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A decubitus ulcer, also known as a pressure ulcer, pressure sore, or bed sore, is an open wound on your skin. Decubitis ulcers often occur on the skin covering bony areas. The most common places for a decubitis ulcer are your:
This condition is common among:
The condition is highly treatable and recovery is good with proper diagnosis.
Decubitus ulcers occur in stages. The National Pressure Ulcer Advisory Panel (NPUAP) has a staging process to help your doctor diagnose and treat you:
The skin isn’t broken, but it’s discolored. The area may appear red if you have a light complexion. The discoloration may vary from blue to purple if you have a dark complexion. It may appear white.
The skin is open and shows signs of some tissue death around the wound. The ulcer is shallow with a red pink wound bed. There might also be a blister filled with fluid.
The ulcer is much deeper within the skin. It affects your fat layer and looks like a crater. There also might be something that looks like pus in the sore.
Many layers are affected in this stage, including your muscle and bone. A dark substance called "eschar" may be inside the sore.
The ulcer may be yellow or green. It can be soft and look like pus, or it can have a brown scab covering. If the damage to your tissue layers is extensive, it will need to be removed. However, if the covering of the ulcer is dry and stable, it shouldn’t be removed because it’s your body’s natural layer of protection.
Pressure is one of the main causes of a decubitus ulcer. Lying on a certain part of your body for long periods may cause your skin to break down. Your skin is thinner in places next to bone or cartilage, and your hips, heels, and tailbone are especially vulnerable to pressure sores.
Decubitus ulcers can also happen when you scrape or rub your skin against a hard or rough surface. Friction burns on the skin may damage the outermost layer of skin cells, called the "epidermis."
Wearing soiled clothing or undergarments for long periods may create open sores on the skin. This may irritate the delicate outer skin layer.
There are a number of risk factors for decubitus ulcers:
Each stage of a decubitus ulcer has different symptoms. Depending on the stage, you may have any of the following:
Your doctor may refer you to a wound care team of doctors, specialists, and nurses experienced in treating pressure sores. The team may evaluate your ulcer based on several things. These include:
Your doctor may take samples of the fluids and tissue in your decubitus ulcer. In addition, they may look for signs of bacteria growth and cancer.
Your treatment will depend on the stage of your ulcer. Treatment can include medications, therapies, and even surgery.
Antibacterial drugs may treat the infection. You may also receive medication to relieve or reduce any discomfort.
A process to remove dead tissue called "debridement" is an option for cleaning your wound.
Keeping the site clean and free of debris is important to promote healing. Your doctor may order frequent dressing changes of your wound.
Your healing process depends on the stage of your ulcer. Treatment is usually less difficult if the ulcer is diagnosed in the first two stages. Your doctor may suggest that you change your diet and increase your fluid intake to help you recover faster. Later stages often require more aggressive treatments and longer recovery times.
Written by: Brindles Lee Macon and Matthew Solan
Medically reviewed on: Nov 03, 2015: Debra Sullivan, PhD, MSN, RN
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