Pressure sores, also called pressure ulcers and bedsores, usually develop gradually due to pressure against the body, moisture, friction and shearing when people are immobile and not giving sufficient relief to the area in contact with another surface. That can be a chair, bed or wheelchair. They can also develop in hours. Most carers and patients aren’t aware of the damage until it’s too late. Like everything in health, prevention is better than cure.
How to recognise the potential problem?
Early symptoms include reddening of the skin in the affected area, pain or itchiness in the reddened area and finally a localised patch of skin that feels warm, moist, spongy or sometimes hard. Medics refer to this stage as a category 1 pressure sore. If untreated, the pressure sore can get worse, from further reddening, to skin blisters, eventually degrading to an open wound. The deeper the wound the higher the category of pressure sore. Category 4 stage of pressure sores are very deep and can be down to the bone.
Pressure sores can trigger all sorts of other medical conditions if left untreated, causing immense pain for the patient that could result in life threatening complications. So they need to be taken very seriously. If you suspect a pressure sore, you should immediately go to your Doctor or HSE Primary Care unit. If you can’t travel it’s important you get a home visit from your Public Health Nurse, without delay. The start of a red area can progress rapidly to a full-blown open wound in days. Do not delay.
Patients who are prone to pressure sores, mostly elderly, immobile or wheelchair users, should be frequently monitored by healthcare professionals or carers. They should try to cease smoking, improve diet and most importantly regularly reposition themselves so the pressure load is redistributed to other areas. Think of a time you’re sitting in the same position for a long time and you shuffle your bottom – that’s redistributing the pressure load to another area. We do that without knowing why, just for comfort. An elderly, immobile or wheelchair user needs to do that frequently each day.
The treatment required to heal a pressure sore depends on how soon you react. The sooner the better, as it’s a lot easier to heal a category 1 than category 4 pressure sore. A category 4 pressure sore could take months to heal and leave the patient in pain for a long time as they try to avoid surface contact with the area in pain.
The common treatments are as follows:
- Dressings are applied by nurses to help stimulate faster healing. This can be a daily requirement.
- Frequent repositioning at regular intervals to alleviate pressure from the affected area.
- Using special medical foam or air cushions/mattresses to relieve pressure. These are supplied by the HSE or through our shops for those not covered by the medical card. Proper quality products are costly but worth the investment.
- 30 Degree rotational mattress underlay’s, like Toto, can stimulate healing in more difficult stages by constantly repositioning the client without human involvement.
- Nurses cleaning out the wound and removing necrotic tissue to allow healing. This is mostly for category 3 and 4 stages, which are very difficult to heal and require constant supervision and treatment.
- Improvement in diet and intake of supplements, including vitamin C. Studies have shown that patients who look after their diet and take Vitamin C can considerably reduce their susceptibility to pressure sores.
- Maintain dry skin. If there’s incontinence, it’s important to ensure the patient is not left in wet pads for a long time as this can exacerbate the progression of pressure sores.
Studies show that the economic cost of pressure sores cost Governments in the EU billions. The cost of healing one single pressure sore has been estimated to cost the HSE as much as €30,000. It’s not impossible to eliminate pressure sores, but with early intervention, it’s possible to reduce the impact, heal more quickly and most importantly spare the patient a lot of pain.
