What are Pressure Ulcers? Symptoms, Risks, Complications and Treatment

Pressure ulcers, which are also known as pressure sores or bedsores, are wounds that develop due to tissue damage caused by shear, friction, and pressure on vulnerable parts of the body. Pressure ulcers can affect the skin and underlying tissue, resulting in pain and discomfort. In acute cases, they can extend through the muscle as deep as the bone, which can result in further problems.

Fortunately, our understanding of how and why pressure ulcers form is now relatively reliable. By recognizing the risk factors and staying alert for early warning signs, caregivers can help avoid the formation of pressure ulcers and aid in the healing process.

This article aims to help you identify these early indicators and to understand how pressure ulcers are currently treated.

Symptoms of Pressure Ulcers

Although an advanced pressure ulcer will appear as a blister or an open sore, the early warning signs are harder to detect. They typically first appear as swelling, discoloration, or alterations in texture on the skin. These changes may be accompanied by temperature variations, which can be detected by touch alone. These early symptoms can progress into what is referred to as a stage two pressure ulcer if left untreated.

Stage 1: Stage one pressure ulcers are painful areas of unbroken skin that may appear reddened. The area may also feel cooler / warmer to touch than the skin around it.

Stage 2: Stage two pressure ulcers look like blisters or shallow wounds, occurring when the skin breaks open due to friction and associated shearing forces, potentially combined with prolonged pressure.

Stage 3: Stage three pressure ulcers start to extend into the tissue under the skin. These are especially severe wounds that may begin to expose layers of fat.

Stage 4: Stage four pressure ulcers are extremely deep injuries that can pierce through muscle down to the bone. These open wounds can damage both joints and tendons.

Who is at Risk of Pressure Ulcer Formation?

Pressure ulcers form on areas of the body that are subjected to the forces of friction, shearing, and pressure over long periods. People who have limited or no mobility are at high risk of developing pressure ulcers, as are people whose restlessness may cause them to frequently rub their heels, for example, on the bed. Clinicians also believe that it could affect people with medical conditions limiting blood flow, but the elderly are, by a great deal, the largest at-risk group.

Common Sites of Pressure Ulcers

Although pressure ulcers can form on multiple areas of the body, the underlying risk factors mean that they typically occur in the following regions:

  • Hips and tailbone
  • Spine and lower back
  • Shoulder blades and backs of the arms
  • Heels and ankles

Complications of Pressure Ulcers

Further problems can be caused by pressure ulcers, including skin and soft tissue infections (cellulitis), joint infections (septic arthritis), and bone infections (osteomyelitis).

In very rare cases, late-stage pressure ulcers may result in sepsis. Patients with long-term, persistent stage three and four pressure ulcers may have a greater risk of developing cancer.

How to Treat Pressure Ulcers

In pressure ulcer treatment, prevention is key. It is vital to know the risks and consistently monitor for early symptoms if you have, or someone that you care for has mobility issues. A movement schedule can help alleviate pressure on affected areas, such as the hips and buttocks of wheelchair users. It is significant to note that movement coaching may be necessary to make sure that patients are moved with care, to prevent shear and friction.

Products to Ease Pressure Ulcer Discomfort

While readjustment is crucial in prevention and treatment, it can also be a slow and painful solution. There are products designed to moderate this discomfort without reducing the effectiveness of dressings. Parafricta fabric is an exceptionally soft textile designed to ease the friction between a surface and a person’s skin.

Returning to the example of the wheelchair, undergarments made with Parafricta materials offer a low-friction barrier between the trunk of the body and the seat, making sliding movements less painful and easier than ever before. With Parafricta undergarments, two issues that contribute to pressure ulcer development (friction and shear) are almost eradicated.

Although it’s always worthwhile to consult the care team before buying new products for pressure ulcer treatment, studies have increasingly shown that Parafricta technology offers many clinical advantages and is an encouraging development to be able to routinely reduce skin damage for at-risk patients.

About Parafricta Parafricta

APA Parafricta Ltd’s range of Parafricta®-branded medical garments and bedding have been clinically proven to offer protection to fragile skin from the damaging effects of friction, which can lead to painful skin breakdown and ulceration (medically known as “pressure” or decubitus ulcers and commonly known as “bedsores”). The products can also ease movement in bed for patients with impaired mobility.

Parafricta® medical products are expertly designed to be easy to use and apply to the areas most at risk of skin damage and ulceration. They are washable and reusable. Bootees are used to protect the vulnerable heel area and undergarments to protect the lower back and buttocks. Parafricta® bedding offers greater ease of movement and comfort to patients whilst in bed, including for patient suffering other fragile skin conditions (e.g. premature babies and burns patients).

Parafricta® medical products incorporate proprietary ultra-low friction fabrics to protect patient skin. Friction can cause skin to stick to surfaces on sheets and mattresses which leads to jolting or wrenching and damages the skin’s structure and integrity. Parafricta® ultra-low friction fabrics move much more freely and smoothly over skin and the underlying surface. The technology employed in Parafricta® products is covered by granted and pending patents (for example European Patent EP1 641420 B1).

Published research has demonstrated that use of Parafricta® garments can reduce the cost of treating skin damage by £63,000 per 100 at risk patients. Elimination of “pressure” ulcers is a key objective of the NHS’s Harm-Free Care agenda and the new Clinical Commissioning Groups in England are incentivising successful reduction in the prevalence of skin damage with extra payments to providers of acute and community care.

Parafricta technology has other potential applications in the non-medical arena such as sportswear and consumer products. Please contact Parafricta if you have a non-medical enquiry.


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Last updated: Nov 21, 2019 at 5:13 AM

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