We all crack under pressure- our skin and its underlying tissue are no different and such injuries arising from prolonged pressure on them are called pressure ulcers. Though theoretically everyone can be affected- practically we know that there are some who crack under pressure more quickly than others. Similarly, there are some people who are more likely to develop pressure ulcers. They include personnel above the age of 70, obese individuals, those confined to bed/wheelchair due to surgery or illness, those who lack sensation in the skin (paralysis), those with reduced blood flow to the skin, etc.
Pressure Ulcers also called bedsores or pressure sores usually develop gradually due to external pressure, moisture, friction, and shearing. But in rare cases, they can develop in as little as a few hours. Early symptoms include discoloration (redding) of skin, pain and/or itchiness in the affected area, a patch of skin that feels warm, spongy, or hard, etc. Medical practitioners refer to this stage as a category 1 pressure ulcer. If untreated, the pressure ulcer can get worse and form a blister or an open wound. The deeper the wound- the higher the category of pressure ulcer. Pressure ulcers also tend to trigger other medical conditions that cause immense pain. If left unattended post-recovery, they can also recur leading to complications that can at times be life-threatening.
Patients who are prone to pressure ulcers should be frequently monitored, advised to stop smoking, kept on a healthy diet, and regularly repositioned to redistribute pressure and induce movement thereby minimizing the probability of contraction. Even though your GP or care home can try to assess the risk of developing pressure ulcers, it is important to remember that even the most advanced standards of medical care are not full proof. To this end, some countries have developed machine learning models based on electronic health records (EHR data) to automate assessing the risk of exposure to enable early intervention and care.
For patients who contract pressure ulcers, one must try to minimize the severity and seek medical expertise immediately if any of the following symptoms are to be observed- red swollen skin, a higher heart rate and skin that feels cold to touch, high temperature, severe pain or pus from the pressure ulcer wound. The treatments depend heavily on the severity. However, some of the common treatments used include:
Dressings are applied to facilitate faster healing and relieve pressure. Biofilms occur rapidly and cause inflammation of the wound, hence applying antiseptics and dressings are crucial
Frequent repositioning with the help of a set schedule should be made use of where the interval between each repositioning should depend on the patient’s risk level
Using specially designed foam mattresses that regulate pressure and provide a constant flow of air is also a very effective method for the treatment
Debridement is the practice of cleaning the wound and removing necrotic tissue that aids bacterial infection from pressure ulcers
The importance of a healthy and balanced diet is often overlooked. Protein and calorie intake may be supported with necessary supplements. Studies have shown that the risk of pressure ulcers is considerably lower in patients who maintain a vitamin C intake
A study conducted in the US revealed that more than 2.5 million people contract pressure ulcers on an annual basis and hospitals bear costs of over 5 Billion USD. This insight sheds light on the huge economic cost borne for the treatment of pressure ulcers. It is to be pondered if the opportunity cost of an avoidable disease holds the healthcare sector back from directing its funds to more critical areas. In short, while eliminating pressure ulcers may not be possible, with enough care preventing them on an individual basis is certainly possible. And that is why pressure ulcers are among one of the eight preventable iatrogenic illnesses according to the Centers for Medicare and Medicaid Services in the US. Tech migration and data analytics can certainly aid intervention at an early stage- but to ensure maximum care, health authorities must also make use of best-in-class medical devices like pressure distributing mattresses to keep this avoidable menace at bay.
– Haanie Bilal