Pressure Ulcers

Pressure ulcers, also known as decubitus ulcers or bedsores, are localized injuries to the skin and underlying tissue resulting from prolonged exposure to increased pressure on the skin.  Pressure ulcers first appear as reddened inflamed skin, most commonly over bony areas.  If the pressure is not eliminated, the inflamed skin can form into a blister and then an open sore.  They can develop quickly and are often difficult to treat.

Pressure ulcers are most frequently seen on the heel, ankles, hips or buttocks.  You are more likely to get a pressure ulcer if you have a disease that affects blood flow including diabetes or vascular diseases.  Poor-nutrition, fragile skin, use of wheelchairs, braces or prosthetics and confinement to a bed for extended periods of time are common causes of pressure ulcers.

Pressure ulcers are defined by four stages with the higher stages involving prolonged healing time and frequent complications which can be severe.  Stages are always described in terms of the deepest original depth recorded regardless of the current depth noted in the treatment process.

  • Stage I ulcers appear as intact reddened skin localized over a bony prominence and can be painful.  The skin does NOT briefly lighten when touched.
  • Stage II ulcers involve the outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) and may appear as a blistered or shiny, dry shallow open area with a pinkish-red basin-like wound.  It may also appear as an intact or ruptured fluid-filled blister.
  • Stage III ulcers involve a full thickness deep wound with tissue loss and exposure of subcutaneous fat.  Depth of this crater-like appearance can vary and damage may extend beyond the primary wound with undermining and tunneling below the layers of healthy skin.  The bottom of the wound may have some yellowish dead tissue (slough).
  • Stage IV pressure ulcers are very serious wounds that involve large-scale full thickness tissue loss exposing muscle, cartilage, tendon and bone.  The bottom of the wound likely contains slough or dark, crusty, dead tissue (eschar) and damage often extends beyond the primary wound by undermining and tunneling.    Bone infection (Osteomyelitis) is likely to occur in Stage IV ulcers.  Other complications of pressure ulcers include sepsis, cellulitis, bone & Joint infections and squamous cell cancer that can develop in chronic non-healing wounds.

If you see an area of reddened skin indicating the beginning of a pressure ulcer, the pressure on that area needs to be relieved by pillows, frequent position changes, off-loading devices or temporary removal of the device that is creating pressure.  Pressure ulcers should be taken seriously.  If a sore develops call your doctor immediately.

AMERIGEL Hydrogel Wound Dressing is indicated for stage 1-4 pressure ulcers and provides a moist wound environment to promote wound healing.

To care for a wound, cleanse the wound with AMERIGEL Saline Wound Wash.  Apply AMERIGEL Hydrogel Wound Dressing directly to the wound and cover with a fabric bandage or sterile gauze pad and secure in place.  Change the dressing once or twice daily.