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What is an ulcer?
Ulcers are wounds that develop on the skin. These wounds are seen most frequently in those with diabetes or who have a low potential to heal from injury. Ulcers can have many causes, however, many are caused by:

  • Loss of integrity of the skin
  • A decondary infection of the site by bacteria, fungus or virus
  • Generalized weakness of the patient
  • Delayed healing

Pressure Ulcers
Pressure ulcers are also known as pressure sores, bedsores, and decubitus ulcers. These wounds are caused by the breaking down of the skin when constant pressure is placed against the skin. Pressure against the skin reduces blood supply to that area, and the affected tissue dies. This may occur when remaining in one position for too long without shifting your weight.

The following factors increase the risk for pressure ulcers:

  • Being bedridden or in a wheelchair
  • Being older
  • Being unable to move certain parts of your body without help, such as after a spine or brain injury or if you have a disease like multiple sclerosis
  • Having a chronic condition, such as diabetes or vascular disease, that prevents areas of the body from receiving proper blood flow
  • Having a mental disability from conditions such as Alzheimer's disease
  • Having fragile skin
  • Having urinary incontinence or bowel incontinence
  • Not getting enough nourishment (malnourishment)

Pressure sores are categorized by how severe they are, from Stage I (earliest signs) to Stage IV (worst):

  • Stage I: A reddened area on the skin that, when pressed, does not turn white. This indicates that a pressure ulcer is starting to develop.
  • Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.
  • Stage III: The skin breakdown now looks like a crater. There is damage to the tissue below the skin.
  • Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes to tendons and joints.

Prevention of pressure ulcers includes:

  • Checking those who are bedridden or cannot move for pressure sores every day (head to toe).
  • Paying special attention to the areas where pressure ulcers often form. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters.
  • Change position at least every 2 hours to relieve pressure.
  • Use items that can help reduce pressure -- pillows, sheepskin, foam padding, and powders from medical supply stores.
  • Eat well-balanced meals that contain enough calories to keep you healthy.
  • Drink plenty of water (8 to 10 cups) every day.
  • Exercise daily, including range-of-motion exercises.
  • Keep the skin clean and dry.
  • After urinating or having a bowel movement, clean the area and dry it well. A doctor can recommend creams to help protect the skin.

Healing & Treatment
The following measures may help avoid ulcers in those who may be susceptible:

  • Debridement: removal of dead tissue
  • Infection Control: use of antiseptics and antimicrobobials, along with frequent changing of dressings
  • Nutritional Support: administering vitamins and minerals in appropriate doses (ie. protein, vitamin C, vitamin A, Zinc)

For anyone who has developed an ulcer, medical attention should be sought immediately so that a course of care and treatment may be initiated.


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Last Updated: 7/23/2013