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What are pressure ulcers?

elderly man in bed

Pressure ulcers are commonly known as pressure sores or bed sores. They most often affect people who are confined to bed or chair. Pressure ulcers can be superficial or deep and vary in appearance. The skin may be intact, appear as a graze or a deep opening in the skin. They usually occur over bony areas of the body, e.g. base of the spine, buttocks, heels, hips etc. 

How are they caused? 

  • Pressure – due to sitting or lying in one position for too long.  

  • Shearing (Dragging/Sliding) – caused by the body sliding down the bed or chair.  

  • Friction – caused by skin rubbing on the bed or chair  

  • Continuous use of devices such as oxygen masks 

A pressure ulcer can take as little as one or two hours to form. There are many reasons why you may be at risk of getting a pressure ulcer: 

  • You have poor posture, have difficulty moving about, are elderly or weak, or have a serious illness or life threatening illness.  

  • If you are incontinent or you have trouble keeping your skin dry, your skin has lost the sense of feeling, for example because you are diabetic or have had a stroke, you have heart problems or poor circulation and most commonly if you are in bed most of the time or spend long periods in a chair. 

Where can they occur? 

Pressure ulcers most often develop on skin that covers bony areas of the body such as, heels, ankles, hips, buttocks, tailbones, or areas where devices are used (such as braces, collars, masks, tubes, etc). 

SYMPTOMS INCLUDE: 

  • Unusual changes in skin colour or texture  

  • Swelling  

  • Some bony prominences might seem cooler or warmer to touch than the other  

  • Tenderness over bony prominences  

  • Leaking fluid if there is a wound present  

If you notice any red, purple, or blue areas on your skin, or have any parts of your body that are tender or sore to touch, be sure to tell a member of the team looking after you.  

On darkly pigmented skin there may not be visible blanching, the colour may differ from the surrounding skin. The area may be painful, firm or soft. You can try a skin test to check: 

Press a finger on a discoloured area of skin, then release. 

  • If the skin remains discoloured after the finger is released, damage may have occurred. This may soon worsen if the cause is not removed or reduced. 

  • If, after changing position and relieving pressure for 20 minutes, an area of redness remains, even if it still blanches this may indicate early skin damage. 

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