Pressure sores are one of the biggest risks to the health of disabled people, particularly those with mobility challenges. They are often thought of as a minimal health issue but the fact is they can occur very quickly, and become very dangerous to the overall health of a disabled person. Additionally, the ongoing treatment and management of a pressure sore can significantly impact the daily activities and quality of life of a disabled person who has one. They are slow to heal, and as I go into more detail below, they heal by having the pressure on them relieved. So, for example, a pressure sore on your bottom, means you can’t sit on your bottom for a while. Easier said than done.

When actor Christopher Reeve was thrown from a horse during a riding accident he became a quadriplegic. It was shocking to see “Superman” in a wheelchair unable to move his arms or legs, or breathe fully on his own. Yet, as he went on to live an active life with his disability, working for the Christopher Reeve Foundation, as well as producing some creative projects, he developed a life-threatening pressure sore, which ultimately did take his life. I’ll make the assumption that he did everything he was advised to do from his medical staff to heal his wound, and yet, it wasn’t enough. With all of his resources and his affluence, the threat of a fatal pressure sore was the same for him as it is for any other disabled person.

That is why I think it is important we understand what pressure sores are, their risks, and how to prevent them.

A pressure sore, also known as a pressure ulcer or bedsore, is a localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear and/or friction. Pressure sores typically develop in individuals who have limited mobility and are unable to change positions easily. These wounds occur when constant pressure reduces blood flow to specific areas of the body, leading to tissue damage and skin breakdown. Pressure sores can vary in severity from mild inflammation to deep wounds that expose muscle and bone, posing serious health risks if left untreated. Preventative measures such as frequent repositioning, proper nutrition, and good skin care are crucial in managing and avoiding pressure sores.

I developed a pressure sore on my back once when I was hospitalized for a serious pulmonary issue. I was positioned to lay on my back for long periods of time and developed a sore. Thankfully we caught it early. I was able to reposition more often and reduce the amount of time I was in bed. With good cleaning, bandage changes, and consistent wound care, the sore completely healed.

Stages of Pressure Sores

Pressure sores are categorized into four stages, depending on the severity of the injury:

• Stage 1: The skin is not broken but it is red and does not turn white when you apply pressure to it. The area may be painful, firm, soft, warmer, or cooler compared to the tissue near it.

• Stage 2: The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost. The sore may look like a blister or a shallow crater.

• Stage 3: The loss of skin usually exposes some fat, and the sore may look like a crater. This stage may include damage to the tissue below the skin.

• Stage 4: The sore is very deep, reaching into muscle and bone, and causing extensive damage. Damage to deeper tissues, tendons, and joints may occur.

Risk Factors of Pressure Sores

• Immobility, due to conditions like paralysis, severe illness, or old age.

• Lack of sensory perception, which can result from spinal cord injuries, neurological disorders, or other conditions. In other words, someone may not have the sensory nerve function to feel that they have a pressure sore.

• Poor nutrition and hydration, which affect skin health and elasticity.

• Medical conditions affecting blood flow, such as diabetes and vascular disease.

Why Are Pressure Sores Dangerous for Disabled People?

Pressure sores are particularly dangerous when they become infected due to their proximity to the bones and the potential for bacteria to enter the bloodstream. Once an infection takes hold, it can spread quickly and lead to serious complications such as cellulitis or sepsis. Infections in pressure sores can be challenging to treat as blood flow to these areas is often compromised, hindering the body's natural immune response. Prompt and appropriate treatment is crucial when managing infected pressure sores to prevent further deterioration of the skin and underlying tissues. Aside from infection, there can also be actual tissue death called necrosis. Once skin tissue is that far gone, it typically cannot be healed with conventional topical treatments. Often surgical intervention is the next option for treatment.

When a pressure sore is severe enough, they often require hospital care, which can be lengthy and complicated, particularly for individuals with underlying health conditions. When left untreated, pressure sores can progress in severity, potentially leading to infections that penetrate deep into the skin and underlying tissues. In such cases, surgery may be necessary to remove dead tissue, control the infection, and promote healing. Hospitalization may also be required for intravenous antibiotics, wound debridement, and specialized wound care to prevent further complications and facilitate the recovery process.

Besides the physical discomfort and health risks, pressure sores can significantly affect an individual's quality of life, causing pain, stress, and anxiety. The constant pain, discomfort, and potential risk of infection can restrict mobility and daily activities, leading to feelings of frustration and isolation. The necessity for frequent medical treatments and lifestyle adjustments can also result in emotional strain and financial burden. Moreover, pressure sores may require long periods of rest and recovery, affecting one's independence and overall well-being.

How to Prevent Pressure Sores

Prevention is crucial when it comes to pressure sores, especially for disabled people who may be at higher risk. Here are some effective strategies for prevention:

1. Regular Movement and Repositioning

Regular movement and repositioning are crucial in preventing pressure sores for individuals with limited mobility. Prolonged pressure on certain areas of the body can lead to tissue damage, which can result in painful sores. By changing position frequently and ensuring weight is evenly distributed, the risk of pressure sores can be significantly reduced. Incorporating regular movement and repositioning into daily routines is essential for maintaining skin integrity and overall comfort for individuals at risk of developing pressure sores.

2. Use of Support Surfaces

Special mattresses and other durable medical equipment play a crucial role in preventing pressure sores for individuals with limited mobility. These specialized products are designed to distribute body weight evenly, reduce pressure on vulnerable areas, and improve circulation. By using pressure-relieving cushions, alternating air mattresses, or foam overlays, the risk of developing pressure sores is significantly reduced. It is essential for caregivers and healthcare providers to assess the individual's specific needs and recommend the most suitable equipment to ensure comfort and prevent skin breakdown. Regular monitoring and adjustments are key to maintaining skin integrity and overall well-being for individuals at risk of pressure sores.

3. Skin Care and Inspection

A good routine for skin care and inspection to prevent pressure sores involves checking skin integrity daily, especially in areas prone to pressure sores such as the heels, hips, and tailbone. Use a mirror to inspect hard-to-see areas. Keep the skin clean and dry, avoiding harsh soaps and hot water. Moisturize regularly to prevent dryness and cracking. Change positions frequently to relieve pressure on vulnerable areas. Use pressure-reducing devices such as cushions or mattresses when sitting or lying down for long periods. If any changes in skin color, temperature, or texture are noticed, consult a healthcare professional immediately. Regularly monitoring skin condition and taking proactive measures can help prevent pressure sores and maintain healthy skin.

4. Nutrition and Hydration

Maintaining good nutrition and hydration is crucial in preventing pressure sores from developing. Adequate intake of nutrients, particularly protein, vitamins, and minerals, helps support overall skin health and repair. Hydration plays a key role in maintaining skin elasticity and preventing dryness, reducing the risk of skin breakdown. A well-balanced diet and sufficient water intake can help improve circulation, leading to better tissue oxygenation and nutrient delivery to the skin, ultimately reducing the likelihood of pressure sore formation.

5. Education and Awareness

Education and awareness about the prevention and risks of pressure sores for disabled people are crucial for maintaining their health and well-being. By understanding the causes of pressure sores and learning how to manage and prevent them, disabled individuals can take proactive steps to avoid this debilitating condition, improving their overall quality of life and reducing the need for medical interventions. Early education and awareness can empower disabled individuals to advocate for themselves and ensure they receive the necessary care and accommodations to prevent pressure sores from occurring.

Pressure sores are a serious concern for the disabled community, but with proper care and prevention, they can often be avoided. Understanding the causes and implementing effective preventative measures can significantly reduce the risk of these painful and dangerous injuries. For disabled individuals, caregivers, and healthcare providers, staying informed and vigilant is key to maintaining skin integrity and overall health. Through education, appropriate care, and the use of adaptive equipment, the incidence and severity of pressure sores can be substantially reduced, leading to better health outcomes and improved quality of life for those at risk.

Please note that this post is based on my own life experience and my own opinions. It does not constitute medical advice. Always do what you feel is best for your own care.