1. Claudia Mormino Anatomy & Physiology P. 4

2.  A pressure sore is caused by pressure on an area of the skin that interferes with circulation.  They can develop on areas of the body that rub together and moisture collects (under breasts, buttocks and thighs).  Pressure sores are mainly caused in three ways: friction (rubbing together), shearing (skin stays in place and muscles continue to move in the opposite direction), and prolonged pressure (staying in the same place for a long period of time), which interferes with the circulation of that certain area.

4.  The first sign of a pressure sore is a change in skin color, which usually turns to a red color.  Pressure sores occur in four main stages.

5.  The skin is red, darkened or non blanchable (red skin that does turn white when pressure is applied), that is still present thirty minutes after pressure is relieved.  One should position off area and report it. Do not, by any means, try to massage this area.  Observe every two hours and report any changes.

6.  Blister like lesions may begin to appear, and the skin may be broken.  Keep the area positioned off and report the need for dressing changes.  Report any odors, drainage and change in size.

7.  The skin tissue is destroyed and fatty tissue may be involved.  Infection and eschar (scab) may result.  Continue to position off and report any changes whatsoever.

8.  Skin, and fatty tissue are destroyed and muscle and bone may be involved.  Continue to position off and report changes.  In stage four, signs of systemic infection may appear. Be sure to report any of the following changes: wound odor, pain, elevated temperature, and confusion.

9. Stage One Stage Three Stage Two Stage Four

12.  Use these methods to prevent bedsores: make sure skin is clean and dry; reposition every two hours; keep the linen dry, wrinkle free, and clear of any objects that cause pressure; clean urine and feces from skin ASAP; make sure clothing and shoes do not bind or constrict; encourage the person to drink and have proper nutrition; massage pressure points (prior to stage one).  Some preventative devices include: bed cradles, heel and elbow protectors, flotation devices, pillows, waterbeds, pressure mattresses, and egg crate mattresses.  The BEST way to prevent a bed sore is look for and REPORT any changes in skin!!

13.  Dugan, Diana. Successful Nursing Assistant Care. Second. Albuquerque, New Mexico: Hartman Publishing, Inc., 2008. 320-337. Print. (NOTES)  Staff, Mayo Clinic. "Pressure Sore." Mayo Clinic. 2 Aug. 2011. Web. 10 Feb. 2012.. http://www.mayoclinic.com/health/bedsores/DS00570/DSECTION=causes  Garden Rain. 2009. Web. 10 Feb. 2012. http://gardenrain.files.wordpress.com/2009/05/sitting- pressure_sores04-e1.jpghttp://gardenrain.files.wordpress.com/2009/05/sitting- pressure_sores04-e1.jpg  Nursing Home Abuse. 22 Oct. 2012. Web. 10 Feb. 2012. http://www.nursinghomesabuseblog.com/images/Screen%20shot%202010-10- 22%20at%202.53.02%20PM.png http://www.nursinghomesabuseblog.com/images/Screen%20shot%202010-10- 22%20at%202.53.02%20PM.png  "Pressure Ulcer." Web. 10 Feb. 2012. http://1.bp.blogspot.com/_MjVQ- cqUpVs/TPH9rriTvzI/AAAAAAAAAaY/UqhhsM1i3nk/s1600/Pressure%2Bulcer.jpghttp://1.bp.blogspot.com/_MjVQ- cqUpVs/TPH9rriTvzI/AAAAAAAAAaY/UqhhsM1i3nk/s1600/Pressure%2Bulcer.jpg  "Bed Sore." Hamill Law. Web. 9 Feb. 2012. http://hamill-law.com/bedsore4.jpghttp://hamill-law.com/bedsore4.jpg  "Www.wjes.org - Figure." World Journal of Emergency Surgery. 2010. Web. 14 Feb. 2012. http://www.wjes.org/content/2/1/10/figure/F17 http://www.wjes.org/content/2/1/10/figure/F17  Web. 10 Feb. 2012. http://www.sciencephoto.com/image/263094/530wm/M2800097- Close_up_of_pressure_sore_ulcer_on_heel-SPL.jpghttp://www.sciencephoto.com/image/263094/530wm/M2800097- Close_up_of_pressure_sore_ulcer_on_heel-SPL.jpg  "Pressure Sore." Seattle Times. Web. 10 Feb. 2012. http://seattletimes.nwsource.com/ABPub/2010/09/09/2012855576.jpg http://seattletimes.nwsource.com/ABPub/2010/09/09/2012855576.jpg