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January 25, 2022  
WOUND NEWS: Wound Technology

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  • Frequently Asked Questions

    January 20, 2002

  • Request information on pressure-relief surfaces

  • What are pressure ulcers?

  • Where are pressure ulcers most likely to develop?

  • Who is at risk to develop pressure ulcers?

  • Are pressure ulcers preventable?

  • How can pressure ulcers be prevented?

  • What technology is available to help?

  • Once I have an ulcer, how do I treat it?

  • What if my doctor does not know a lot about pressure ulcers?
  • What are pressure ulcers?
    Pressure ulcers, also known as bedsores or decubitis ulcers, develop when skin is squeezed between a bone and an external surface, such as a bed or chair. Unrelieved pressure on skin squeezes the blood vessels that supply nutrients and oxygen to skin and other tissue. This kills the tissue, starting with the tissue closest to the bone.

    Even mild rubbing or friction can cause or increase the severity of a pressure ulcer, which can develop in as little as 1-2 hours. Some pressure ulcers stop at a mild redness, while others can develop into deep craters, where the skin is open and a cavity can open all the way to the bone. They can cause secondary infections that can cause death.

    Where are pressure ulcers most likely to develop?
    They are most likely to develop at the tailbone, heels, elbows, shoulder blades, knees, ankles, the back of the head or the spine-wherever there is a lot of pressure between the bone and an outside surface.

    Who is at risk to develop pressure ulcers?
    Anyone confined to a chair or bed is at risk. Incontinence and decreased sensory perception (due to a stroke, for example) increase the likelihood of developing bedsores.

    How can pressure ulcers be prevented?
    You can take a variety of steps to help prevent pressure ulcers, or to minimize them once they begin to develop. However, for the bed- or chair-bound individual, some bedsores may be unavoidable.

    Bed-bound individuals should be moved at least every two hours. Chair-bound individuals should change positions every 15 minutes if possible. The patient or the caretaker should take care to wash the patient properly, especially if the patient is incontinent. Over-washing, and certain types of cleansers, can irritate the skin, and should be avoided. For more information, see our risk and prevention fact sheet.

    What technology is available to help prevent pressure ulcers?
    A variety of pressure-reducing beds and cushions are available, including air-fluidized beds and low air-loss beds. Tempur-Med makes cushions and beds with a high-density, fluid-like material that reacts to pressure and heat and distributes weight more evenly than the traditional foam used in health care mattresses.

    Lifting devices help minimize friction when moving chair- or bed-bound individuals. These include lift sheets, belts, sliding boards and hydraulic lifts for the most serious cases. For more information on assistive devices, try the Senior Care Web site.

    Once I have an ulcer, how do I treat it?
    Until it is in its most serious stage, pressure ulcers may be healed without surgery. In the early stages (Stage 1 and 2), characterized by redness (Stage 1), and blistering and cracking (Stage 2), the area should be kept exposed, free from pressure and dry. Gentle massage can help facilitate healing. Even in Stage 3, when the ulcer is a crater-like sore and bacterial infection is probably present, treatment may focus on draining and dressing the wound, and using topical ointments to promote healing. Moist wound dressings facilitate the body's natural healing process.

    Stage 4 is characterized by tissue death as deep as the muscle and bone. The wound may be dry, black in color, and covered with tough, dead tissue, or it may be moist and oozing dead cells. At this point, surgery is probably necessary to replace the dead cells with healthy tissue. A skin graft is likely, and plastic surgery may be necessary. Talk to your doctor for more information about which surgical options are right for you.

    What if my doctor does not know a lot about pressure ulcers?
    You may have to see a wound specialist for proper treatment.

  • Request information on pressure-relief surfaces

    Last updated: 20-Jan-02

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