elevate the head of the bed more than 30 degrees. This helps to prevent shearing.

Tips for the care of the skin

Keep in mind these tips for the care of the skin:

  • Keep the skin clean and dry. Wash the skin with a mild cleanser and pat dry. Do this routine of cleaning on a regular basis to limit exposure of the skin to moisture, urine and feces.
  • Protect the skin. The use of the moisture barrier creams to protect the skin from urine and stool. Change of bed linen and clothes often if necessary. Watch for the buttons on the clothing and the wrinkles in the bed-clothes which can irritate your skin.
  • Inspect the skin daily. Look closely at your skin every day for warning signs of a bedsore.

Diagnosis

Your health professional likely to look closely at your skin to decide if you have a pressure ulcer. If a pressure ulcer is found, your healthcare provider will assign a stage to the wound. Staging helps determine what treatment is best for you. You may need blood tests to learn about their health in general.

The doctor's questions

Your health care professional might ask questions such as:

  • When did the pressure sores appear for the first time?
  • How painful are pressure ulcers?
  • Has had decubitus ulcers before?
  • How they were treated, and what was the outcome of the treatment?
  • What type of care assistance is available to you?
  • What is your routine to change your position?
  • What medical conditions you have been diagnosed with, and what is your current treatment?
  • What do you normally eat and drink?

Treatment

The treatment of pressure ulcers is to reduce the pressure on the affected part of the skin, wound care, pain control, infection prevention, and to eat well.

Treatment team

The members of your care team may include:

  • A primary care professional who oversees your treatment plan.
  • A health care professional specializing in the care of the wound.
  • Nurses or medical assistants who provide care and education to manage wounds.
  • A social worker who helps you or your family access to resources and focus on the emotional concerns related to long-term recovery.
  • A physical therapist who helps you move better.
  • An occupational therapist helps to make sure the surfaces of the seats are to the right.
  • A dietitian that tracks what you should eat and recommend a good diet.
  • A health professional who specializes in diseases of the skin, also known as a dermatologist.
  • A neurosurgeon, vascular surgeon, orthopedic surgeon, plastic surgeon.

The reduction of the pressure

The first step in the treatment of a pressure ulcer is lower than the pressure and friction that cause. Try:

  • Change of position. If you have a pressure ulcer, turn and change position frequently. How often you change your position depends on your condition and the quality of the surface is in.
  • The use of support surfaces. The use of a mattress, bed linen and cushions that are special to help you sit or lie in a way that protects the vulnerable skin.

The cleaning and care of wounds

The care of pressure ulcers depends on the depth of the wound. In general, tending to a wound includes these steps:

  • Clean. If the skin is not broken, wash it with a mild cleanser and pat dry. Clean the open wounds with water or saline solution each time the dressing is changed. The saline solution is a salt water solution.
  • Put on a bandage. A bandage speeds healing by keeping the wound moist. It also creates a barrier against infection and keeps the skin around it dry. Bandage options include films, scrims, gels, foams, and treaties of the coverings. You might need a combination of bandages.

The removal of the damaged tissue

To properly heal, the wounds should be free of damage, the dead or infected tissue. The health professional can remove the damaged tissue, also known as debridement, gently removing the wound with water or cut the damaged tissue.

Other interventions

Other interventions include:

  • Medications to control the pain. Nonsteroidal anti-inflammatory drugs, also known as Nsaids, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), could reduce the pain. These can be very useful before or after you change the position and with the care of the wound. Pain medication that is applied to the skin can also help in wound care.
  • A healthy diet. Good nutrition promotes the healing of wounds.

Surgery

A large sore that does not heal may require surgery. One of the methods of surgical repair is the use of filling of the muscles, the skin or other tissue to cover the wound and cushion the affected bone. This is called flap surgery.

Coping and support

People with pressure ulcers may have discomfort. Also may be socially isolated or depressed. Talk with your health care team about your needs for support and comfort. A social worker can help you find community groups that provide services, education and support for people dealing with long-term care of children or terminal illness.

Parents or caregivers of children with pressure ulcers can talk to a child life specialist to assist in overcoming the tension of the situations of health. Family and friends of people who live in assisted living facilities can help the residents and work with the nursing staff to ensure that they receive appropriate preventative care.

Symptoms and treatment of Bedsores (pressure ulcers)