Articles From Experts
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A pressure ulcer is an injury caused by unrelieved pressure that damages the skin and underlying tissue. Also known by the term bedsores they range in severity from mild (minor skin reddening) to severe (deep craters down to muscle and bone). Unrelieved pressure on the skin squeezes tiny blood vessels, which supply the skin with nutrients and oxygen. When skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms. Skin reddening that disappears after pressure is removed is normal and not a pressure ulcer.Causing factors: If a person slides down in the bed or chair, blood vessels can stretch or bend and cause pressure ulcers. Even slight rubbing or friction on the skin may cause minor pressure ulcers. Anyone who must stay in a bed, chair, or wheelchair because of illness or injury can get pressure ulcers. Fortunately, most pressure ulcers can be prevented, and when pressure ulcers do form, they do not have to get worse. Pressure ulcers occur where bone causes the greatest force on the skin and tissue and squeezes them against an outside surface. This may be where bony parts of the body press against other body parts, a mattress, or a chair. In patients who must stay in bed, most pressure ulcers form on the lower back below the waist (sacrum), the hip-bone (trochanter), and on the heels. In people in chairs or wheelchairs, the exact spot where pressure ulcers form depends on the sitting position.Pressure ulcers can also form on the knees, ankles, shoulder blades, back of the head, and spine. Nerves normally "tell" the body when to move to relieve pressure on the skin. Persons in bed who are unable to move may get pressure ulcers after as little as 1-2 hours. Persons who sit in chairs and who cannot move can get pressure ulcers in even less time because the force on the skin is greater. Risk factors: Bed or chair confinement. If you must stay in bed, a chair, or a wheelchair, the risk of getting a pressure ulcer can be high. Inability to move. If you cannot change positions without help, you are at great risk. Persons who are in a coma or who are paralyzed or who have a hip fracture are at special risk. Risks of getting pressure ulcers are lower when persons can move by themselves. Loss of bowel or bladder control. If you cannot keep your skin free of urine, stool, or perspiration, you have a higher risk. These sources of moisture may irritate the skin. Poor nutrition. If you cannot eat a balanced diet, your skin may not be properly nourished. Pressure ulcers are more likely to form when skin is not healthy. Lowered mental awareness. When mental awareness is lowered, a person cannot act to prevent pressure ulcers. Mental awareness can be affected by health problems, medications, or anesthesia.
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