Pressure Ulcers: Causes and Treatments

When consistent pressure and rubbing occurs on one area of the body, it can cause the skin to break down. This is because the pressure results in reduced blood flow in the area that contributes to dying skin. Also referred to as pressure ulcers, these spots are more likely in patients who are older, have fragile skin, or have a condition that affects blood flow, such as diabetes or vascular disease.

What are the symptoms of pressure ulcers?

Pressure ulcers are characterized by red skin that worsens over time. Blisters will form first, followed by an open sore. There are four main stages of pressure ulcers:

• Stage I – The area of skin is reddened
• Stage II – There are blisters or an open sore, and the area around the blister/sore is red and irritated
• Stage III – There is an open, sunken hole in the skin called a crater, and possible damage to tissue under the skin
• Stage IV – The ulcer is so deep and severe, the muscle and bone underneath is damaged

Many patients also notice that the affected area is more firm, tender, warmer, or cooler compared to nearby areas of skin. Pressure ulcers are common on the feet, ankles, and heels, but can also develop on the buttocks, hips, shoulders, and back depending on the root cause and source of pressure.

How are pressure ulcers treated?

Treating pressure ulcers is very important, because without treatment, the area can become infected and the infection can spread to the rest of the body.

It is most important to relive pressure on the area and prevent further friction. This can be done with rest, wide and comfortable shoes, or shoe inserts that redistribute weight. Your doctor will provide specific instructions for cleaning and it is important to follow them carefully. In most cases, cleaning involves a salt water rinse and washing the area with gauze. Your doctor might also prescribe medication for pain or to prevent infection. You should also eat a balanced diet to encourage the healing process, change your bedding frequently, and use talcum powder if your feet are vulnerable to being moist.

If the pressure ulcer does not heal, surgery may be necessary to treat an infection, reduce fluid loss, or improve hygiene. Often, a pad of skin or muscle is used to cover the wound.