Pressure sores

Question 1

Define pressure sore

Answer 1

Localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure or of pressure in combination with shear.

Question 2

What are risk factors for pressure sores?

Answer 2

Immobility

Poor nutritional status

Neuropathy (not feel it)

Pain (may not want to move)

Increasing age and frailty

Cognitive impairment

Incontinence

Question 3

What score is used to risk assess patients at risk of developing pressure sores?

Answer 3

Waterlow Score

includes a number of factors including body mass index, nutritional status, skin type, mobility and continence.

Question 4

What areas commonly affected by pressure sores?

Answer 4

Bony prominences

Ears (O2 tubing)

Face (CPAP)

Splints, casts, slings areas

Question 5

What are the stages of pressure sores?

Answer 5

1 = non blanching erythema

2 = partial thickness (superficial skin loss, shallow ulcer)

3 = full thickness skin loss (see SC fat)

4= full thickness tissue loss (see the bone)

Question 6

What Ix in pressure sores?

Answer 6

Clinical diagnosis, so don’t need any

May do wound swab if it looks infected (discharge, smell, erythema, warmth)

Question 7

What is Rx of pressure sores?

Answer 7

Tissue viability: position changes, mattress support, dressings, creams)

Analgesia

Abx if infected.

Orthotics can give pressure relieving footwear

Dietary support

PT/OT

Deep ulcers may surgical debridement

Question 8

What are complications of pressure sores?

Answer 8

Osteomyelitis

Bedbound patients

Nursing home

Sepsis

Pain