b. Stages of Development. Pressure sores develop in three recognized
The first stage reveals redness of the skin in the area.
(2) In the second stage, a bluish or mottled (blotches of different shades)
discoloration of the skin occurs.
(3) In the third stage, there is a break in the skin that can develop rapidly
into a decubitus ulceration (a destruction of underlying tissue).
c. Preventive Nursing Measures. Pressure sores can complicate recovery of
the patient for weeks and even months. Therefore, nursing personnel must be alert and
perform the following preventive measures.
(1) Change the patient's position at least every 2 hours, or more frequently if
necessary. Remember that there are four body surfaces on which to turn the patient to
relieve pressure on any one area.
(2) Inspect all skin areas of all bed patients daily during the bath procedure
and at evening care. Massage skin areas over bony prominence to stimulate
circulation. Report any suspicious (reddened) area immediately to the nurse in charge,
and relieve pressure by changing position. Report any complaint of numbness or
tingling under a cast or splint.
(3) Keep the patient's skin clean and dry. Wash areas soiled by body
excretions immediately with soap and water, rinse well, and dry thoroughly.
(4) Keep bed linen clean, dry, free of wrinkles, and free of crumbs and any
other foreign matter.
(5) Use pillows and all positioning and comfort devices properly. Rubber
rings, cotton doughnuts, and similar articles often cause new circumscribed pressure
areas; hence, they should not be used.
d. Treatment of Pressure Sores. The best treatment is prevention by proper
nursing care. The medical officer's orders must be followed for application of any
medication. Aseptic technique must be used on any broken skin areas.