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Pressure Ulcers (Bedsores)

An ulceration caused by prolonged pressure on the skin and tissues when one stays in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected.

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(Source: NIH - National Library of Medicine)

About Pressure Ulcers

Some people inevitably spend a lot of time in a sitting or lying position. Most of them keep moving and shifting a little, consciously or subconsciously. But people who are extremely weak, paralyzed or unconscious may sit or lie motionless in the same position for a very long time. This puts them at greater risk of developing pressure ulcers (also called bedsores or pressure sores), which are open wounds caused by persistent external pressure against the skin. They can be very painful and usually take a long time to heal.

Causes

Pressure ulcers nearly always develop in places where there are bones right under the skin. This includes the tailbone, heels, hips, shoulder blades, ankles, elbows, ears, and the back of your head.

If your body weight constantly "squashes" your skin in these places when you are sitting or lying, not enough blood can get through to provide oxygen and nutrients. The skin becomes thinner, and it may gradually die over time. This creates an open wound that is especially sensitive when you sit or lie on it.

Risk factors

People who are healthy quickly notice pain whenever there is too much pressure on one part of their body. But some health conditions can affect how you feel pain, and certain external factors can make pressure ulcers more likely to occur:...
Read more about Pressure Ulcers

What works? Research summarized

Evidence reviews

The Prevention and Management of Pressure Ulcers in Primary and Secondary Care

Prevention of pressure ulcers usually involves an assessment to identify people most at risk of pressure ulcers, such as elderly, immobile people or those with spinal cord injury. Assessments are most commonly carried out using specific pressure area risk scores (for example, the Braden or Waterlow scales for predicting pressure sore risk or the, Glamorgan scale for paediatric pressure ulcers).

Pressure Ulcer Treatment Strategies: Comparative Effectiveness [Internet]

Pressure ulcers affect up to 3 million Americans and are a major source of morbidity, mortality, and health care cost. This review summarizes evidence comparing the effectiveness and safety of pressure ulcer treatment strategies.

Pressure‐relieving devices for treating heel pressure ulcers

Pressure ulcers (also known as pressure sores, decubitus ulcers and bed sores) are areas of localised damage to the skin and underlying tissue, believed to be caused by pressure, shear or friction. Pressure‐relieving devices such as beds, mattresses, heel troughs, splints and pillows are used as part of the treatment to reduce or relieve the pressure on the ulcer. Heel ulcers were studied specifically as their structure is very different to the other body sites which are prone to pressure ulcers (such as the bottom) and they are more prone to diseases, such as poor circulation, which do not affect other pressure ulcer sites. We identified one study that was at moderate to high risk of bias. This study lost over half the participants to follow up. More high quality research is needed to inform the selection of pressure relieving devices to treat pressure ulcers of the heel.

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Summaries for consumers

Pressure‐relieving devices for treating heel pressure ulcers

Pressure ulcers (also known as pressure sores, decubitus ulcers and bed sores) are areas of localised damage to the skin and underlying tissue, believed to be caused by pressure, shear or friction. Pressure‐relieving devices such as beds, mattresses, heel troughs, splints and pillows are used as part of the treatment to reduce or relieve the pressure on the ulcer. Heel ulcers were studied specifically as their structure is very different to the other body sites which are prone to pressure ulcers (such as the bottom) and they are more prone to diseases, such as poor circulation, which do not affect other pressure ulcer sites. We identified one study that was at moderate to high risk of bias. This study lost over half the participants to follow up. More high quality research is needed to inform the selection of pressure relieving devices to treat pressure ulcers of the heel.

Electromagnetic therapy for treating pressure ulcers

Pressure ulcers (also called bed sores, decubitus ulcers or pressure sores) are sores on the skin caused by pressure or rubbing. They usually affect immobile people on the bony parts of their bodies such as hips, heels and elbows, and take a long time to heal. Electromagnetic therapy is not a form of radiation or heating, but uses an electromagnetic field with the aim of stimulating healing. However, the review of trials concluded that there is no strong evidence that electromagnetic therapy helps or hinders healing of pressure ulcers.

The effect of therapeutic ultrasound on pressure ulcers.

Pressure ulcers (also called pressure sores, bed sores or decubitus ulcers) are sores on the body caused by pressure or rubbing. They usually happen to immobile people, on bony parts of their bodies, such as hips, heels and elbows.

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More about Pressure Ulcers

Photo of an adult

Also called: Decubitus ulcers, Pressure sores

Other terms to know:
Skin, Tissue

Related articles:
Mattresses and Overlays to Prevent Pressure Ulcers

Keep up with systematic reviews on Pressure Ulcers:

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