Pressure ulcers are a serious issue for anyone who is confined to bed or spends long periods of time sitting in a chair or wheelchair or lying in bed in the same position for many hours. The pressure on the skin can cause it, and you may not even know that this has happened until hours later when you start feeling pain in the affected area.
As the pressure causes damage, the skin and tissue breaks down and blood seeps out into the pressure area, resulting in swelling and pressure on the surrounding tissues. Ulcers can occur anywhere pressure is exerted for a long period of time, such as hips (where someone sits all day) or heels (if they can’t move their legs).
What causes pressure ulcers?
Poor blood supply to tissues. Pressure on soft tissue – which contains few blood vessels – reduces the amount of oxygen and nutrients it receives, making it more difficult for the body to repair itself and causing pressure ulcers.
As people age, their skin becomes thinner, dries out and is less elastic, meaning it has a harder time adjusting to pressure or friction. In addition, older people are more likely to have medical conditions that make pressure ulcers more likely. While most pressure ulcers develop in people over age 60, they can affect young adults or even children.
Illnesses or conditions that weaken the body’s ability to heal itself, such as diabetes, cancer, pressure sores and other skin conditions.
Nerve damage from a spinal cord injury or disease that leads to decreased sensation and inability to tell pressure apart from pain pressure.
Sedentary lifestyle. If you don’t move around much, pressure on your skin may not be distributed evenly and cause pressure ulcers. For example, if you can’t change positions to relieve pressure (such as when sitting in a wheelchair), pressure ulcers are more likely to develop in areas without much soft tissue, such as the tailbone, hips and elbows.
Illness or injury that results in a temporary loss of sensation (for example, after a stroke).
Long-term pressure on tissue. Prolonged pressure reduces blood flow to an area and causes pressure ulcers. For example, sitting or lying in one position for too long can place pressure on the skin, underlying tissue and bone. People who use wheelchairs or bedridden patients are most at risk for pressure ulcers.
Diarrhea and vomiting, which can cause pressure as they press on soft tissue from within (intra-abdominal pressure).
Fecal impaction, constipation or diarrhea, which can cause pressure and irritation on the skin and tissues.
What are the symptoms of pressure ulcers?
Pressure ulcers may not be painful when they first develop. As pressure continues, however, people often experience:
- Redness in an area where pressure has been applied for a long time. Depending on the stage of pressure ulcer, the area may appear less red as tissue die.
- Skin that will not heal.
- Wet or weeping skin.
- Ulcers with yellow or greenish fluid, which are signs of infection. Ulcers also can have a noticeable odor to them if they are infected or become infected.