My elderly mother, who is quite infirm, developed a pressure sore on her back. While it has now healed, I'd like to know how these sores occur.
Pressure sores, also known as bed sores or decubitus ulcers, are areas of skin damage resulting from a lack of blood flow. They can develop in individuals of all ages who are bed-bound, chair-bound or who are unable to change their position.
Although the sores tend to develop below the waist, they can occur in any area of the body, particularly over bony projections where pressure is concentrated.
The skin is rich in blood supply which delivers oxygen to skin and tissue layers. When the blood supply is compromised by pressure for a period of time, the skin is deprived of oxygen and dies. When the skin breaks down, it forms a sore which is susceptible to infection.
The sore was small but it took a very long time to heal. Why?
In the very early stages of a sore, it may heal itself once the pressure is taken off. However, if the area breaks down or becomes infected, specialised dressings will be required to aid the healing process.
There are a wide range of these to treat pressure sores and your public health nurse or practice nurse will be able to advise on the best one.
Once an ulcer is infected, antibiotics will be needed, while very deep sores may require skin grafting.
The reason why pressure sores take so long to heal is because the lack of movement and the pressure on the skin compromise the circulation of oxygen.
As oxygen is required to help recovery, its absence prolongs the healing process.
What can be done to stop them developing again?
Prevention of pressure sores involves meticulous attention from all care givers. Close daily inspection can detect early redness or discoloration of the skin.
Any signs of redness is a signal the person needs to be kept from lying or sitting on the area until it returns to normal. Movement should be encouraged to allow blood flow. If the person cannot move themselves, then turning them at least every two hours will be necessary.
The skin should also be kept dry and clean. Bony projections such as heels and elbows should be protected with soft material or pads. Special mattresses can reduce pressure on those who are bed or chair-bound. An occupational therapist or public health nurse will advise you on the most suitable ones to help prevent sores.