Pressure ulcer surgery can be challenging, especially because most people who have the procedure are already in a poor state of health. There is a risk of a large number of possible complications occurring after surgery, including:. Despite the risks, surgery is often a necessity to prevent life-threatening complications, such as blood poisoning and gangrene the decay or death of living tissue. Even with the best possible medical care, complications can arise from grade 3 or grade 4 pressure ulcers and can occasionally be life-threatening.
Infection can spread from the site of the pressure ulcer to a deeper layer of skin. This type of infection is called cellulitis. It causes symptoms of pain and redness, plus swelling of the skin. It will need to be treated with a course of antibiotics.
Left untreated, there is a risk that the infection can spread to the blood see below or the underlying bone or joint. In rare cases, where pressure ulcers involve the lower back, tail bone and spine, the pressure ulcer can spread to the membranes that surround the spine and brain. This is known as meningitis. If a person with a weak immune system has a pressure ulcer that becomes infected, there is a risk that the infection will spread into their blood and other organs.
This is known as blood poisoning or septicaemia. In the most serious cases of blood poisoning, damage to multiple organs can lead to a large drop in blood pressure, known as septic shock , which can be fatal. Symptoms include cold skin and an increased heart beat. Blood poisoning is a medical emergency.
It requires immediate treatment in an intensive care unit ICU , so that the functions of the body can be supported while the infection is treated with antibiotics or antiviral medication. Read more information about blood poisoning. Infection can also spread from a pressure ulcer into underlying joints septic arthritis and bones osteomyelitis.
Both of these infections can damage the cartilage, tissue and bone. They may also affect the joints and limbs. Antibiotics are required to treat bone and joint infections. In the most serious of cases, infected bones and joints may need to be surgically removed.
Necrotising fasciitis, commonly known as "flesh-eating" bacteria, is a serious skin infection that causes rapid tissue death. It can occur when a pressure ulcer becomes infected with a particular type of bacteria, such as Group A streptococci. Emergency treatment is required. It involves a combination of antibiotics and surgical debridement of the dead tissue.
Gas gangrene is a serious but rare form of infection that occurs when a pressure ulcer becomes infected with the clostridium bacteria. The bacteria thrive in environments where there is little or no oxygen. They produce gases and release dangerous toxins. Symptoms of gas gangrene include severe pain and rapid swelling of the skin.
Gas gangrene requires immediate treatment with surgical debridement. In the most serious of cases, it may be necessary to amputate the affected body part to prevent the gangrene from spreading to the rest of the body. As part of your treatment plan, your care team will discuss with you the best way to prevent pressure ulcers. This will be based on your individual circumstances. Making regular and frequent changes to your position is one of the most effective ways of preventing pressure ulcers.
If a pressure ulcer has already developed, regularly changing position will help to avoid putting further pressure on it, and give the wound the best chance of healing. As a general rule, wheelchair users will need to change their position at least once every 15 to 30 minutes. People who are confined to bed will need to change their position at least once every 2 hours. Once you have developed a pressure ulcer, it's important that you minimise or avoid putting any further pressure on it to give the wound the best chance of healing.
If you are unable to change position yourself, a carer or relative will need to assist you. For more information and advice about positional changes, read about treating pressure ulcers.
Eating a healthy, balanced diet that contains an adequate amount of protein and a good variety of vitamins and minerals can help prevent skin damage and speed up the healing process. You may be referred to a dietitian so that a dietary plan can be drawn up for you. If you currently have a reduced appetite due to a pre-existing health condition, the following advice may be useful:. Read more information about healthy eating for more advice.
If you have known risk factors for pressure ulcers, it's important that you check your skin on a daily basis for any signs of pressure ulcers, such as discoloured areas of skin. This is particularly important if you have an underlying condition, such as nerve damage or diabetes, which may dampen or numb feelings of pain in certain parts of your body. You can use a mirror to check the parts of your body that are difficult to see, such as your bottom and the heels of your feet.
If you notice any damage, report it to your care team. If you are at home, contact your GP or community nurse. If you are in hospital or a nursing home, inform one of your nurses or carers. If you are a smoker, giving up is one of the most effective ways of preventing pressure ulcers. Smoking reduces the levels of oxygen in your blood. It also weakens your immune system, which increases your risk of developing pressure ulcers.
Read about quitting smoking for further information and advice about giving up smoking. Home Illnesses and conditions Skin, hair and nails Pressure ulcers. Pressure ulcers See all parts of this guide Hide guide parts 1. About pressure ulcers 2. Symptoms of pressure ulcers 3. Causes of pressure ulcers 4. Diagnosing pressure ulcers 5. Treating pressure ulcers 6. Complications of pressure ulcers 7. Preventing pressure ulcers. About pressure ulcers Pressure ulcers are an injury that breaks down the skin and underlying tissue.
They are sometimes known as "bedsores" or "pressure sores". How pressure ulcers develop Pressure ulcers can develop when a large amount of pressure is applied to an area of skin over a short period of time.
Who is affected? Treating and preventing pressure ulcers Treatment for pressure ulcers includes the use of dressings, creams and gels designed to speed up the healing process and relieve pressure. These include: regularly changing a person's position using equipment to protect vulnerable parts of the body — such as specially designed mattresses and cushions Read about treating pressure ulcers and preventing pressure ulcers for more information.
Symptoms of pressure ulcers The parts of the body most at risk of developing pressure ulcers are those that are not covered by a large amount of body fat and are in direct contact with a supporting surface, such as a bed or a wheelchair. For example, if you are unable to get out of bed, you are at risk of developing pressure ulcers on your: shoulders or shoulder blades elbows back of your head rims of your ears knees, ankles, heels or toes spine tail bone the small bone at the bottom of your spine If you are a wheelchair user, you are at risk of developing pressure ulcers on: your buttocks the back of your arms and legs the back of your hip bone Severity of pressure ulcers Healthcare professionals use several grading systems to describe the severity of pressure ulcers.
Grade 1 A grade 1 pressure ulcer is the most superficial type of ulcer. Grade 2 In grade 2 pressure ulcers, some of the outer surface of the skin the epidermis or the deeper layer of skin the dermis is damaged, leading to skin loss. Grade 3 In grade 3 pressure ulcers, skin loss occurs throughout the entire thickness of the skin. Grade 4 A grade 4 pressure ulcer is the most severe type of pressure ulcer.
Pressure ulcers also known as pressure sores or bedsores are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. They can happen to anyone, but usually affect people confined to bed or who sit in a chair or wheelchair for long periods of time.
Pressure ulcers can affect any part of the body that's put under pressure. They're most common on bony parts of the body, such as the heels, elbows, hips and base of the spine. If you're in hospital or a care home, tell your healthcare team as soon as possible if you develop symptoms of a pressure ulcer. It'll probably continue to get worse if nothing is done about it.
You should be regularly monitored and offered advice and treatment to reduce the risk of pressure ulcers, but sometimes they can develop even with the highest standards of care. If you're recovering from illness or surgery at home, or you're caring for someone confined to bed or a wheelchair, contact your GP surgery if you think you or the person you're caring for might have a pressure ulcer. These symptoms could be a sign of a serious infection that needs to be treated as soon as possible.
What are pressure sores? Symptoms of pressure sores Pressure sores go through 4 stages. Stage 1. During this stage, the area of the sore looks red. It may feel warm to the touch. It may burn, hurt, or itch. The pressure sore may look blue or purple in people who have dark skin. Stage 2. During this stage, the area is more damaged. The sore may be open. It may look like a cut or blister.
The skin around the sore may be discolored. The sore is painful. Stage 3. During this stage, the sore will have a crater-like look. This is due to increased damage below the surface.
This makes the wound deeper. Stage 4. This is the most serious stage. Skin and tissue are severely damaged. The sore becomes a large wound. Infection is possible. Signs of infection at the site include: Thick, yellow, or green pus A bad smell coming from the sore Redness or skin that is warm to the touch Swelling around the sore Tenderness around the sore Signs that the infection has spread include: Fever Chills Confusion or difficulty concentrating Rapid heartbeat Weakness.
What causes pressure sores? How are pressure sores diagnosed? Can pressure sores be prevented or avoided? Lastly, if you smoke, quit. Smoking increases your risk of pressure sores. Pressure sores treatment Treatment depends on the seriousness of the sore. Other things that can help include: Move often. When in bed, change your position at least every 2 hours. Ask for help, if needed. Use foam pads or pillows to take pressure off the sore. Special mattresses, mattress covers, foam wedges, or seat cushions provide support in bed or in a chair.
It can help to use pillows under one side so that your weight rests on the fatty part of your buttocks instead of on your hip bone.
Sit upright and straight when sitting in a chair or wheelchair. This allows you to move more easily and help prevent new sores. Improve your nutrition. This helps heal the sores.
Maintain good hygiene. Stage 1 sores can be cleaned with mild soap and water. Clean stage 2 sores with a salt and water solution. The saltwater removes extra fluid and loose material. Your doctor or nurse can show you how to clean stage 1 and 2 pressure sores.
Your doctor or nurse will likely need to clean stage 3 and 4 pressure sores because of their seriousness. Living with pressure sores Living with pressure sores requires a plan to move and turn frequently. Questions for your doctor What should I do if I or a loved one has pressure sores and is too heavy to move? Does an adjustable bed help reduce the risk of pressure sores?
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