Types of Pressure Ulcers and Bed Sores
There are several types of skin ulceration. Pressure ulcers or bedsores occur when the skin is subjected to constant pressure, which is why they happen so frequently in hospitals and in older patients. They generally start as a blister, and then become an open sore, finally ending in a “crater.” In addition to pressure ulcers, areas of skin breakdown may be due to other types of ulcers, having to do with insufficient blood flow or to diabetic neuropathy.
Insufficient blood flow through the veins usually occurs in the lower legs, and can result in venous insufficiency ulcers, which are often chronic and difficult to heal. They can cause pain in the foot and usually appear purplish in color. They are never found above the level of the knee or in the forefoot, and may occur singly or in multiples.
A related condition, caused by insufficient blood flow through the arteries, is known as arterial insufficiency ulcers, which are painful lesions that usually occur over the ankle or other areas of the foot. Although they may be seen near bony prominences (i.e., joints), they are distinguished from pressure ulcers by their “punched-out” or star-like appearance. The wound may be pale and dry, surrounded by red and taut skin, and can include an area of dead skin.
Diabetic ulcers occur on the foot, usually over the joints or on the top of the toes. These ulcers often occur on the ball of the foot in diabetic patients, due to neuropathy or repetitive injury. Diabetic foot ulcers are often surrounded by a significant thickening of the skin, and are usually insensitive to touch.
There are other, less common causes of ulcers in the legs and feet, which include connective tissue diseases (e.g., rheumatoid arthritis), sickle cell disease, and certain forms of cancer. One’s doctor should take special precaution to rule out these more serious conditions before arriving at a diagnosis of an ulcer.
About the Author
Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.