Pressure ulcers – prevention, treatment and what to look out for

Pressure ulcers, bedsores or pressures sores are all different labels for the same, potentially dangerous problem which can affect anyone but especially frail older adults.

Causes and risks?

These ulcers develop when the blood supply to the skin is cut off for more than 2 to 3 hours.  As the skin dies, it turns red, becomes painful and eventually turns purple. If it is not treated, the skin can break down and become infected causing sepsis.

Although anyone can develop a pressure ulcer, they are more likely to develop in older adults because they are more likely to have mobility problems and skin that’s more easily damaged through dehydration and other factors.

The people most likely to be affected are those who are confined to bed or use a wheelchair, and those who have poor sensation, circulation, or nutrition.

It’s thought that one fifth of people in nursing and residential care homes are affected by pressure ulcers.

These ulcers most commonly – but not exclusively – affect the skin around the tailbone (sacrum), and heels.

Pressure ulcers vary in severity depending on how much skin and tissue is damaged.  They can often take a long time to heal.

What can you do about pressure ulcers?

Good quality care at home or in hospital can prevent most pressure ulcers from forming but there is evidence that that patients, families and carers are poorly informed about what they can do and staff could do more to help them and those at risk.

If you are concerned that someone you care about might have or develop a pressure ulcer then do not delay asking their doctor for help and advice.

As you can read in this NHS leaflet you can also ensure that:

• • They have the correct Support – this might be in the form of a special support cushion if they use a wheelchair or an air mattress for their bed

• • Their Skin is inspected regularly to identify any early signs of a problem – early inspection means early detection. If appropriate you should be shown what to look for.

• • They are Kept moving as much as possible to avoid any prolonged pressure causing problems with the blood supply to any area of the skin

• • They are kept clean and dry in the event of any Incontinence or moisture

• • They have the right Nutrition and hydration

These are the SSKIN principles which are explained in this dramatic 2 minute video:

You can also find out more about preventing and treating pressure ulcers on this NHS site all about pressure ulcers, and the more general NHS information site.