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According to the Agency for Healthcare Research and Quality (AHRQ), the number of hospital patients who develop pressure sores, also known as decubitus ulcers, pressure ulcers or bed sore has rose by 63% over the last 10 years. Those most at risk of developing pressure sores are those whose mobility or sensation of pressure are impaired. This includes the elderly, stroke victims, people with dementia or head injuries and anyone who is bedridden or confined to a wheelchair. This injury is caused by unrelieved pressure to the skin, which cuts off the circulation to the area. While pressure sores can develop on any area where pressure is not relieved, it often happens over "bony" prominence such as the heels, ankles or the sacrum. These areas have less "padding" of fatty tissue or muscle and the skin is compressed between the hard surface the skin is against and the bone. Pressure ulcers can also be caused by friction on delicate skin from rubbing on sheets, casts or braces.

Seniors are at higher risk as they typically lose muscle and subcutaneous tissue and may have conditions such as diabetes that affect their circulation. Poor nutritional status also makes them more vulnerable.

Pressure ulcers are graded on a scale of one to four based on the severity and depth of tissue injury. There can be mild redness that resolves in short time when pressure is relieved. More severe injury can result in blisters or progress to open wounds that may be very deep and involve organs or bone. Treatment is based on the severity of the wound and can often be extensive. The AHRQ found that the average stay for patients admitted to hospital for treatment of pressure sores was 13 days, with an average cost of $37,500 dollars per hospital stay.

For anyone at risk pressure sores are not a minor health event. The best treatment is prevention. Patients, family and caregivers need to understand the risks of pressure ulcers and how they can be prevented. There are several ways to relieve pressure on skin. Any patient who is bedridden, in a wheelchair or otherwise immobilized should have a change in position every two hours at a minimum. This may include moving a patient from bed to chair or just helping them to turn in bed. There are also devices that can help relieve pressure and pad bony areas. These devices include sheep skin padding, air mattresses, silicone pads and specialized flotation mattresses. It is also very important to keep the skin clean and dry, especially if the patient may be incontinent. Plastic or rubber should not be used right against the skin as it can hold in moisture that is a breeding ground for infection. Nutritional status should also be addressed as it can affect healing.

SOURCES:Number of Patients With Pressure Sores Increasing, Medscape, Posted June 15, 2006; Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland.

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