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Relieve pressure on the skin
Relieving and spreading out pressure is the most important part of both preventing and treating pressure injuries. Putting pressure on one spot for long periods of time decreases blood flow to that area. This damages or kills the cells and creates a sore. Pressure can be relieved and spread in several ways. Often a combination of these is best.
To relieve and spread pressure:
Protect your skin
Take good care of your skin.
Good health habits can also help protect your skin.
If a pressure injury forms, keep using the prevention steps listed above to relieve pressure and protect the skin. It's also important to keep the sore clean, covered, and slightly moist. Used together, these steps can help keep the sore from getting worse and help your skin heal.
Keep the sore clean
The pressure injury must be cleaned every time the bandage (dressing) is changed. Saline is often used for cleaning. This is a saltwater solution that you can buy at a drugstore. But there are many cleansing products for wounds. Your doctor will recommend a cleansing solution for you. In some cases, it may be okay to use tap water to clean the wound.
Keep the sore covered and slightly moist
Your doctor will recommend a bandage for the pressure injury. There are many types of bandages. Over time, your doctor may use several different kinds of bandage as the pressure injury heals.
The general idea is to keep the wound a little moist and not let it dry out between bandage changes.
Treat pain as needed
Pain may or may not be a problem with pressure injuries. Some people who have pressure injuries do not need any pain medicine. Some need it just when the sore is being treated, and some need it on a regular schedule. If you have pain, talk to your doctor.
Often a doctor will remove (debride) the dead tissue in a pressure injury. Dead tissue gives bacteria a good place to grow and can cause infection. It can also slow the growth of healthy tissue. But sometimes it is best to leave the dead tissue or scab in place and let it act as a sort of bandage. Your doctor may do this if the tissue is very stable or if the sore is not likely to heal.
Skin grafts or surgical flaps are sometimes needed. Skin grafts help new skin grow at the site of the sore if the wound extends into muscle and deeper tissues. The wound may be surgically closed to promote healing after a skin graft.
Several other treatments are sometimes used in treating pressure injuries. These are done most commonly in clinics that specialize in treating serious wounds. They include:
Researchers continue to study these and other treatments for pressure injuries and other wounds.
As you treat a pressure injury, you will know it is healing correctly if:
After a pressure injury is healed, the skin is still very fragile. It is easy for the skin to break down again, especially in the first month after the sore is healed. To decrease the risk that the pressure injury will come back, slowly return to the positions that put pressure on the area where the sore was. For example, apply pressure for no more than 15 to 30 minutes at first. Then check to see if the redness fades within 15 minutes after you take the pressure off. Talk to your doctor or nurse about a plan for returning to your normal positions and activities after a pressure injury is healed.
Open wounds, such as pressure injuries, are easy places for infections to start. Your doctor will be watching for signs of infection, and you can help watch for these signs. Tell your doctor if you notice:
To treat an infection, you may use medicine, such as antibiotics, along with special care of the wound. You and the people around you will also be taught to take steps to keep germs from spreading to other parts of your body or to other people. These steps include keeping the sore covered at all times except during treatment, good hand-washing before and after caring for the pressure injury, and properly wrapping and throwing away used bandages.
How well a pressure injury heals depends in part on its stage.
Other Works ConsultedQaseem A, et al. (2015). Risk assessment and prevention of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5): 359–369. DOI: 10.7326/M14-1567. Accessed April 9, 2015.Qaseem A, et al. (2015). Treatment of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5): 370–379. DOI: 10.7326/M14-1568. Accessed April 9, 2015.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerMargaret M. Doucette, DO - Physical Medicine and Rehabilitation, Wound Care, Hyperbaric Medicine
Current as ofNovember 21, 2017
Current as of: November 21, 2017
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Margaret M. Doucette, DO - Physical Medicine and Rehabilitation, Wound Care, Hyperbaric Medicine
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