Dr. MJ Bazos MD,
What are pressure
Pressure sores are areas of injured skin and
tissue. They are usually caused by sitting or lying in one position for too
long. This puts pressure on certain areas of the body. The pressure can reduce
the blood supply to the skin and the tissues under the skin. When a change in
position doesn't occur often enough and the blood supply gets too low, a sore
may form. Pressure sores are also called bed sores, pressure ulcers and
Are pressure sores
Pressure sores can be serious, depending on how
much the skin and tissues have been damaged. You should call your doctor if you
think a sore is forming.
Mild damage causes the skin to be discolored,
but a sore doesn't form. In light-skinned people, the damaged skin may turn dark
purple or red. In dark-skinned people, the area may become darker than normal.
The area of damaged skin may also feel warmer than the surrounding skin.
Deep sores can go down into the muscle, or even
to the bone. If pressure sores are not treated properly, they can become
infected. An infection in a pressure sore can be serious. Pressure sores also
hurt a lot and make it hard for a person to move around.
Who gets pressure
Anyone who sits or lies in one position for a
long time might get pressure sores. You are more likely to get pressure sores if
you use a wheelchair or spend most of your time in bed. However, even people who
are able to walk can get pressure sores when they must stay in bed because of an
illness or injury. Some chronic diseases, such as diabetes and hardening of the
arteries, make it hard for pressure sores to heal because of a poor blood supply
to the area.
Where on the body can you get
Pressure sores usually develop over bony parts
of the body that don't have much fat to pad them. Pressure sores are most common
on the heels and on the hips. Other areas at risk for pressure sores include the
base of the spine, the shoulder blades, the backs and sides of the knees, and
the back of the head.
How are pressure sores
Three things help pressure sores heal:
- Relieving the pressure that caused the sore
- Treating the sore itself
- Improving nutrition and other conditions to help
the sore heal
can be done to reduce pressure on the
Don't lie on pressure sores. Use foam pads or
pillows to take pressure off the sore. Special mattresses, mattress covers, foam
wedges or seat cushions can help support you in bed or in a chair to reduce or
relieve pressure. Try to avoid resting directly on your hip bone when you're
lying on your side. Use pillows under one side so that your weight rests on the
fleshy part of your buttock instead of on your hip bone. Also, use pillows to
keep your knees and ankles apart. When lying on your back, place a pillow under
your lower calves to lift your ankles slightly off the bed. Change your position
at least every 2 hours.
When sitting in a chair or wheelchair, sit
upright and straight. An upright, straight position will allow you to move more
easily and help prevent new sores. If you cannot move by yourself, have your
caregiver shift your position at least every hour, or more often if possible.
How should the pressure sore be kept
In order to heal, pressure sores must be kept
clean and free of dead tissue. You can clean the sore by rinsing the area with a
salt-water solution. The salt water removes extra fluid and loose material. Your
doctor or nurse can show you how to clean your pressure sore.
Pressure sores should be kept covered with a
bandage or dressing. Sometimes gauze is used. The gauze is kept moist and must
be changed at least once a day. Newer kinds of dressings include a see-through
film and a hydrocolloid dressing. A hydrocolloid dressing is a bandage made of a
gel that molds to the pressure sore. These dressings can stay on for several
days at a time.
Dead tissue (which may look like a scab) in the
sore can interfere with healing and lead to infection. There are many ways to
remove dead tissue from the pressure sore. Rinsing the sore every time you
change the bandage is helpful. Special dressings that help your body dissolve
the dead tissue can also be used. They are left in place for several days.
Another way to remove dead tissue is to put wet
gauze bandages on the sore and allow them to dry. The dead tissue sticks to the
gauze and is removed when the gauze is pulled off. Sometimes dead tissue must be
Removing dead tissue and cleaning the sore can
hurt. Your doctor can suggest a pain reliever for you to take 30 to 60 minutes
before your dressing is changed.
Why is good nutrition important for
Good nutrition is important because it helps
your body heal the sore. If you don't get enough calories, protein and other
nutrients, your body won't be able to heal, no matter how carefully you care for
the pressure sore. Your doctor or nurse or a dietitian can give you advice about
a healthy diet. Be sure to tell your doctor if you have lost or gained weight
What if the sore gets
Pressure sores that become infected heal more
slowly and can spread a dangerous infection to the rest of your body. If you
notice any of the signs of infection listed below, call your doctor right away.
Signs of an infected pressure sore include the
- Thick yellow or green pus
- A bad smell from the sore
- Redness or warmth around the sore
- Swelling around the sore
- Tenderness around the sore
Signs that the infection may
have spread include the following:
- Fever or chills
- Mental confusion or difficulty concentrating
- Rapid heartbeat
How are infected
pressure sores treated?
The treatment of an infected pressure sore
depends on how bad the infection is. If only the sore itself is infected, an
antibiotic ointment can be put on the sore. When bone or deeper tissue is
infected, intravenous antibiotics (given through a needle put in a vein) are
How can I tell if the sore is
As a pressure sore heals, it slowly gets
smaller. Less fluid drains from it. New, healthy tissue starts growing at the
bottom of the sore. This new tissue is light red or pink and looks lumpy and
shiny. It may take 2 to 4 weeks of treatment before you see these signs of
How can pressure sores be
The most important step to prevent pressure
sores is to avoid prolonged pressure on one part of your body, especially the
pressure points mentioned previously. It's also important to keep your skin
healthy. Keep your skin clean and dry. Use a mild soap (like Dove, Basis or Oil
of Olay) and warm (not hot) water. Apply moisturizers so your skin doesn't get
too dry. If you must spend a lot of time in bed or in a wheelchair, check your
whole body every day for spots, color changes or other signs of sores. Pay
special attention to the pressure points where sores are most likely to occur.