About Physiatry

About Physiatry

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Pressure Ulcers and Wounds

Condition: Pressure ulcers—also called bedsores or pressure sores—are injuries to the skin and/or the underlying tissue.

Background: When there is pressure and rubbing on an area for a prolonged time, blood and fluids cannot reach that area. Eventually this causes the skin to become damaged. As a result, the tissue dies and a pressure ulcer forms. 

Risk Factors: People who cannot move their own bodies are especially susceptible to pressure ulcers, such as individuals with spinal cord injuries and strokes. Others with limited mobility like older people who stay in bed for long time periods are also more prone to pressure ulcers. Other risk factors are having a vascular disease that affects blood flow, like diabetes. People with bowel and bladder incontinence are also at risk for pressure ulcers as well as bowel or bladder incontinence.

History and Symptoms: An early symptom of pressure ulcers is reddened skin that does not turn white when it is pressed. Over time, this area forms a blister, then a pressure ulcer.  

Physical Exam: Physicians usually examine the location, appearance and size of the wound, as well as the surrounding tissue.

Diagnostic Process: To help determine if a wound is a pressure ulcer, physicians often check if there is an odor or seeping from the wound, or dead tissue. Common areas where they occur are on the buttocks, elbows, heels and the back of the head.

Rehab Management: A health care provider may remove the damaged tissue before applying wound dressings. Pillows or special cushions are often used to help reduce pressure on the healing wound. It’s also important to keep the area clean to reduce bacteria, as well as reconfigure the patient’s environment so the issue does not reoccur.

Other Resources for Patients and Families: A guide, "Pressure Ulcers: What You Should Know: A Guide for People with Spinal Cord Injury” is available from the Consortium for Spinal Cord Medicine.


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