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What is a pressure sore (decubitus ulcer)?

A pressure sore consists of skin or tissue damage that occurs due to decreased blood circulation at the site of pressure.
Slight redness at the affected skin site can be seen initially (the first sign of tissue damage). The tissue underneath it perishes due to poor blood supply. Various skin layers, muscle and bone can be affected. 

Every patient, who stays immobile due to chronic illness or during the post-operative period, is exposed to high risk of developing pressure ulcers.

In the patients care program during his hospital stay as well as at home, the patient and his family are informed about the risk factors and preventive measures, he has to take to avoid pressure ulcers. 

In case a pressure ulcer is already formed, wound management with the application of modern wound dressings and pressure reliving devices is necessary. 

Risk factors: 

The most important cause of tissue damage leading to pressure ulcer development is pressure. Tissue damageis proportional to pressureintensity and the duration of capillary compression.

Other factors contributing to the risk of developing pressure ulcers:

• Ageing
• Smoking
• Skin status: elasticity, edema, dryness
• Tissue hypoxia, caused by underlying disease
• Nutritional anomalies (being overweight or underweight)
• Immunological anomalies
• Neurological disorders
• Altered level of consciousness
• Incontinence
• Medications
• Decreased mobility, caused by pain, tiredness or stress
• Hygiene deficit
• Lack of knowledge of potential damage

Preventive measures:

Change patients' position: 

One of the simplest and most effective measures is changing the patients position frequently.

• If the patient is unable to change position himself, caregivers and healthcare professionals should assist him.
• People who are confined to bed need to change their position at least once every two hours.
• The person in a wheelchair should change position at least every 15 to 30 minutes.

In the case that a pressure ulcer is already formed, it is important to avoid putting additional pressure on it, either by regular changing the position or by using pressure off-loading devices. This will give the wound the best chance of healing.

Follow a healthy and balanced diet:

A healthy and balanced diet with an adequate amount of proteins, vitamins and minerals helps prevent skin damage and in case a pressure ulcer has already formed, it will help wounds heal faster. If necessary, the patient may be referred to a dietitian who will establish a dietary plan for him.

Care the skin:

It is important to inspect the areas of skin at risk daily. You can use a mirror to check the parts of your body that are difficult to see, such as your buttocks and heels. If you notice any change, skin discoloration (permanent redness, brown color) you should contact your healthcare professional, GP or community nurse if you are at home, or one of your nurses if you are in a hospital or nursing home.