Pressure Sore, Bed Sore, Pressure Ulcer

Difference Between Bedsore and Pressure Sore

A bedsore and a pressure sore refer to the same condition. They are also known as pressure ulcers, decubitus ulcers, or pressure injuries. These terms are used interchangeably to describe injuries to the body that typically occurs over bony areas of the body. It is important to note that they are a serious medical condition that requires immediate medical attention. In severe cases they can cause death.

Causes of Pressure Sores

Pressure sores are caused by sustained pressure on the skin, which reduces blood flow to the area. The main contributing factors include:

  • Pressure: Prolonged pressure on a specific area of the body, especially over bony prominences like the hips, heels, and tailbone.
  • Shear: When the skin moves in one direction and the bone moves in another, causing tissue damage.
  • Friction: Rubbing of the skin against a surface, which can make the skin more vulnerable to injury.
  • Moisture: Excessive moisture from sweating or incontinence can weaken the skin, making it more susceptible to damage.

What is the Risk Factor

Individuals at higher risk of developing bedsores include:

  • Immobility: Those who are unable to change positions often, such as bedridden patients or wheelchair users.
  • Incontinence: Exposure to urine and feces can increase the risk of skin breakdown.
  • Poor Nutrition and Hydration: Lack of adequate nutrition and hydration can impair skin health and wound healing.
  • Medical Conditions: Conditions like diabetes and vascular diseases that affect blood flow can increase susceptibility to bedsores.

Stages of Bedsores

Bedsores are categorized into 4 stages based on their severity:

Stage 1: The skin is intact but shows signs of redness that does not blanch (turn white) when pressed. The area may be painful, firm, soft, warmer, or cooler compared to surrounding tissue.

Stage 2: The outer layer of skin (epidermis) and part of the underlying layer (dermis) are damaged or lost. The sore may look like a shallow, open wound or a blister filled with clear fluid.

Stage 3: Full-thickness skin loss involving damage or necrosis of subcutaneous tissue. The ulcer may look like a deep crater, with or without undermining of adjacent tissue.

Stage 4: Full-thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar (dead tissue) may be present. These sores are often severe and can lead to significant complications.

Indication of Neglect

While the presence of pressure sores can be a sign of neglect, it is not always the case. Factors to consider include:

  • Quality of Care: Whether proper measures, such as regular repositioning, skin inspections, and use of pressure-relieving devices, are being implemented.
  • Patient Condition: Some patients may have medical conditions that make them more susceptible to pressure sores despite adequate care. Such as spinal cord injury patients or anyone else with mobility challenges.
  • Documentation: If there is clear evidence of neglect, such as failure to provide necessary care or documentation of neglectful practices, it could be considered neglect.

Lack of Sensation in Pressure Sores

Individuals may not feel pressure sores due to:

  • Nerve Damage: Conditions such as diabetes or spinal cord injuries can cause nerve damage, reducing sensation in affected areas.
  • Immobility: Patients who are immobile may not be able to reposition themselves or feel the early signs of pressure, leading to sores.

Treatment of Pressure Sores

Treating pressure sores involves several steps:

1. Relieve Pressure: Use specialized mattresses, cushions, or pads to reduce pressure on the sore.

2. Clean the Wound: Keep the sore clean and covered with proper dressings to prevent infection.

3. Remove Dead Tissue: Debridement may be necessary to remove dead or infected tissue.

4. Promote Healing: Ensure adequate nutrition and hydration to support healing. Use medications and topical treatments as prescribed.

5. Monitor and Reassess: Regularly check the sore and adjust treatment as needed.

Legal Action for Neglect

If a person in a care home develops a pressure sore and there is evidence of neglect, it may be possible to take legal action. Consider the following steps:

1. Document Evidence: Keep detailed records of the sore, the care received, and any communication with the care home.

2. Consult Professionals: Seek advice from medical professionals to understand the extent of neglect and from legal experts to explore your options.

3. File a Complaint: Report the issue to the right regulatory bodies.

4. Legal Action: Consider pursuing a lawsuit for neglect or malpractice, depending on the severity and evidence of neglect.

Complications from Pressure Sores

  • Pressure sores can lead to severe complications, including:
  • Infections: Including cellulitis, bone infections (osteomyelitis), and sepsis.
  • Chronic Pain: Persistent pain at the site of the sore.
  • Delayed Healing: Wounds that do not heal properly can become chronic.
  • Amputation: In severe cases, damaged tissue may require surgical removal.
  • Death: In extreme cases, untreated infections and other complications can be fatal.

Early intervention and proper care are crucial in preventing and managing pressure sores. If neglect is suspected, it is essential to act promptly to protect the health and rights of the affected individual. 

Do you need help ?

If you have a loved one that is in a care setting that has developed pressure sore and do not know how to address the situation or would like to speak with a lawyer about your options, please contact Robyn Wishart at Wishart Brain and Spine Law. Take advantage of the free consultation so that you know you have the best care and options possible for your loved one.