Treatment of pressure sores

Diagnosing a pressure sore

Pressure sores develop when the skin breaks down and creates a wound. There is a risk that the wound can get infected. This can be a serious problem. It is very important to treat infections quickly.

A nurse or doctor must examine you. District nurses can visit and advise on how to look after your skin if you are at home. In hospitals, there are specialist nurses known as tissue viability nurses. They have training in treating pressure sores. They can advise you on the best treatment.

It can take a long time for pressure sores to heal.

Signs of pressure sores

Signs to look out for include:

• purplish or bluish patches on black or brown skin

• red or white patches on white skin

• soreness, itching or pain

• blisters

• swelling

• shiny areas

• dry patches

• cracks and wrinkles

• skin temperature

Relieving the pressure

Changing position

If you develop a pressure sore, it is vital to relieve pressure on the area. Depending on your situation, this may be from as often as every 15 minutes to every 6 hours. The best way to do this is by not lying or sitting on that skin area.

Mattresses and cushions

Several types of special mattresses and cushions can relieve pressure on pressure areas of the body. Your healthcare team will tell you more about the types of mattresses and cushions for your situation.

Mattresses include:

• specially designed foam mattresses, which relieve the pressure on your body

• more sophisticated mattresses or bed systems. For example, a mattress connected to a constant flow of air. This automatically changes the pressure as and when needed

Dressings for pressure sores

If your skin has broken down you may need to have a dressing on it. The dressing protects the area, keeps it clean and moist and helps it to heal.

There are different types of dressings, the one you need will depend on your wound. These could include:

• hydrocolloid dressings – these dressings contain a special gel. The gel helps with the growth of new skin cells in the ulcer. The dressing keeps the surrounding healthy area of skin dry

• alginate dressings – these dressings are made from seaweed. They contain sodium and calcium which helps to speed up the healing process

• other dressings include foams, films, hydro fibres or gelling fibres, gels and antimicrobial (antibiotic) dressings

Your nurse will assess your pressure sore to decide which dressing is best for you, change it as needed and monitor how well it is working.

Surgery for pressure sores

Dead tissue around the sore can slow healing. You may need to remove the dead cells in a process called debridement. It can be done in different ways.

Your nurse may be able to remove the dead tissue when cleaning your wound and changing the dressing. Some of the dressings may help to remove it but sometimes a specialist tissue viability nurse needs to cut dead areas away.

This can usually be done at home or at your GP surgery. More rarely, when the sore is deeper you may need to have an operation in hospital to remove the dead cells and clean the wound.

Other treatments

Other treatments may help in certain circumstances. Your healthcare team can tell you more about them.

They include:

• diet changes and supplements

• suction treatment to remove excess fluid from the wound

• sterile maggots (larvae) are very good at removing dead cells and cleaning the wound