The Complete Guide to Pressure Ulcers (Bed Sores)
Pressure Ulcers/Bed Sores
What are pressure ulcers?
Pressure ulcers (known also as pressure sores, bed sores, and decubitus ulcers) are areas of skin that have been subjected to sustained amounts of pressure, resulting in the skin and tissue becoming damaged. Constant pressure on a vulnerable area of the body results in the circulation of blood being cut off, which leads to the decay of the affected area. Extended pressure occurs when a person is sat or laid in a particular position on a static surface for a long period of time.
How do you get a pressure ulcer?
So what causes pressure ulcers? Pressure that results in an ulcer can be either a large amount of pressure over a small period of time or a small force over a long period of time. Either way, the extra pressure reduces and sometimes stops the flow of blood through the skin. Without sufficient circulation, the skin becomes starved of oxygen and nutrients and begins to break down, forming an ulcer. The ulcer worsens if pressure is sustained, deepening as tissue breaks down. If left untreated, there is a high risk that the ulcer will become infected by bacteria.
Who is affected by pressure ulcers?
A healthy person with ordinary mobility will not develop a pressure ulcer/bed sore because their body makes hundreds of regular movements, preventing pressure from building up on specific parts of the body. Even when sleeping, you will subconsciously move as pressurised areas omit signals to the brain which acts by telling the body to move to relieve the affected area.
A person with only partial mobility is at risk of developing a pressure ulcer. The risk can be greatly reduced by movement whenever possible, either by the person themselves or by a carer or assistant. The risk can be almost eliminated by using pressure relieving equipment and accessories. Choosing the right pressure care equipment for your specific circumstances is absolutely paramount and with such a wide range of possibilities out there, it is crucial that you spend time making the right choice and if possible, seek the advice of an expert.
Immobile or paralysed individuals are the most at risk of pressure sores. Whilst regular repositioning by carers will help, advanced pressure care equipment is a vital component to beating pressure ulcers. A nurse or clinician will need to assess the individual to ascertain their risk of developing sores, and then specify equipment and establish a care plan that will prevent ulcers from occurring.
Pressure Ulcer Grading
There are four grades (types) of pressure ulcers that define the severity of the ulcer, the fourth being the most severe. A fifth grade is also used in the United States, but the criteria for this grade is so severe, it is better known as ‘unclassified’ or ‘non-gradable’ in the UK.
A reddening of the skin that persists after the pressure is relieved, scientifically defined as a non-blanchable erythema of intact skin. The ulcer does not result in skin loss but can cause pain and will often omit warmth. In darker skin the ulcer may be blue or purple.
A superficial wound that appears as an abrasion or a blister with partial skin loss. The ulcer penetrates deeper layers of the skin and is likely to show as a small, red, crater-like mark. These ulcers do not penetrate any tissue but can result in irrepairable/dead skin.
Full thickness skin loss that may uncover subcutaneous fat, but bone, tendon and muscle are not exposed. Grade 3 ulcers are not usually painful despite their gruesome appearance. They can be a shallow crater or they can be extremely deep, depending on how much tissue there is the affected area. Deep ulcers are often obscured by slough in the wound bed.
A deep wound with full thickness skin loss and extensive tissue damage exposing muscle and bone. Often includes undermining and tunnelling. The depth of the wound varies according to the amount of subcutaneous tissue in the area affected. Grade 4 ulcers can extend into the muscle and/or supporting structures.
Pressure Ulcer Care
Prevention and Cure
Pressure ulcers/bed sores are the single most costly chronic wound to the NHS, costing between £1.4bn and £2.1bn every year. Where ulcers have been allowed to develop, costs incurred have been as much as £100,000 for an individual case. With the right equipment and nursing, prevention is possible, and the initial cost of buying equipment is far more affordable than the excessive costs to cure an ulcer. If the right equipment that is suited to the person’s clinical needs is bought first time round, the cost of pressure care can be kept affordable.
For more information on pressure ulcer prevention, view Avacare Medical’s helpful guide: How to Prevent Bed Sores.
Pressure care equipment
Pressure ulcers result from long periods of being in the same position. This is usually sitting or lying. Therefore, pressure care equipment focuses primarily on solutions for the bed with pressure relieving mattresses, and solutions for the chair with cushions and specialist seating. There are also pressure care accessories for everyday relief.
If you are at risk or suffer from pressure ulcers, buying the right equipment to provide the best pressure care is the most important factor to get right. More help including equipment advice and pressure care information can be found by calling us.