A pressure ulcer, often known as a pressure sore or bed sore, is an area of damage to the skin and underlying tissue.
They are caused by three main things:
- Pressure - Normal body weight can squash the skin and damage the blood supply to an area, leading to tissue damage.
- Shearing - Sliding or slumping down in a bed or chair can damage the skin and deeper layers of tissue.
- Friction - Poor lifting and moving techniques can remove the top layer of skin. Repeated friction can increase the risk of pressure ulcers.
The first sign that a pressure ulcer may be forming is usually discoloured skin, which may get progressively worse and eventually lead to an open wound. The most common places for pressure ulcers to occur are over bony prominences (bones close to the skin) like the bottom, heel, hip, elbow, ankle, shoulder, back and the back of the head.
Pressure ulcers can develop very quickly in some people if the person is unable to move for even a very short time – sometimes within an hour. Without care, pressure ulcers can be very serious. They can damage not just the skin, but also deeper layers of tissue under the skin. Pressure ulcers may cause pain, or mean a longer stay in hospital. Severe pressure ulcers can destroy the muscle or bone underneath the skin, so they can take a very long time to heal. In extreme cases, pressure ulcers can become life threatening, as they can become infected, and sometimes cause blood poisoning or bone infections.
Who gets pressure ulcers?
Anyone can get a pressure ulcer, but some people are more likely to develop one than others. People with a pressure ulcer are also at risk of developing another pressure ulcer. People may be at risk of getting a pressure ulcer if, for example, they:
- have problems moving and cannot change position by themselves without help
- cannot feel pain over part or all of their body
- are incontinent
- are seriously ill or undergoing surgery
- have had pressure ulcers in the past
- have a poor diet and don't drink enough water
- are very old or very young
- have damaged their spinal cord and can neither move nor feel their bottom and legs
- are older people who are ill or have suffered an injury, for example a broken hip.