Pressure Sores

PRESSURE/BED SORES/ULCERS

What are they?

Essentially a pressure or bed sore, also known as a pressure ulcer is a wound that has developed due to constant pressure, and/or rubbing or friction (this can be as little as minute shifting of position), which causes a rupture of the upper and then inner layers of skin.

Although often called “bed” sore or ulcer, this is slightly misleading because they can form on people who are, for example, sitting in a chair or wheelchair.

Causes:

The medical explanation for the formation of a sore is the cutting off of oxygen via blood supply to the affected area, which causes the health of the skin cells to deteriorate and then die. The skin layers then start to break down with considerable speed and ultimately a wound appears.

Who are affected?

In theory anyone could develop a pressure sore but in practice, because immobility is the fundamental cause, those most at risk are the elderly and infirm.

This could include those in care confined to bed or (the irony is obvious) comfy lounge chair however there is also a significant risk of sores developing in patients following surgery or simply being immobile in hospital for some other reason such as serious illness hence hospitals are fully aware of the need for in-patients to keep mobile wherever possible.

Statistically, the NHS records that every year almost 500,000 people will develop at least one pressure sore.

Are there different types?

There are not different types as such but the medical profession grades them differently according to severity as follows (the higher the number, the worse the sore):-

Grade 1 – discoloration of the skin
Grade 2 – partial loss of skin thickness like a blister
Grade 3 – complete loss of skin, crater appearance, extends to layer of skin below the outer layer
Grade 4 – complete loss of skin, crater appearance as above, significant necrosis extending to lower layers

What are the risks of pressure sores?

While obviously very painful, a minor sore – say a so called Grade 1 or 2 sore – is usually amenable to simple treatment by application of creams and appropriate dressing however a more serious pressure can have very profound implications.

To be clear, a deeper pressure sore – as above, a Grade 3 or 4 sore – can lead to serious illness or indeed can sometimes even be life threatening.

As with any wound, infection is the greatest concern.

This brief note is not intended to explain the details of the types of infection that might occur – the reader can conduct research elsewhere – beyond making reference to cellulitis (infection of and inflammation of the skin and skin cells), osteomyelitis (infection of a bone or bones), fasciitis (a bacterial infection affecting the flesh), gangrene (like fasciitis a bacterial infection which results in the killing of the flesh), and septicaemia (infection of the blood which is always a medical emergency because it can swiftly lead to organ failure and death).

How can they be prevented?

Prevention is largely a matter of common sense but there are a number of things to bear in mind.

Since pressure sores are (obviously) a skin condition, the better the health of your skin, the greater the chance that they will be avoided.

As with most organs (skin is deemed to be an organ) of the body, skin will be in a better state if you are of appropriate weight and take regular exercise and enjoy a good balanced diet. This will also enhance the immune system, assisting in fighting off any infections in any event.

Since sores result a lack of oxygen, stopping or refraining from smoking is also an obvious factor in preventing them.

Finally, most obviously, since sores usually develop in immobile persons, a simple regular change of position, perhaps at least several times an hour, should ordinarily minimize the risk; and/or pressure relieving pads and mattresses should be used.

Legal considerations

Bearing in mind the causes and effects of developing pressure sores are so well known and because they are generally so easy to avoid, the most vulnerable should routinely receive a proper risk assessment, undertaken by any one of a range of appropriate professionals, which should include recording the appropriate level of re-positioning (or supervising the person to ensure he/she does so him/herself), giving advice about movement, support and equipment to the person, and ensuring that this is regularly reviewed and updated.

Failure to take these basic steps is likely to be deemed a breach of the duty of care to the affected person on the part of the relevant hospital, nursing home or carer.

What can we do?

Lloyd Green, Solicitors, have handled many cases where the care given fell below what could and should have been expected and received.

We have considerable experience and expertise in these situations and will be more than happy to guide you through the process of making an initial complaint, if that is your preference, and/or presenting a formal legal claim to the culpable body.

We work closely with independent medical practitioners and specialists, and will ensure that any claim is handled sensitively and swiftly, to secure an explanation and apology, where possible, and ultimately thereafter fair and proper compensation for any errors that have occurred and have caused you or your loved one injury.





 

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