Author Archives: Adam Peck

Treating a pressure sore is much more difficult than preventing one. The main goals of treatment are to relieve pressure on the sores, keep them clean and free of infection, and provide adequate nutrition. Adequate nutrition is important in helping pressure sores heal and in preventing new sores from forming. A well-balanced, high-protein diet is recommended as well as a daily high-potency vitamin and mineral supplement. Supplemental vitamin C and zinc may help with healing as well. Electrical stimulation, heat therapy, massage therapy, and hyperbaric oxygen therapy have not proven helpful.

In the earliest stage, pressure sores usually heal by themselves once pressure is removed. When the skin is broken, a doctor or nurse considers the location and condition of the pressure sore when recommending a dressing. Film (see-through) dressings help protect early-stage pressure sores and allow them to heal more quickly. Hydrocolloid (oxygen- and moisture-retaining) patches protect, keep the skin appropriately moist, and provide a healthy environment for deep sores. Other types of dressings may be used for deeper sores, those that ooze a lot of fluids, and those that are infected.

If the sore appears infected or oozes, rinsing with saline and dabbing gently with a gauze pad are helpful. A doctor may need to remove (debride) dead tissue with a scalpel or a chemical solution. Removal of dead tissue is usually painless, because pain is not felt in dead tissue. Some pain may be felt because healthy tissue is nearby. Health care practitioners may flood (irrigate) the sore, particularly its deep crevices, with a sterile solution to help clean away hidden debris.

Sometimes a bed that circulates air (an air-fluidized bed) is used in hospitals and nursing homes. This special bed helps reduce or redistribute pressure on the body.

Deep pressure sores are difficult to treat. Sometimes they require skin and muscle flaps, in which healthy, thicker tissue with a good blood supply is surgically repositioned to cover the damaged area. This type of surgery is not always successful, however, especially for frail older people who are malnourished. Often, when infections develop deep within a sore, antibiotics are given. When bones beneath a sore become infected, the bone infection (osteomyelitis—see see Bone and Joint Infections: Osteomyelitis) is extremely difficult to cure and may spread through the bloodstream, requiring many weeks of treatment with an antibiotic.

If the skin is intact or appears red on a person whose skin color is lighter, then the person’s condition falls under stage I of pressure ulcers. Some other characteristics of the skin are that it does not lighten for a short period of time when it is touched and the site on the skin may feel painful, firm, soft and either warmer or cooler when compared to the skin that surrounds the site.

If the pressure ulcer is an open wound, then it is considered to be in stage II. In this stage both the upper layer of the skin and a part of the underlying layer are either damaged or even lost. The wound itself will look like a shallow and basin-like wound, red in color. In some cases, it may look like a blister.

If the decubitus ulcer, pressure sore or bed sore has become a deep wound and looks like a crater, then it is already in stage III. The loss of skin is present and even some fat is visible. It is common for the bottom of the ulcer to have some dead tissue of yellow color. At this stage it is not only the healthy layers of the skin that are damaged.

Stage IV is the final and most severe stage of pressure ulcers and bed sores. The wound on the skin will show muscle, bones and tendons and the bottom of it will usually contain slough which is dark in color. Multiple layers of skin are damaged in the final stage.

Every person whose movement is limited needs to make sure to inspect the skin almost daily as a part of routine nursing or home care. At the first signs of pressure ulcers the patients need to contact the doctor because there are a lot more chances of success if the condition is treated in the early stages. If a person experiences a fever or drainage or foul odor from the wound, he or she should immediately contact the doctor and be very concerned about deadly infection.