Pressure Sores

Pressure sores, also known as pressure ulcers, are preventable wounds that result from prolonged pressure on the skin. The Centers for Disease Control found in 2004 that 1 in 10 nursing home residents suffer from pressure sores, most commonly on bony prominences like elbows, heels, hips, and the back. If nursing home staff fails to properly assess and care for patients who are at risk of pressure sores, residents or loved ones can pursue legal action for pain and suffering resulting from neglect.

Causes of Pressure Sores

When a nursing home resident spends a prolonged period in one position in bed or in a chair, the risk of developing a pressure sore increases significantly. As blood flow slows or stops in the compressed area between bone and the surface of a bed or a chair, the tissue suffers oxygen and nutrient deprivation, resulting in painful sores.

Pressure sores also develop from shearing, where the skin moves in a direction opposite of the underlying bone, or from friction. Sliding or slumping can cause shear and friction irritation that leads to a pressure sore.

Pressure Sore Stages 

Understanding the stages of pressure sores helps staff monitor residents more effectively. Pressure sore stages include:

• Stage I: Non-blanchable erythema, in which the skin is intact and there is non-blanchable redness over a localized area
• Stage II: Partial thickness, in which there is a shallow, open ulcer or blister
• Stage III: Full thickness tissue loss, in which subcutaneous fat may be visible, but muscle, tendon, and bone are not
• Stage IV: Full thickness tissue loss, in which there is exposed bone, tendon, or muscle

Additional serious stages may include an unclassifiable stage with full thickness or tissue loss at an unknown depth, and a suspected deep tissue injury stage at an unknown depth.

Pressure Sore Treatment

Although pressure sore treatment varies based on the stage and severity of the sore, there are steps that nursing home staff can take to treat the wounds. Prompt and consistent repositioning usually heals Stage I sores, while Stage II through Stage IV typically require a multidisciplinary approach between staff, a physician, and nurses. A change of diet to include nutrient-rich foods aids with healing, as does regular wound cleaning with a saline solution and removal of damaged tissue. Proper bandaging and frequent dressing changes are also vital to the treatment of pressure sores.

Pressure Sore Prevention

Nursing home staff must take proactive steps for pressure sore prevention in at-risk residents. Preventative measures include:

• Regular re-positioning to reduce pressure
• Leg support to reduce pressure
• Lying at 30-degree angles in bed
• Close inspection of high-risk areas
• Foam padding for elevation and comfort
• Dry bedding and dry clothing
• Foam, air, water, or gel mattresses

Left undetected and untreated, pressure sores can lead to serious and irreversible problems for residents. Taking legal action after a loved one suffers a pressure sore in a nursing home provides peace of mind and may prevent future incidences for residents.