Written by

Saima Mazhar - Partner, Head of Medical Negligence

Pressure sores, also known as pressure ulcers or bedsores, are injuries to the skin and the underlying tissue, they are primarily caused by prolonged pressure on the skin. Pressure sores can be a common concern for individuals who have reduced mobility or anyone who is on bedrest for a long period of time. In this article, we will be covering common areas to get pressure sores, the symptoms and treatment. 


What are pressure sores? 

Pressure sores occur when the skin and underlying tissue is broken down, they are caused when an area of the skin is placed under pressure. The level of severity can range when you develop pressure sores, they can be in the form of patches of discoloured skin to open wounds that expose the underlying bone or muscle. 

According to NHS inform, pressure sores develop when there is a large amount of pressure applied to an area of skin over a short period of time or, they can also occur when less pressure is applied but over a longer period of time. The extra pressure applied to the skin will disrupt the flow of blood through the skin, and this causes the affected area of skin to become starved of oxygen and nutrients. The skin will then begin to break down and this will then lead to an ulcer forming. 


Most common areas to get pressure sores 

According to the NHS, pressure sores are most common on bony parts of the body. Some areas of the body which can be susceptible to pressure sores are: 

  • Elbows and knees – elbows and knees can be prone to pressure sores if they have a large amount of pressure applied because they are extremely bony and have limited padding.
  • Hips and pelvis – the hips and pelvis can be a vulnerable area for developing pressure sores, especially for individuals who spend long periods in a seated position, for example people who spend a long amount of time in a wheelchair.
  • Base of the spine – the back, in particular the base of the spine can be one of the most susceptible areas for pressure sores. If an individual is spending extended periods of time lying down without shifting their weight, for example if they are on bed rest, pressure will build up on the back and compromise blood flow.


Symptoms of pressure sores 

There are different grades that are used to describe the severity of pressure sores, and the higher the grade means that there is more severe injury to the skin and underlying tissue. 

Grade 1 – a grade 1 pressure sore is the most superficial type of ulcer and symptoms for a grade 1 pressure sore include: 

  • Part of the skin becoming discoloured 
  • Discoloured patches not turning white when pressed 
  • A patch of skin that will feel warm, spongy or hard when touched 
  • Any pain or itchiness in the affected area 

Grade 2 – a grade 2 pressure sore will damage some of the outer surface of the skin, the epidermis, or the deeper layer of skin, the dermis, this will lead to skin loss and the pressure sore will form an open wound or blister. 

Grade 3 – in a grade 3 pressure sore, skin loss will occur throughout deeper layers of the skin, the underlying tissue will also be damaged and it will form a deep wound that will reach the deeper layers of the skin. 

Grade 4 – a grade 4 pressure sore is the most severe type and the skin will be severely damaged and the tissue surrounding the affected area will begin to die. A grade 4 pressure sore will form a very deep wound that may reach the muscle and bone, and people with grade 4 pressure sores have a high risk of developing a life-threatening condition. 

If you are in a hospital or care home and you believe you have a pressure sore, you should tell your healthcare team as soon as possible because if nothing is done about it, it is likely that it will continue to get worse. 

If you are at home and you believe you have a pressure sore, you should contact your GP surgery. 

According to the NHS, you should get medical advice immediately if there is: 

  • Red, swollen skin 
  • Pus coming from the wound 
  • Cold skin and a fast heartbeat 
  • Severe pain or worsening pain 
  • A high temperature 

Any of these symptoms surrounding a pressure sore could be a sign of a serious infection and this would need to be treated as soon as possible. 


Causes of pressure sores 

Pressure ulcers are caused by a sustained amount of pressure being placed on a particular area of the body, examples include: 

  • Pressure from a hard surface, such as a bed or a wheelchair 
  • Pressure placed on the skin through involuntary muscle movements, for example muscle spasms 
  • Moisture that can break down the outer layer of the skin 

There are several factors that can increase the risk of developing pressure sores, and individuals with normal mobility will be very unlikely to develop pressure sores as their body will make hundreds of regular movements that will prevent pressure building up on any part of their body. For example, when you are sleeping, you may think you are lying still, but you may shift your position up to 20 times per night, therefore stopping you from developing pressure sores. 

The factors that can put individuals at increased risk of developing pressure sores can include:

  • Mobility problems – there are many mobility problems that can affect your ability to move parts of your body or all of your body, this can put you at an increased risk of developing pressure sores as you are not able to make regular movements 
  • Poor nutrition – poor nutrition can put you at an increased risk of developing pressure sores because in order for your skin to remain healthy, it requires nutrients that can only be obtained from eating a well balanced, nutritious diet 
  • Health conditions – if you have an underlying health condition that disrupts your blood supply, it could put you at an increased risk of developing pressure sores. These health conditions can include diabetes, heart failure, or kidney failure. 


Treatment of pressure sores 

Pressure sores can be extremely painful and recognising the signs of pressure sores and seeking prompt treatment is extremely important in order to prevent further complications and promote healing. 

For some people, pressure sores are just an inconvenience that will need basic nursing care, however, in some cases, pressure sores can be extremely serious and may require surgery in order to remove any damaged tissue and close the wound. 

Treatment of pressure sores can include: 

  • Applying dressings – these are designed to help speed up the healing process and could also help to relieve some of the pressure 
  • Moving and regularly changing position to avoid any further pressure 
  • Using specially designed static foam mattresses or cushions, or dynamic mattresses and cushions that have a pump in order to provide a constant flow of air to the affected areas 
  • Debridement – this is a procedure that would clean the wound and remove any damaged tissue 


Pressure sore claims 

Pressure sores are caused by excessive pressure on body parts that have continuous contact with a surface and they can be extremely painful and in some cases lead to further health problems. Pressure sores can sometimes be caused by negligence, and if this has happened, you may be entitled to seek compensation. At Patient Claim Line, we work on a no win no fee basis, and if you feel as though you have suffered from a pressure sore that was caused by medical negligence, get in touch today and one of our medical negligence experts will be able to guide you through your pressure sore claims process.

Concerned about your medical treatment?

Contact us today!