A pressure ulcer is a wound that occurs due to prolonged pressure or friction on the skin, disrupting blood circulation to the affected tissue. This results in inadequate blood flow, leading to the accumulation of waste products and cell damage. Pressure ulcers can range from redness, numbness, or abnormal pain to open wounds that may result in tissue death or extend to the bone.
The Four Stages of Pressure Ulcers
Stage 1: Characterized by redness or discoloration of the skin, but the skin remains intact without any breaks or tears.
Stage 2: The wound begins to form as a shallow sore, with the skin starting to blister or show clear fluid.
Stage 3: A deeper wound appears, reaching the fat layer beneath the skin, with total destruction of the affected skin.
Stage 4: A deep wound is visible, exposing bone, tendon, or muscle due to severe skin damage.
Pressure ulcers that appear pale or black are classified as “unstageable.” These often indicate that dead tissue extends deeply into the fat or muscle layers. While the exterior may seem dry, the tissue necrosis can continue to deepen if not treated promptly.
Why Are Pressure Ulcers Dangerous?
If neglected or improperly cared for, pressure ulcers can lead to tissue necrosis that spreads widely and deeply in a short amount of time. This may result in organ loss or infections that could ultimately lead to organ failure and even death.
Who Needs to Be Cautious About Pressure Ulcers?
- Individuals who cannot move normally, such as those with weakness, paralysis, elderly patients, bedridden individuals, or those who must wear casts or assistive devices for extended periods, are at higher risk.
- Additionally, people with incomplete sensation in their limbs, such as those experiencing numbness in their extremities due to diabetes or individuals who have undergone brain, bone, or nerve surgeries, also face increased risk.
Moisture: A Key Factor Increasing the Risk of Pressure Ulcers
In addition to the pressure and friction between the skin and various surfaces, moisture is another significant factor that increases the risk of developing pressure ulcers. Moisture and irritation from sweat, urine, and feces can cause the skin in damp areas to become macerated, peeling, inflamed, and increasingly prone to cell death.
Pressure Ulcers Can Heal, but They May Recur
Most pressure ulcers result from repeated pressure. If positions are changed regularly and equipment is used to avoid prolonged pressure on the same area, there is a chance for the ulcer to heal completely. However, there is also a risk of recurrence.
How to Care for Pressure Ulcers to Reduce the Risk of Complications
- Avoid Repeated Pressure: Ensure that the ulcer is not subjected to repeated pressure. Use tape for securing devices without applying tight pressure to the skin. Change body positions frequently and use pillows to cushion the sore spots and bony prominences.
- Manage Underlying Conditions: If you have pre-existing conditions, it is essential to manage them effectively, such as controlling blood sugar in diabetes or adjusting medications for heart, liver, or kidney issues. Ensure a nutritious diet.
- Keep the Wound Clean: Choose appropriate wound dressing materials.
- Change Positions Regularly: Reposition yourself every two hours.
- Seek Medical Attention: If you notice any unusual symptoms or if the ulcer does not improve within 48 hours, consult a doctor immediately.
Dr. Benjaporn Nantasanti
Specialist in Laparoscopic Surgery
Advanced Technology Surgical Center
Phayathai 3 Hospital
