Although they are relatively unknown medical conditions, pressure ulcers cost the NHS more than £1.4 million every day (Guest et al, 2017), but what exactly are they and how can they be prevented?
Our brief guide below will help explain the topic in some more detail, however please note that the information we provide is not intended to replace advice or treatment that has been provided by a Healthcare Professional.
What is a pressure ulcer?
A pressure ulcer in an area of damage to the skin and/or underlying tissue, usually over a bony area of the body. Pressure ulcers are also commonly known as bed sores, pressure sores or decubitus ulcers and in severe cases, these can become life threatening.
The areas most vulnerable to pressure ulcers include the bottom, heel, elbow and shoulder although it is not uncommon for pressure ulcers to develop on the back of the ear or on other areas of the head.
The red circles on the three images below identify the most vulnerable areas where pressure ulcers are likely to appear when sitting, lying on your back or lying on your side.
Who is at risk of developing a pressure ulcer?
Pressure ulcers can develop at any age, although those most at risk include:
- People who have difficulty moving or repositioning themselves,
- Those who cannot feel pain over part or all of their body,
- People with poor circulation,
- Those with a poor diet and low fluid intake.
What causes pressure ulcers?
The damage to the skin and the underlying tissues can be caused by a combination of pressure and shear. Pressure in combination with shear is thought to be the most significant factor in pressure ulceration. Friction is also considered a major contributing factor.
Pressure is a direct force which occurs when part of our skin makes contact with a surface. Pressure causes the skin around an area to compress and squash, restricting our blood flow and preventing Oxygen and nutrients being carried to the skin.
Shear is a horizontal force that works in a different direction to pressure, which is a vertical force. Shear causes the skin and underlying tissues to stretch irregularly and usually occurs when someone partially slips down a mattress or chair.
Friction occurs when the skin is rubbed against another surface and can occur when sliding up or down a mattress or chair. Commonly, this damage is on the surface and should heal without any problems, but for some individuals this could potentially progress to something more serious.
In addition to the above, a number of other factors may also contribute to pressure ulcer risk including:
- Body temperature,
- Bad posture,
How can you spot a pressure ulcer?
Most pressure ulcers can be seen just by looking. On lighter skin, you can see pressure ulcers forming when persistent red patches appear after pressure is removed from a specific area, whilst on darker skin, purple patches may be present. Remember, if in any doubt you must contact a Healthcare Professional.
For prevention, you should also keep an eye out for:
- Dry areas of skin,
- Change in skin colour,
- Changes in skin density and feel.
If you think you have, or anybody that you care for has, a pressure ulcer then please contact your doctor or local Healthcare Professional immediately. Don’t wait!
How can you prevent a pressure ulcer?
There are 6 main ways in how you can help prevent an individual forming a pressure ulcer. These are:
- Check the skin for sign of damage at least once a day if lying or sitting for long periods.
- Ensure that the individual experiences regular movement.
- Reposition the person every 15-30 minutes.
- Make sure that the individual has a well-balanced diet and drinks plenty of fluids.
- Ensure that they have a suitable cushion or mattress to help reduce the risk of damage.
- Keep their skin clean and dry using only mild soaps.
For more information on pressure ulcer prevention and to learn more about Invacare’s range of pressure area products, please visit www.thinkpressurecare.co.uk or follow @Tpressurecare on Twitter.
Please note, this content does not constitute medical guidance or diagnosis. If you have any concerns in relation to pressure ulcer preventions and treatment, you must contact your Healthcare Professional.
Guest, J. Vowden, K & Vowden, P. (2017). The health economic burden that acute and chronic wounds impose on an average clinical commissioning group/health board in the UK. Journal of Wound Care - https://www.magonlinelibrary.com/doi/10.12968/jowc.2017.26.6.292