What are pressure ulcers?
Pressure ulcers are areas of damaged skin and/or underlying tissue. Some people call them pressure sores or bedsores.
Pressure ulcers start with a change in colour to the skin and may appear darker or red in colour. The redness will not turn white (blanch) when it is lightly pressed. The skin can feel hot or cold and you might feel tingling, pain or tenderness in the skin. People with darker skin tones will not present with reddening of the skin, therefore closer inspection of the area may be needed. The area may be, compared to the surrounding tissue:
- Painful
- Firm
- Soft
- Warmer
- Cooler
The most common areas for pressure are the points of the body that take your weight when lying and sitting. These areas will be your bottom, the base of your spine, hips, heels, elbows, shoulders, ankles or the back of your head. However you can get a pressure ulcer anywhere on the body. Pressure ulcers can also occur if a device is in contact with the skin, such as casts, artificial limbs ,orthopaedic braces, urinary catheters, TED stockings, ill fitting footwear and oxygen masks.
What can cause a pressure ulcer?
Pressure ulcers can develop either over a long period of time or quickly. The skin damage happens due to the skin and tissues below having a lack of oxygen. When there is pressure on the skin this prevents the oxygenated blood from flowing to that area.
Pressure ulcers can be cause by two main things:
- Pressure – The weight of a device or body pressing down on the skin
- Rubbing (shearing) – when layers of skin are forced to slide over one another, for example when you are repositioned in a bed or chair or when you slide down a bed or chair
Who is more at risk of developing a pressure ulcer
Anyone can get a pressure ulcer but some people are more at risk than others. These people can include the following if you:
- Are incontinent
- Have problems moving or changing your position your self
- Cannot feel pain in part or all of your body
- Have had a previous pressure ulcer
- Are older or very young
- Are seriously ill or undergoing surgery
- If you are unwell
- Had a broken hip or similar
- Have dementia, problems with thought and/or memory loss, learning disability or brain injury
- Have damage to your spine and can’t feel your bottom and legs
- You have poor circulation or reduced sensation
- You have poor food and/or fluid intake (having poor nutrition and hydration)
- Your skin is frequently moist due to perspiration (sweating) or have loss of bowel and bladder control
- You have dry skin
- You have diabetes
Preventing pressure ulcers
The majority of pressure ulcers are preventable. The best way to avoid developing a pressure ulcer is to keep moving as this eases the pressure on your skin. Other advice is
- Turn over in bed or change your position as often as you can
- Keep the pressure ulcer clean and healthy along with using non scented soaps and moisturisers
- When cleaning the skin use warm water, not hot water and gently pat the skin dry, not rub, with a clean towel or soft cloth
- Eating a healthy diet
- It is just as important to keep well hydrated to maintain heathy skin
- Check your own skin for signs of redness, swelling, blisters, cracks and pain as these may be signs of pressure and report this to a staff member or carers/family
How are Pressure ulcers treated
Pressure ulcers can be very serious if they are not cared for properly. Treating a pressure ulcer is more difficult than preventing one.
Treatments of pressure ulcers can include
- Removal of dead tissue
- Dressings can be used to encourage healing
- Antimicrobial gel if an infection is present
- Relieving pressure with movement
- Keeping the ulcer clean
- Being placed onto a specialist mattress or cushion
Do’s and Don’ts of how to care for your skin
- Do wash your skin with a soap substitute like Aqueous Cream or Emulsifying Ointment or Hydromol
- Do use warm water (not hot tap water)
- Do gently pat the skin dry with a soft cloth or clean towel. No rubbing
- Don’t use soap, shower gel or a foam cleanser
- Don’t use baby wipes to clean the skin
- If using incontinent products Don’t use sudocrem, Metanium, Drapolene or Conotrane as they can effect how the product works
Where can I get further information?
During your hospital stay if you or your family require further information or wish to discuss this, please contact the Ward Staff or the Tissue Viability Team.
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If you have concerns or complaints about a service, please tell a member of staff. You can also call our complaints teams on Freephone 0800 052 0219 or email [email protected]
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(L1208, 11/06/24, archived 12/09/27 V1)
