Treating And Preventing Pressure Ulcers
Treatment for pressure ulcers includes the use of dressings, creams and gels designed to speed up the healing process and relieve pressure. Surgery is sometimes recommended for the most serious cases.
For some people, pressure ulcers are an inconvenience that require minor nursing care. For others, they can be serious and lead to life-threatening complications, such as blood poisoning or gangrene.
Read more about the complications of pressure ulcers.
Pressure ulcers can be unpleasant, upsetting and challenging to treat. Therefore, a range of techniques is used to prevent them developing in the first place. These include:
- regularly changing a person’s position
- using equipment to protect vulnerable parts of the body such as specially designed mattresses and cushions
Unfortunately, even with the highest standards of care, it’s not always possible to prevent pressure ulcers in particularly vulnerable people.
What Is Meant By Pressure Damage
What is pressure damage? Pressure damage is a form of damage to the skin and underlying tissue. It is also known as pressure ulcers, pressure sores, or bed sores. If untreated it can get worse and seriously affect a persons health and delay their recovery. Fortunately, most pressure damage can be prevented.
What Are The Causes Of Pressure Injuries
Pressure injuries are caused when a force is applied to the skin, causing damage to the tissue. Several types of force include:
- Pressure: Constant pressure on the skin results from remaining in the same position for a prolonged period of time.
- Shear: Shear damage or a dragging force can occur when the head of the bed is raised and the body slides down. The skin sticks to the sheets, but internal structures are damaged.
- Moisture: Fluids that remains on the skin can cause the skin to become overly wet, which increases the risk for pressure injury development.
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Stages Of Pressure Ulcers
Physicians stage bedsores according to the seriousness of the wound in relation to the layers of the skin. These injuries range from mild skin reddening to severe tissue damage and infection that affects muscle and bone. Severe ulcers may require surgery or other invasive interventions.
The National Pressure Ulcer Advisory Panel is an expert group on bedsores. They categorize pressure injuries into four stages. The NPUAP pressure injury stages are:
Causes Of Pressure Sores
Pressure sores happen if you cant move around and so stay in one position for a long time. We normally move about constantly, even in our sleep. This stops pressure sores developing.
People who are unable to move around tend to put pressure on the same areas of the body for a long time. If you are ill, bedridden or in a wheelchair, you are at risk of getting pressure sores.
A number of things can increase your risk of pressure sores, including:
- being unable to move around easily due to old age or illness
- weight loss – you may have less padding over bony areas
- sliding down in a bed or chair – pressure on the skin cuts off blood supply because the skin is being pulled in different directions
- friction or rubbing of the skin, for example against sheets
- moist skin – for example, due to sweating or incontinence
- other medical conditions, such as diabetes
- having a previous pressure ulcer
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A Pressure Ulcer By Any Other Name
Just when we think weve figured out pressure ulcer staging, it changes again. In April 2016, the National Pressure Ulcer Advisory Panel held a consensus conference on staging definitions and terminology. The purpose: to analyze and discuss the rationale for the panels changes. One of the key changes is replacing the term pressure ulcer with pressure injury. So instead of calling it a pressure ulcer staging system, NPUAP will refer to it as a pressure injury staging system. The panel explained that the new terminology more accurately describes pressure injuries to both intact and ulcerated skin. Other changes include:
use of Arabic rather than Roman numerals in the stage names
modified descriptions of each individual stage
The revised staging guidelines, along with new schematic artwork for each stage, are available for .
More than 400 people attended the conference. I wasnt able to attend, so I reached out to several clinicians who did and found that their reactions were mixed.
Here are some of their responses:
I was surprised the updated pressure injury guidelines were released so soon.
This was presented by industry experts. I preface what I am about to say with this comment because of the concern I had with the updated staging system by end of the meeting.
I thought the process would serve to simplify and clarify. Im not so sure it accomplished either.
Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
How To Treat Decubitus Ulcers
- Reducing pressure on the area by turning and repositioning the patient regularly at least every 2 hours
- Providing extra support from pillows, etc. to keep the affected area free
- Cleansing the wound regularly with appropriate solutions and applying bandages such as gauze, film, gel, foam, etc.
- Improving diet to promote healing
- Removing damaged tissue in more serious cases
- Performing debridement surgery when wounds appear necrotic, or black of if a wound refuses to heal
These treatments may include the help of doctors, nurses, wound care specialists, and other therapists who can help the patient recover the use of their body as effectively as possible.
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Medical Malpractice In Nursing Homes
When a patient suffers harm because a medical professional fails to provide an appropriate standard of care, this could potentially lead to a Chicago medical malpractice claim. This type of professional negligence may include incorrectly handling a medical procedure, failing to diagnose a condition, not monitoring a patients condition, or prescribing incorrect medication.
The dedicated elder abuse lawyers at Curcio Law have extensive experience with nursing home abuse cases and know how to prove medical malpractice.
Chicago Bedsore Injury Law Firm
You must take immediate action if your loved one develops bedsores. You will prevent their condition worsening and ensure other facility residents dont suffer neglect as well.
An experienced Chicago nursing home abuse attorney helps prove the liable party exercised negligence in their duty of care to their patient. Proving negligence can be tricky, but the legal team at Curcio Law is familiar with Illinois elder abuse laws. Our super lawyers work tirelessly to get you the compensation you or your loved one deserve for pain and suffering, medical expenses, and other damages.
The nursing home abuse lawyers at Curcio Law work for you on a contingency fee basis. We get paid when you get your award. Illinois has a two-year statute of limitations for personal injury or wrongful death claims. So please dont wait to reach out to us. We are here to help you through this difficult time. You may reach us at .
Find Out What Sets Us Apart.
We are committed to utilizing our experience, skills and resources to get you the compensation you deserve. Learn more about us and how we can help.
Call to schedule an appointment at our downtown office or send one of our lawyers an email today.
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Causes Of Pressure Ulcers
Pressure ulcers are caused by sustained pressure being placed on a particular part of the body.
This pressure interrupts the blood supply to the affected area of skin. Blood contains oxygen and other nutrients that are needed to help keep tissue healthy. Without a constant blood supply, tissue is damaged and will eventually die.
The lack of blood supply also means that the skin no longer receives infection-fighting white blood cells. Once an ulcer has developed, it can become infected by bacteria.
People with normal mobility do not develop pressure ulcers, as their body automatically makes hundreds of regular movements that prevent pressure building up on any part of their body.
For example, you may think that you are lying still when asleep, but you may shift position up to 20 times a night.
Pressure ulcers can be caused by:
- pressure from a hard surface such as a bed or wheelchair
- pressure that is placed on the skin through involuntary muscle movements such as muscle spasms
- moisture which can break down the outer layer of the skin
The time it takes for a pressure ulcer to form will depend on:
- the amount of pressure
- how vulnerable a person’s skin is to damage
Grade 3 or 4 pressure ulcers can develop quickly. For example, in susceptible people, a full-thickness pressure ulcer can sometimes develop in just 1 or 2 hours. However, in some cases, the damage will only become apparent a few days after the injury has occurred.
Risk Factors For Pressure Sores
A pressure sore is caused by constant pressure applied to the skin over a period of time. The skin of older people tends to be thinner and more delicate, which means an older person has an increased risk of developing a pressure sore during a prolonged stay in bed.
Other risk factors for pressure sores include:
- immobility and paralysis for example due to a stroke or a severe head injury
- being restricted to either sitting or lying down
- impaired sensation or impaired ability to respond to pain or discomfort. For example, people with diabetes who experience nerve damage are at increased risk of pressure sores
- urinary and faecal incontinence skin exposed to urine or faeces is more susceptible to irritation and damage
- malnutrition can lead to skin thinning and poor blood supply, meaning that skin is more fragile
- obesity being overweight in combination with, for example, immobility or being restricted to sitting or lying down can place extra pressure on capillaries. This then reduces blood flow to the skin
- circulation disorders leading to reduced blood flow to the skin in some areas
- smoking reduces blood flow to the skin and, in combination with reduced mobility, can lead to pressure sores. The healing of pressure sores is also a slower process for people who smoke.
If youre bedridden, pressure sores can occur in a number of areas, including:
- back or sides of the head
- rims of the ears
- backs or sides of the knees
- heels, ankles and toes.
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Some Areas Are More Prone To Infections
Any pressure sore where the skin has broken is susceptible to infection, but the risk is higher when the sore is located around the coccyx or buttocks, particularly if the patient is incontinent, unable to control bowel or bladder. Urine and stool are harsh on the skin and can contribute to the skin breaking down. Once there is a break in the skin, the constant moisture or irritation increases the risk of infection.
Caring For A Pressure Sore
Stage I or II sores will often heal if cared for carefully. Stage III and IV sores are harder to treat and may take a long time to heal. Here’s how to care for a pressure sore at home.
Relieve the pressure on the area.
- Use special pillows, foam cushions, booties, or mattress pads to reduce the pressure. Some pads are water- or air-filled to help support and cushion the area. What type of cushion you use depends on your wound and whether you are in bed or in a wheelchair. Talk with your health care provider about what choices would be best for you, including what shapes and types of material.
- Change positions often. If you are in a wheelchair, try to change your position every 15 minutes. If you are in bed, you should move or be moved about every 2 hours.
Care for the sore as directed by your provider. Keep the wound clean to prevent infection. Clean the sore every time you change a dressing.
Avoid further injury or friction.
- Powder your sheets lightly so your skin doesn’t rub on them in bed.
- Avoid slipping or sliding as you move positions. Try to avoid positions that put pressure on your sore.
- Care for healthy skin by keeping it clean and moisturized.
- Check your skin for pressure sores every day. Ask your caregiver or someone you trust to check areas you can’t see.
- If the pressure sore changes or a new one forms, tell your provider.
Take care of your health.
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Causes And Prevention Of Pressure Sores
Pressure sores are wounds that develop when constant pressure or friction on one area of the body damages the skin. Constant pressure on an area of skin stops blood flowing normally, so the cells die and the skin breaks down.
Other names for pressure sores are bedsores, pressure ulcers and decubitus ulcers.
Who’s Most At Risk Of Getting Pressure Ulcers
Anyone can get a pressure ulcer, but the following things can make them more likely to form:
- being over 70 older people are more likely to have mobility problems and skin that’s more easily damaged through dehydration and other factors
- being confined to bed with illness or after surgery
- inability to move some or all of the body
- medical conditions that affect blood supply, make skin more fragile or cause movement problems such as diabetes, peripheral arterial disease, kidney failure, heart failure, multiple sclerosis and Parkinson’s disease
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A Chronic Ulcer Of The Skin Caused By Prolonged Pressure On It
What Are The Risk Factors For Bedsores
Being bedridden, unconscious, unable to sense pain, or immobile increases the risk that a bedsore will develop. The risk increases if the person is not turned, positioned correctly, or provided with proper nutrition and skin care. People with diabetes, circulation problems and malnutrition are at higher risk.
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How Are Pressure Injuries Treated
Pressure injuries can be treated in many ways depending on the stage. Once the stage and severity of the wound is determined, it must be cleaned, usually with a saline solution. After the wound is cleaned, it needs to be kept clean, moist, and covered with an appropriate bandage. There are several different types of bandages your doctor may use to dress the wound. These include:
- Water-based gel with a dry dressing
- Hydrocolloid dressing
- Alginate dressing
Sometimes debridement is needed. This is a process of ridding the wound of dead tissue. Debridement is an important part of the healing process. It changes the wound from a long-lasting one to a short-term wound. There are several types of debridement. These methods include:
- Ultrasound: Using sound waves to remove the dead tissue.
- Irrigation: Using fluid to wash away dead tissue.
- Laser: Using focused light beams to remove the dead tissue.
- Biosurgery: Using maggots to eliminate bacteria from the wound.
- Surgery: Using surgery to remove the dead tissue and close the wound.
- Topical: Medical-grade honey or enzyme ointments.
Are Bedsores Preventable
Yes, bedsores are absolutely preventable. There are several methods for preventing bedsores. The first is checking the skin for signs of redness each day and paying attention to bony parts of the body. Additional ways of preventing bedsores include:
- Repositioning immobile patients every two hours
- Ensuring those in wheelchairs sit up straight and change position frequently
- Reducing pressure in wheelchairs and beds with soft padding or foam wedges
- Keeping skin clean and dry
- Proper nutrition and hydration. A patient needs fluids, minerals, vitamins, protein, and enough calories to promote healing.
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How Are Bedsores Treated
Specific treatment of a bedsore is discussed with you by your healthcare provider and wound care team and based on the severity of the condition. Treatment may be more difficult once the skin is broken, and may include the following:
- Removing pressure on the affected area
- Protecting the wound with medicated gauze or other special dressings
- Keeping the wound clean
- Removing the damaged, infected, or dead tissue
- Transplanting healthy skin to the wound area
- Negative pressure wound therapy
Healthcare professionals will watch the bedsore closely. They will document size, depth, and response to treatment
If You Use A Wheelchair
Make sure your wheelchair is the right size for you.
- Have your doctor or physical therapist check the fit once or twice a year.
- If you gain weight, ask your doctor or physical therapist to check how you fit your wheelchair.
- If you feel pressure anywhere, have your doctor or physical therapist check your wheelchair.
Sit on a foam or gel seat cushion that fits your wheelchair. Natural sheepskin pads are also helpful to reduce pressure on the skin. DO NOT sit on a donut-shaped cushions.
You or your caregiver should shift your weight in your wheelchair every 15 to 20 minutes. This will take pressure off certain areas and maintain blood flow:
- Lean to one side, then lean to the other side
If you transfer yourself , lift your body up with your arms. DO NOT drag yourself. If you are having trouble transferring into your wheelchair, ask a physical therapist to teach you the proper technique.
If your caregiver transfers you, make sure they know the proper way to move you.
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What Is Another Name For Pressure Injuries
Bedsores are also called pressure injuries, pressure sores, pressure ulcers, or decubitus ulcers. Bedsores can be a serious problem among frail older adults. They can be related to the quality of care the person receives.
What is a pressure injury called?
Bedsores also called pressure ulcers and decubitus ulcers are injuries to skin and underlying tissue resulting from prolonged pressure on the skin.
What is another name for a pressure injury or bedsore quizlet?
The terms , pressure sore, and pressure ulcer have often been used interchangeably in the medical community.
What are common sites for pressure injuries?
Pressure injuries are usually caused by unrelieved pressure on the skin. They often form on skin that covers bony areas. The most common sites are the back of the head and ears, the shoulders, the elbows, the lower back and buttocks, the hips, the inner knees, and the heels.
What types of pressure injuries are there?
The Four Stages of Pressure Injuries
- Stage 1 Pressure Injury: Non-blanchable erythema of intact skin.
- Stage 2 Pressure Injury: Partial-thickness skin loss with exposed dermis.
- Stage 3 Pressure Injury: Full-thickness skin loss.
- Stage 4 Pressure Injury: Full-thickness skin and tissue loss.