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A pressure injury on the skin is caused by constant pressure to one or more areas or spots of the skin. The pressure damages the skin and underlying tissues, creating an injury. This can happen when you lie in bed or sit in a chair or wheelchair for a long time.
Pressure injuries usually occur over bony areas, such as your sit bones, hips, lower back, elbows, heels, and shoulders. Pressure injuries can also occur in places where the skin folds over on itself, or where medical equipment presses on the skin, such as when oxygen tubes press on the ears or cheeks.
Pressure injuries can range from red areas on the surface of the skin to severe tissue damage that goes deep into muscle and bone. Severe injuries are hard to treat and slow to heal. When pressure injuries do not heal properly, problems such as bone, blood, and skin infections can develop.
Pressure injuries are caused by constant pressure on the skin and tissues.
Other things that can make pressure injuries more likely include:
At first, the skin may appear reddened. Or the skin may look purple or dark red. For people with darker skin, the affected area may appear as patches of even darker skin, maroon skin, or purple skin. The injury may be tender and warm to the touch. It may break open or form a wound or an ulcer where fat, bone, or muscle may be visible.
A doctor can diagnose a pressure injury by examining it. In some cases, the doctor may want to do blood tests to check for infection or to see if you're getting enough protein in your diet. The doctor may also want to do a skin and wound culture or a skin biopsy.
Treatment focuses on helping the pressure injury heal. This involves keeping pressure off the area. Injuries with unbroken skin may need to be kept clean and bandaged. Talk to your healthcare provider about how to treat your pressure injury. If the open injuries are wounds or ulcers, your doctor may remove dead tissue from the wound to prevent an infection. You may need special dressings. Some people may need surgery.
Relieving and spreading out pressure over the skin and tissues is the most important part of both preventing and treating pressure injuries. Putting pressure on one spot for long periods of time damages the skin and underlying tissues. Pressure can be relieved and spread in several ways. Often a combination of these is best.
If you or someone you care for is not able to move much, it's important to prevent pressure injuries and to check the skin every day. If you think that a pressure injury is forming, take steps to treat it. Talk to your doctor or nurse about what more you can do.
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
Treatment focuses on preventing a pressure injury from getting worse and on making the skin healthy again. It may include:
Negative-pressure wound therapy, also called vacuum-assisted closure, may be used to help with healing.
Researchers continue to study these and other treatments for wounds, including electrical stimulation, hyperbaric oxygen therapy, platelet-derived growth factor, and ultrasound therapy.
Adaptation Date: 6/13/2023
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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