Pressure sores: Prevention and treatment

Pressure sores: Prevention and treatment



Pressure sores are areas of damage to the skin and the soft tissue underneath the skin caused by ongoing friction, moisture or pressure. Children with physical and complex disability who are immobile or have difficulty with mobility are at risk of developing pressure sores and they can occur quite quickly and require immediate treatment. There are ways to reduce the risks which we talk more about below.

Areas prone to pressure sores

There are areas of the body where pressure sores are more prone to occurring and the skin over bony areas of the body can be particularly vulnerable. Areas of the body at risk of pressure sores for children with reduced mobility include:

  • the back of the head
  • heels, ankles and elbows
  • the tailbone (coccyx)

Risk factors for pressure sores

Some of the risk factors involved in children and young people with complex disability that can lead to pressure sores include:

  • immobility, being restricted to either sitting or lying down
  • impaired sensation or ability to respond to pain or discomfort
  • urinary and faecal incontinence
  • being underweight or overweight
  • circulation disorders
  • areas where a prosthesis or hard object may apply pressure

Grades of pressure sore

In the treatment of pressure sores, they are graded so that it is understood how mild or severe the skin damage is and this directs the appropriate treatment. Pressure sores are graded in four levels with grade 4 being the most severe:

  • Grade 1 – skin discolouration can be seen, usually blue, red, purple or black
  • Grade 2 – some skin loss or damage to the top-most skin layers
  • Grade 3 – necrosis (death) or damage to the skin patch, limited to the skin layers
  • Grade 4 – necrosis (death) or damage to the skin patch and underlying structures, such as tendon, joint or bone.

Preventing pressure sores

A proactive approach is best to try and prevent or reduce the occurrence and/or severity of pressure sores. Our nursing team can work with you on the best ways to prevent pressure sores for your child, some of steps outlined below can help:

  1. Keep skin dry and clean with regular washing and ensuring that skin is properly dried with a clean towel.
  2. Re-position your child if they are not able to do this themselves so that their weight shifts from left to right and back again which helps to encourage blood circulation and distribute pressure evenly.
  3. Pressure cushions can help to prevent bony parts of the body rubbing against hard objects which can cause friction and lead to pressure sores.
  4. Water and other healthy drinks like milk and natural fruit juices can help to keep skin hydrated and healthy.
  5. A healthy diet with foods rich in protein, vitamin C and Zinc helps the body’s ability to renew cells and keep skin healthy. It will also help to maintain a healthy body weight as being underweight or overweight can increase the risk of pressure sores.
  6. Regular skin checks can help to identify the early warning signs of pressure sores such as red, purple or blue skin, especially over bony areas, swelling, cracks or calluses.
  7. Prevent equipment rubbing on areas of skin.

Treating pressure sores

Sometimes, even with the best prevention steps in place, pressure sores can occur. If left untreated, they can lead to other serious complications so they must be assessed and treated by trained health professionals such as the Xavier nursing team.

Your health professionals will treat pressure sores on an individual basis and depending on the severity, however treatment might include:

  • cleaning with appropriate solutions
  • dressing the area based on health advice
  • antiseptic or antibiotics (only if infected)
  • surgery to remove damaged skin (for very bad pressure sores)

Find out more

Our nursing team are here to help. Simply call 1800 XAVIER, email for further information or visit our wound management page.