Pressure Sores

(Pressure Ulcers; Bed Sores; Decubitus Ulcers)

Definition

A pressure sore is a lesion that develops on the skin and underlying tissues, usually over bony areas, due to unrelieved pressure.
Pressure Sore (Skin Ulceration)
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Causes

Pressure sores result from lying or sitting in one position for too long a time. The skin and tissues need enough blood supply for oxygen and nutrients. Prolonged pressure cuts off the blood supply to tissues that are compressed between a bony area and a mattress, chair, or other object. Without oxygen and nutrients, the tissue starts to become damaged and dies.Several factors contribute to the development of pressure sores including:
  • Pressure—Pressure sores can result from the inability to change position or to feel discomfort caused by pressure. People with normal mobility and sensation change position automatically, without thinking.
  • Friction—Even friction from pulling someone across bed sheets can damage small blood vessels that supply the skin tissue.
  • Poor nutrition
  • Moisture—This can come from sweating due to fever or leakage of urine or stool.
  • Obesity —Extra weight increases pressure on the skin over the bones and joints.

Risk Factors

This condition is more common in older adults and people of African American or Hispanic descent. Other factors that may increase the chance of pressure sores include:
  • Immobility, such as being bed- or chair-bound
  • Sensory loss
  • Poor nutrition
  • Low body weight
  • Incontinence
  • Chronic or complex medical problems, such as:
    • Anemia
    • Infection
    • Poor circulation
    • Neuropathy
    • Dementia
    • Cancer
    • Diabetes
    • Stroke
    • Spinal cord injury or paralysis
  • Bone fracture
  • Swelling or water retention
  • Dry skin
  • Fever

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