Classification of pressure ulcers
A pressure ulcer is an injury to the skin and underlying tissues, primarily caused by prolonged pressure on the skin. They can happen to anyone, but usually affect people who are in bed for long periods of time or people who are in a chair or wheelchair for long time.
1. What is a pressure ulcer?
Bedsores - also known as pressure ulcers - are lesions on the skin and underlying tissue caused by prolonged pressure on the skin. Bedsores typically develop on the skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone.
Pressure ulcers are caused by long-term pressure on the skin.
2. Symptoms and classification of pressure ulcers
Pressure sores usually develop gradually, but can sometimes form within hours.
Early symptoms of a pressure ulcer include:
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part of the skin becoming discoloured – people with pale skin tend to get red patches, while people with dark skin tend to get purple or blue patches
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discoloured patches not turning white when pressed
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a patch of skin that feels warm, spongy or hard
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pain or itchiness in the affected area
A doctor or nurse may call a pressure ulcer at this stage a category 1 pressure ulcer.
Later symptoms include:
The skin may not be broken at first, but if the pressure ulcer gets worse, it can form:
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an open wound or blister – a category 2 pressure ulcer
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a deep wound that reaches the deeper layers of the skin – a category 3 pressure ulcer
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a very deep wound that may reach the muscle and bone – a category 4 pressure ulcer
3. Common sites of pressure ulcers
For people who use wheelchairs, bedsores often occur on skin over the following sites:
For people who need to stay in bed, bedsores may happen on:
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The back or sides of the head
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The shoulder blades
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The hip, lower back or tailbone
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The heels, ankles and skin behind the knees
4. Complications of pressure ulcers
Complications of pressure ulcers, some life-threatening, include:
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Cellulitis: Cellulitis is an infection of the skin and connected soft tissues. It can cause warmth, redness and swelling of the affected area. People with nerve damage often do not feel pain in the area affected by cellulitis.
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Bone and joint infections: An infection from a pressure sore can burrow into joints and bones. Joint infections (septic arthritis) can damage cartilage and tissue. Bone infections (osteomyelitis) can reduce the function of joints and limbs.
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Cancer: Long-term, nonhealing wounds (Marjolin's ulcers) can develop into a type of squamous cell carcinoma.
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Sepsis: Rarely, a skin ulcer leads to sepsis.
5. Tips for skin care
You can help prevent pressure ulcers by frequently changing positions to prevent stress on your skin. Other strategies include good skin care, maintaining good nutrition, quitting smoking, managing stress, and exercising daily.
Consider the following suggestions for skin care:
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Keep skin clean and dry. Wash the skin with a gentle cleanser and pat dry. Do this cleansing routine regularly to limit the skin's exposure to moisture, urine and stool.
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Protect the skin. Use moisture barrier creams to protect the skin from urine and stool. Change bedding and clothing frequently if needed. Watch for buttons on the clothing and wrinkles in the bedding that irritate the skin.
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Inspect the skin daily. Look closely at your skin daily for warning signs of a pressure sore.
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Use Multidex products to treat pressure sores: Multidex gel contains maltodextrin to help seal the ulcer, prevent infection, and heal the wound naturally.
Pressure ulcer after 4 weeks of using Multidex gel