Pressure sores develop due to prolonged pressure on areas of skin that interferes with circulation. They are caused by friction, shearing forces, or prolonged pressure. Pressure sores progress through four stages as the skin and tissue below is damaged. Stage one involves changes in skin color and appearance. Later stages involve blistering, destruction of deeper tissue, and risk of infection. Preventing pressure sores involves regular repositioning, keeping skin clean and dry, using support devices, and reporting any skin changes immediately.

1. Claudia Mormino
Anatomy & Physiology P. 4

2.  A pressure sore is caused
by pressure on an area of
the skin that interferes with
circulation.
 They can develop on areas
of the body that rub
together and moisture
collects (under breasts,
buttocks and thighs).
 Pressure sores are mainly
caused in three ways: friction
(rubbing together), shearing
(skin stays in place and
muscles continue to move in
the opposite direction), and
prolonged pressure (staying
in the same place for a long
period of time), which
interferes with the circulation
of that certain area.

4.  The first sign of a pressure sore is a
change in skin color, which usually
turns to a red color.
 Pressure sores occur in four main
stages.

5.  The skin is red, darkened or non blanchable (red skin that does turn white
when pressure is applied), that is still present thirty minutes after pressure
is relieved.
 One should position off area and report it. Do not, by any means, try to
massage this area.
 Observe every two hours and report any changes.

6.  Blister like lesions may begin to appear, and the skin may be
broken.
 Keep the area positioned off and report the need for dressing
changes.
 Report any odors, drainage and change in size.

7.  The skin tissue is destroyed and fatty tissue
may be involved.
 Infection and eschar (scab) may result.
 Continue to position off and report any
changes whatsoever.

8.  Skin, and fatty tissue are destroyed and muscle and bone may be
involved.
 Continue to position off and report changes.
 In stage four, signs of systemic infection may appear. Be sure to
report any of the following changes: wound odor, pain, elevated
temperature, and confusion.

9. Stage One
Stage Three
Stage Two
Stage Four

12.  Use these methods to prevent bedsores: make sure skin is clean and dry;
reposition every two hours; keep the linen dry, wrinkle free, and clear of
any objects that cause pressure; clean urine and feces from skin ASAP;
make sure clothing and shoes do not bind or constrict; encourage the
person to drink and have proper nutrition; massage pressure points (prior
to stage one).
 Some preventative devices include: bed cradles, heel and elbow
protectors, flotation devices, pillows, waterbeds, pressure mattresses, and
egg crate mattresses.
 The BEST way to prevent a bed sore is look for
and REPORT any changes in skin!!

13.  http://www.mayoclinic.com/health/bedsores/DS00570/DSECTION=causes
 Dugan , Diana. Successful Nursing Assistant Care. Second. Albuquerque, New Mexico: Hartman
Publishing, Inc., 2008. 320-337. Print. (NOTES)
 http://gardenrain.files.wordpress.com/2009/05/sitting-pressure_sores04-e1.jpg
 http://www.nursinghomesabuseblog.com/images/Screen%20shot%202010-10-
22%20at%202.53.02%20PM.png
 http://www.nursinghomesabuseblog.com/bedsores-pressure-sores-decubi/hospital-bed-sores/
 http://1.bp.blogspot.com/_MjVQ-
cqUpVs/TPH9rriTvzI/AAAAAAAAAaY/UqhhsM1i3nk/s1600/Pressure%2Bulcer.jpg
 http://hamill-law.com/bedsore4.jpg
 http://tidsskriftet.no/lts-img/2011/L11-ENG-09-1472-01-Over.jpg
 http://www.wjes.org/content/2/1/10/figure/F17
 http://www.visualphotos.com/photo/1x9083430/Pressure_Sore_on_Heel_AB681A.jpg
 http://www.sciencephoto.com/image/263094/530wm/M2800097-
Close_up_of_pressure_sore_ulcer_on_heel-SPL.jpg
 http://www.medical-definitions.com/images/decubitus.jpg
 http://seattletimes.nwsource.com/ABPub/2010/09/09/2012855576.jpg