Pressure ulcers, also known as bed sores or pressure
sores, often occur in persons who cannot move around easily. The skin and
tissue underneath break down from continued pressure and poor circulation.
When the skin breaks down, it becomes red. Open sores develop after the skin
changes. In severe cases, the pressure ulcer causes destruction of muscle
or even bone underneath the skin.
Pressure ulcers usually occur in persons who have predisposing risk
factors, such as poor nutrition, continued moisture (especially from urine
or feces), confinement to a bed or wheelchair, and other medical problems
(especially spinal cord injury, hip fracture, or dementia). Because older
people are more likely to need a wheelchair or to spend more time sitting
in a chair or being confined to bed, they need special attention to prevent
formation of a pressure ulcer. It is important for anyone with risk factors
to discuss pressure ulcer formation with his or her doctor. Even mild skin
redness may be the start of a pressure ulcer. The January 8,2003,issue of
JAMA includes an article about pressure ulcers.
Continued pressure on the skin from sitting or lying in one position
causes poor circulation. Blood and lymphatic fluid have difficulty going to
and leaving the pressurized area, causing both a lack of oxygen and swelling.
In persons with poor nutrition or inability to move themselves, this lack
of blood flow may cause the skin to break down. It becomes reddened and may
tear away from the supporting tissue underneath. If the conditions leading
to the pressure ulcer are not rapidly corrected, the skin damage may spread
to the tissue, muscle, and even bone underneath. Pressure ulcers can become
infected. This may make treatment more difficult.
Keep skin free of moisture
Frequently turn or reposition someone who is confined to bed or
to a wheelchair
Air mattresses may be used for high-risk persons
Correct or treat incontinence
Special dressings may be used
Debridement (cutting away dead tissue)or surgery
may be required for severe pressure ulcers
National Pressure Ulcer Advisory Panel
American Academy of Family Physicians http://familydoctor.org/handouts/039.html
National Institutes of Health
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Sources: American Academy of Family Physicians, National Institutes
of Health, National Pressure Ulcer Advisory Panel
Keyword: SKIN CONDITIONS
Pressure Ulcers. JAMA. 2003;289(2):254. doi:10.1001/jama.289.2.254