Pressure Sores: What Are They?
Pressure sores are areas of damaged skin and underlying tissue that can develop when the blood supply to a certain part of the body is reduced, due to prolonged pressure. They can affect anyone who spends long periods in the same position, although older people – whose skin tends to be thinner – are often more at risk.
If left untreated, pressure sores can develop into open wounds which, in turn, brings infection risk and serious complications.
It’s important to understand the causes and recognise the early warning signs so that you can reduce the risk of pressure sores occurring or becoming serious.
Where do pressure sores occur?
Pressure sores usually develop in areas where bones are close to the surface of the skin, commonly heels, ankles, hips and sacrum, also elbows, shoulders and the back of the head. They develop in these areas because constant body weight causes soft tissue to press against a bone. The blood vessels supplying underlying tissues and skin in that area can then become compressed, reducing blood flow and therefore the vital delivery of oxygen and nutrients to the area. If the pressure continues, the affected tissue can become damaged and eventually die.
In the early stages, a pressure sore may appear as an area of skin that is red, purple or discoloured. Pressure sores actually develop from the inside (deep tissue layers), progressing to the outside (the skin). The injury begins in the layers of muscle, fat and tissue close to the bone where compression is the highest. This deep tissue can die beneath an intact outer layer before a wound is visible on the surface, which is why early detection is so important. By the time the wound breaks through the skin, often as an open blister or weeping sore, severe damage may have already occurred internally. Left untreated, pressure sores can affect not only skin but also muscles, tendons or even bones
What causes pressure sores?
As the name suggests, the primary cause of pressure sores is prolonged pressure on a particular area. People with limited mobility or lack of movement, who have difficulty moving independently, are the most vulnerable to developing pressure sores as they are less able to move position and are therefore more likely to sit or lie in one place for extended periods of time. They may be unable to move themselves when a position becomes uncomfortable. Reduced mobility can be a result of a long-term condition or can occur more suddenly through onset of illness, injury or surgery. People with paralysis, nerve damage, spinal injury or loss of sensation in certain areas are also at high risk as they can’t feel the discomfort when pressure occurs and will therefore be unaware of the need to shift position
There are other contributing factors, too, in addition to pressure, such as shearing – when the skin is moving one way whilst the underlying tissue moves another, which can occur through slipping or sliding down a bed or chair. This opposite movement between the skin and deeper level tissues can cause damage.
In a similar way, friction can also contribute. Repeated rubbing against bedding, clothing or furniture can weaken the skin and level it susceptible to injury. This is particularly risky for older people whose skin tends to be thinner, more fragile and heals more slowly.
Moisture can further increase the risk. Sweat or prolonged exposure to urine or stools can make the skin weak, damp and more vulnerable to damage. It also adds the extra complication of bacteria, causing higher risk of infection. This added moisture risk through sweating has been a serious concern during the recent heatwaves that we have been experiencing.
In addition to these ‘mechanical’ risk factors, there are also relevant health and lifestyle factors that can increase the risk of pressure sores. These include poor nutrition – lack of protein, vitamins and minerals can weaken skin and limit its ability to repair, dehydration – low fluid intake reduces skin elasticity and blood flow, and circulatory problems – conditions such as diabetes and vascular disease restrict healthy blood flow to skin and tissue.
Recognising the warning signs
To alert you to a potential pressure sore, you need to be aware of any areas of skin that look or feel different to those around them. It may feel warm to the touch, discoloured (red or dark/purple colouring which doesn’t go away when pressed), or feel hard, or sometimes spongy. If you’re able to feel sensation in that area it may feel painful, burning or itchy. Early detection is really important, as is addressing the issue as soon as you realise there’s a problem, to prevent a small area of damage from developing into a much more serious wound. If you have any concerns or if you suspect a pressure sore, contact a healthcare professional urgently.
However, as with most medical conditions, prevention is better than cure. In next month’s blog we’ll be looking at how the right chair can relieve pressure and help to prevent pressure sores from occurring.
For more information about our seating and pressure-relief options, please contact our team of chair experts who will be happy to help and advise you. Call on 01283 704071 or email info@stuartmobility.co.uk.