Pressure Ulcers - Causes

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Pressure ulcers: causes

The pressure ulcer is not an independent disease, but occurs in connection with other diseases or when those affected are generally in poor health. In the development of pressure ulcers (pressure sores, pressure ulcers, pressure sores, bedsores), several factors usually interact: the condition of the skin, general constitution, age and mobility of the patient.

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• What are the causes?
• Frequently affected parts of the body
• Who is particularly at risk?

What are the causes?

The development of a pressure ulcer is promoted primarily by pressure, shear forces and friction.

• Print:The blood vessels in a tissue are compressed by either long-lasting or excessive pressure on a certain area of skin - for example from mattresses, folds in sheets or shoes. The result is insufficient blood flow. Arterial, nutrient-rich and oxygen-rich blood is no longer transported to the cells. These die off, with the corresponding nerve cells being irreversibly damaged earlier. The venous blood flow is also interrupted. As a result, acidic metabolic products can no longer be transported away. The body reacts to the increasing acidity in the tissue by widening the blood vessels (vascular dilation). There is a stronger blood flow, recognizable by a strong reddening of the skin. Furthermore, liquid and protein leak from the vessels into the tissue,this promotes the development of edema and blisters. In addition, there is a vascular occlusion (thrombosis). A pressure sore develops.
• Shear forces: Shear refers to the displacement of skin layers against each other - for example when the patient is turned around, pulled and positioned. This also affects the blood circulation. Shear forces on the skin of older people are particularly harmful. This has a lower water content and less elasticity. She becomes limp and drier.
• Friction: This is caused, for example, by sliding down in bed or sitting while the skin remains in its original position. Unsuitable clothing, nightwear or shoes that are too tight can also cause friction.

Frequently affected parts of the body

A decubitus ulcer occurs primarily on parts of the body where the skin lies directly over the bone and in places with little padding from muscle and fat tissue, especially heels, toes, ankles, knees, pelvic bones, sacrum, vertebral protrusions. But ears, back of the head or shoulder blades can also be affected. The skin is particularly vulnerable if it is constantly moist from sweat, wound secretions, urine or stool - especially if there is poor personal hygiene or incontinence. Other risk factors include circulatory disorders (eg circulatory disorders in the legs, heart failure, blood pressure that is too low), plaster casts, but also being severely underweight or overweight.

Who is particularly at risk?

The risk of developing a pressure ulcer is inherent in every patient who has to lie in bed for a long time. Under normal circumstances, the nervous system sends signals, such as pain, when there is too much pressure on a part of the body. The body reacts by changing its position. These involuntary compensatory movements to relieve endangered areas can be absent in certain situations, e.g.

• seriously ill,
• with very weak people,
• while taking certain medications such as strong painkillers or narcotics,
• in diseases that affect the nervous system and reduce or cancel the pain threshold, e.g. diabetes, stroke or spinal cord injuries.