Pressure injuries

A pressure injury, also known as a bedsore or pressure ulcer, is an area of skin that breaks down or forms an ulcer because of prolonged pressure on the area. Pressure injuries can also be aggravated by friction (skin rubbing against clothing or bedding) or shear (two surfaces moving in the opposite direction). Older people are more likely to develop pressure injuries because of thinner skin or lessened mobility. Body parts that are most at risk of pressure injuries include the tailbone or bottom, hips, the backs of your arms and legs, the back of your head, and shoulder blades.

Signs and symptoms

Pressure injuries can develop in a matter of hours, but noticing a pressure injury early will increase the chance of recovery. Some important signs to watch out for include:

  • A discoloured area of skin that does NOT turn white when pressed
    • People with light skin may get red patches
    • People with dark skin may get purple or blue patches
  • Swelling
  • Tenderness
  • Skin that is hotter or colder than other areas of your skin
  • Blisters
  • Pus draining from the area
  • Itchiness

Prevention

The Health Quality and Safety Commission NZ recommend the SSKIN care bundle for preventing pressure injuries. The five elements of SSKIN are:

Surface – Use a supportive or pressure relieving surface. Avoid creases in bed linen and sitting/lying on buttons. Use pillows to stop knees or ankles touching.
Skin inspection – Regularly check for discolouration or pain in bony and pressure-prone areas.
Keep moving – Change positions often. If lying down, reposition every 2-3 hours. If sitting, reposition or lean every half an hour. Avoid sliding down the bed as this can cause injury to bottom and heels.
Incontinence/moisture – Keep dry and clean.
Nutrition/hydration – Eat a healthy diet and drink lots of fluids.

Treating a pressure injury

If you develop a pressure injury, it is important to address it as early as possible. Pressure injuries are easier to treat in the early stages when the skin is intact. When the skin is broken, it is important to prevent infection so the sore can heal. Treatment may include:

  • Reducing pressure by changing positions frequently or using pressure-relieving mattresses and cushions
  • See your doctor for prescription medicines for pain or itchiness
  • Use gel or foam-based dressings
  • Keep the wound clean and dry
  • Keep up good nutrition and hydration
  • Protect the wound from infection

Talk to your doctor if your pressure injury worsens. See a doctor immediately if there are any signs of infection.

Websites of interest

Find your nearest Age Concern