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PRESSURE ULCERS

Pressure ulcers, also known as bedsores, pressure injuries, or decubitus ulcers, can be a serious problem for older adults, wheelchair users, or those who are bedridden for extended of time. These sores occur when areas of the skin break down due to prolonged pressure, which can reduce blood flow to the affected area. It's important take preventative measures to avoid pressure ulcers and seek medical attention if they do occur.

Although pressure ulcers can happen anywhere on the body, they usually occur on the more bony parts of the body including the hips, back, elbows, heels of the feet, ankles, shoulder blades, tailbone, and the back of the head. For some, pressure ulcers can be uncomfortable and interfere with quality of life, for others they can be even more dangerous and potentially life-threatening if not cared for. Fortunately, most pressure sores can be treated and through proper wound care even prevented.

RISK FACTORS & CAUSES OF PRESSURE ULCERS

Pressure ulcers are a type of slow healing wound caused by prolonged pressure that reduces blood flow or friction that can make the skin more fragile. Some of the people who might be at added risk of developing pressure ulcers include:

  • Older individuals

  • If an injury or surgery causes prolonged inactivity

  • Paralysis or not being able to move without assistance

  • Obesity and/or poor diet

  • Disorders that impair circulation and skin strength such as diabetes

  • If you suffer from incontinence

  • If your injury has caused a loss of sensation

PRESSURE ULCER STAGES

​Pressure ulcers are generally categorized into four stages depending on how deep the wound is and the severity of the symptoms. Categorizing the wound into these stages can help wound care specialists determine the right course of treatment.

  • Stage 1: pressure ulcers are the least severe and can be identified by a reddened, painful area on the skin. The skin does not become white when pressure is applied and the ulcer has not yet broken through the skin. With early intervention, a stage 1 ulcer can heal within a few days.

  • ​Stage 2: categorized by the formation of an open sore as the skin blisters. During this stage the top two layers of skin (epidermis and dermis) have been broken, potentially forming a shallow wound. Stage 2 ulcers typically heal within a few days to a few weeks.

  • Stage 3: categorized by a sunken hole known as a crater or ulcer caused by tissue damage under the skin. During this stage, the sores have fully broken through the skin and fatty tissue can often be seen. Stage 3 ulcers can take anywhere between a month to a few months to fully heal.

  • Stage 4: The final stage is the most severe and serious. During stage 4, the pressure ulcer has become so deep that they have started to damage the underlying muscle and in severe cases the bones. At this stage, there is a higher risk of infection. Due to how severe these types of ulcers are, they can take anywhere between a few months to a couple of years to fully recover.

Deep pressure injury and unstageable sores are two types of severe pressure ulcers that require specialized attention. These ulcers can be more difficult to diagnose and treat, making it important to seek the help of a specialist. If you suspect you may have a pressure ulcer, it's important to seek medical attention as soon as possible to further complications.

​Development and treatment of pressure ulcers depend upon the care you receive. Diagnosis is followed by ulcer staging which, in conjunction with the degree of pain and time of onset, helps determines the course of wound care.

While stage 3 and 4 pressure ulcers should be cleaned and treated by a wound care specialist, there are things you can do to for wounds that are in the first two stages. That said, it’s still recommended to seek professional guidance on proper caring methods.

By implementing this comprehensive approach to fast-acting advanced diabetic wound care, our podiatry wound care office can significantly improve outcomes for patients with diabetic foot ulcers. Our doctors help create the environment where wounds heal faster, reducing complications, and enhancing overall quality of life.

4 Stages of Pressure Ulcers
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