Pressure ulcers, also known as pressure sores and bed sores, occur when circulation is cut off resulting in skin and tissue damage. Pressure ulcers often occur due to limited mobility, such as when a person is wheelchair bound or paralyzed. It is essential one position in not maintained for a prolonged period of time to prevent pressure ulcers from developing. Should a pressure ulcer develop, it is vital that prompt treatment for the ulcer is received. Timely treatment of pressure ulcers is critical because the severity of the ulcer can increase, causing numerous and severe complications.
Pressure ulcers are often caused by three factors: friction, sustained pressure and shear. While it is important to shift positions frequently to prevent pressure ulcers, in doing so the friction from the movement can damage the skin, making it more susceptible to the ulcers. Sustained pressure is the leading cause of pressure ulcers. This occurs when the skin becomes trapped between the bone and a surface, decreasing circulation to the area. Shear causes pressure ulcers when the skin is moved in one direction while the bone within the skin moves in another direction, causing the skin to stretch excessively.
Stages of Pressure Ulcers
There are four stages that classify pressure ulcers. Each stage measures the severity of the pressure ulcer. If timely treatment of pressure ulcers is not received, the stage the ulcer is classified under will increase, as well as the risks and complications associated with it.
A stage I pressure ulcer occurs when the skin begins to become irritated and can quickly be treated once the pressure is removed from the area. If a stage I pressure ulcer is not treated, it develops into a stage II ulcer, which occurs when skin loss causes the sore to become an open wound, often taking the form of a blister or abrasion. If a stage II ulcer does not receive treatment, the severity of the pressure ulcer continues and develops into a stage III, which results when extensive tissue damage has occurred. When left untreated, a stage III ulcer develops into a stage IV, which causes damage to the muscles, bones and tendons.
Complications of Pressure Ulcers
Timely treatment for pressure ulcers is essential because ongoing pressure ulcers can cause a skin infection known as cellulitis and even osteomyelitis, which is a bone infection. Further complications of pressure ulcers include a blood infection known as bacteremia, a soft tissue infection known as necrotizing fasciitis, and endocarditis, an infection of the heart lining. Pressure ulcers can even cause an infection in the spinal fluid, known as Meningitis.
Septic arthritis is likely to occur during the later stages of untreated pressure ulcers, which involves joint pain and inflammation due to a bacterial infection. Often, abscesses occur from untreated pressure ulcers. These abscesses typically cause pain, swelling, and tenderness and are most likely to occur near the hips. If an untreated pressure ulcer reaches the fourth stage, it is even possible for cancer cells to develop, known as Squamous cells.
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