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Patient Resources


The Doctor’s Guide To: Pressure Ulcers Prevention and Treatment

Kenneth Wright – June 2011
Download this helpful guide to help you or a loved one better understand how to prevent, treat, and live with pressure ulcers.

What Is A Pressure Ulcer?

A pressure ulcer is an injury to the skin as a result of sustained pressure applied to the skin over time (friction and shear play a role as well). The pressure results in reduced blood flow and eventually causes skin breakdown and the development of an open wound. If the conditions leading to the sore are not rapidly corrected, the localized skin damage may spread to deeper tissue layers, affecting muscle, tendon, and bone. If not adequately treated, open ulcers can become a source of pain, disability, and infection.

Why is Prevention Important?

Prevention of pressure ulcers is key because treatment can be difficult. Prevention plans require the skin to be kept clean and moisturized, frequent careful changing of body position (with proper lifting, not rubbing across surfaces), use of special mattresses or supports, management of other contributing illnesses, and implementation of a healthy diet. Relieving or reducing the pressure on the area is essential.

Stages of a Pressure Ulcer

The mild stage, appearing as pink, red, or mottled, unbroken skin that stays that way for more than 20 minutes after the pressure is relieved. The skin feels warm and firm (evidence of swelling under the skin.)

STAGE 1
The mild stage, appearing as pink, red, or mottled, unbroken skin that stays that way for more than 20 minutes after the pressure is relieved. The skin feels warm and firm (evidence of swelling under the skin.)

A blister or a superficial loss of skin appears as an abrasion or shallow crater. It may be painful and visibly swollen.

STAGE 2
A blister or a superficial loss of skin appears as an abrasion or shallow crater. It may be painful and visibly swollen.

A deep crater develops in the skin. Foul-smelling yellow or green fluid may ooze from it if there is infection present. The center is usually not painful because the nerve cells are dead.

STAGE 3
A deep crater develops in the skin. Foul-smelling yellow or green fluid may ooze from it if there is infection present. The center is usually not painful because the nerve cells are dead.

Tissue is now destroyed from the skin to the bone or close to the bone.

STAGE 4
Tissue is now destroyed from the skin to the bone or close to the bone.

When a thick layer of other tissue and puss that may be yellow, gray, green, brown, or black covers the base of the sore and the base of the sore cannot be seen to determine the stage.

UNSTAGEABLE
When a thick layer of other tissue and puss that may be yellow, gray, green, brown, or black covers the base of the sore and the base of the sore cannot be seen to determine the stage.

When there isn’t an open wound but the tissues beneath the surface have been damaged, the sore is called a deep tissue injury (DTI). The area of skin may look purple or dark red, or there may be a blood-filled blister.

DEEP TISSUE INJURY
When there isn’t an open wound but the tissues beneath the surface have been damaged, the sore is called a deep tissue injury (DTI). The area of skin may look purple or dark red, or there may be a blood-filled blister.


How To Treat Heel Pressure Ulcers

Overall, the most effective strategy to prevent and treat heel pressure ulcers is pressure redistribution. A professional heel-offloading device that floats the heel is usually recommended for successful pressure redistribution. The device needs to provide patient comfort and ease of use as it floats the heel. Appropriate offloading, adequate ventilation and friction-free materials are all important features for any product that will be used to prevent or treat heel pressure sores.