Pressure Ulcer

Pressure ulcers may also be known as “bed sores.”  Either way, an unpleasant sight should enter your mind.  These areas can occur in a person of any age, but most generally they occur in the elderly on bony prominences if they remain in one position for an extended period of time.  This is why in most hospitals and long-term care facilities there is usually a protocol for turning and repositioning patients every 1 to 2 hours to maintain the integrity of the skin and keep the blood flowing adequately.

Pressure ulcers are caused by increased pressure against areas of the skin that results in limitations of the blood flow to that specific area and to the nearby tissues.  Friction and shear are also contributory factors to the development of pressure ulcers.   Friction and shear can cause a compromised skin area when a patient is pulled up in bed or turned and repositioned.  Or, if the head of the bed is elevated and the patient gradually moves down the skin may be pulled gradually in opposite directions.  If correct technique is not used when assisting someone to turn or reposition, the skin could tear when it is dragged across a surface.  Pressure ulcers fall into one of four categories and are staged according to the characteristics of the wound itself as follows, including:

·        Stage I.  Skin is intact, but appears red, and does not briefly lighten (blanch) when touched.  Area may be tender, painful, firm, soft, warm or cool in comparison with the skin around it.

·        Stage II.  Outer layer of skin and part of the underlying layer is damaged or lost.  Wound area may be shallow, or look like a fluid-filled or ruptured blister.

·        Stage III.  Ulcer is a deep, crater-like wound.  Skin loss usually exposes fat and in the bottom of the wound you may notice some yellowish dead tissue.

·        Stage IV.  At this stage, there will be a large loss of tissue.  The wound may even expose muscle, bone or tendons.  There will still be yellowish dead tissue in the bottom of the wound, and it could also appear dark and crusty.  Damage often extends beyond the primary wound below layers of healthy skin in this stage.

Your provider and a professional who is specially trained in wound treatment will decide which category your pressure ulcer falls into.  A pressure ulcer may also be considered unstageable if its surface is covered with yellow, brown, black or dead tissue.  When the wound is covered with all this different tissue, it is not possible to see how deep it actually is.  You will see that your wound treatment is frequently adjusted in order to keep up with the progression or worsening of the pressure ulcer itself.  The wound treatment professional assigned to your specific case will make frequent visits to you in order to assess your wound and keep up with its course in order to provide the best treatment to see that it resolves as quickly as possible.

Common sites of pressure areas include those areas which are bony prominences such as the tailbone or buttocks, shoulder blades, elbows, back of skull, heels, hips, ankles, skin behind the knees, rims of ears.  Of course the affected area will depend on which position the individual spends the greatest length of time in.  Risk factors of developing a pressure ulcer include increased age, inability to feel pain or discomfort, weight loss, skin that is too moist or too dry, incontinence, having a condition that affects blood flow, smoking, decreased level of alertness, and muscle spasms. 

Total Home Health has a program that is right for you and your specific needs related to your pressure ulcer.  Our professionals will work in conjunction with other providers to ensure that you receive the best and most up-to-date treatment available to provide the best outcomes for your pressure ulcer.  Your safety and overall health is our priorities and we want to make you feel like one of our own.  You, as the client will be involved in your care as much as possible, and our Total Home Health professionals will do our best to see that you understand all aspects of your treatment process.  A trusting relationship and great communication makes all the difference to provide more successful outcomes of treatment.  We guarantee with Total Home Health you will see this first hand…let’s start our journey today!