What are the signs of infection to watch out for with pressure ulcers?

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When it comes to pressure ulcers, waiting for an infection to arise can have severe consequences. For this reason, it is absolutely crucial to be aware of the key signs to look out for. These wounds, commonly known as bedsores or pressure sores, present a significant health risk, especially for people with limited mobility or those who sit for prolonged periods or are on bed rest. The truth is, when it comes to pressure ulcers, the top concern of healthcare professionals is the possibility of infection. Why? Because infections can grow out of nowhere. When they happen they can cause substantial harm, impede the healing process, and lead to a range of complications, ultimately increasing the risk of death. The purpose of this essay is to show you the indicators of infection. By enabling early detection and immediate medical intervention, the overall patient outcome is much better. So, keep on reading for the signs you need to look out for!

Why Do Pressure Ulcers Occur? 

Pressure ulcers happen as a result of prolonged pressure in areas where bones protrude, like the elbows, heels, hips, and sacrum. This pressure on the skin and underlying bones leads to impaired blood flow, tissue damage, and breakdown. However, the formation of pressure ulcers is influenced by other factors as well. Many things need to be at work for a pressure ulcer to occur. Sustained pressure compresses the small blood vessels, compromising blood flow and depriving the affected area of vital resources. Friction and shear forces between the skin and the surface the patient is laying on further contribute to tissue damage. Limited mobility makes patients more vulnerable. Other factors include decreased sensation, moisture, inadequate nutrition, and underlying health conditions. Understanding these mechanisms and risk factors helps healthcare professionals understand what to look out for. Preventing pressure ulcers is important for reducing the occurrence of these sores and minimizing the likelihood of infection and other complications.

Signs of Infection

  1. A Change in Skin Color and Texture: Examine the skin surrounding the pressure ulcer for notable changes. Watch out for areas with discoloration, unusual redness, or darker patches when compared to the surrounding skin. Also look out for the development of roughness or scaliness.
  2. Swelling: Keep an eye out for swelling around the site because it could also indicate infection. More swelling than previously noted is important too. That’s because changes in the size and level of swelling could mean the infection is growing or getting worse.
  3. Pay close attention to Pus-like Drainage: It is crucial to look for discharge or fluid that drains from the pressure ulcer. It is particularly concerning if the drainage appears thick, yellowish, or resembles oozing or pus, which often bubbles out of wounds that are compromised. Also, continuously monitor for any increase in the quantity or viscosity of the drainage.
  4. Skin Temperature Changes: Take a look at the temperature of the skin around the pressure ulcer. Is it different from the temperature surrounding healthy skin? Take note of noticeable differences in temperature. Determine if the area feels notably cooler or warmer to the touch.
  5. Tenderness: You’re going to want to pay close attention to the sensitivity of the skin surrounding the pressure ulcer. Increased tenderness or pain in the area may suggest infection. Take note of any discomfort reported by the individual with the pressure ulcer.
  6. Delayed Healing: If a pressure isn’t healing or there are signs that it’s actually getting worse, it could be infection. Watch for indications such as an increase in size or depth of the wound, along with the emergence of new areas displaying tissue breakdown or necrosis.
  7. A Bad Smell: If an unpleasant or foul odor emanates from the pressure ulcer, it may be infected. Foul odor is commonly associated with bacterial colonization and tissue necrosis. 

How to Prevent Infection

When it comes to prevention, the best line of defense is repositioning. Here are some helpful tips and recommendations for repositioning and skin care. Let’s get into it. 

  1. Reduce Pressure & Reposition: Shift weight and reposition the patient regularly to relieve pressure. Ask for assistance with repositioning approximately every hour for  adequate relief.
  2. Encourage the Patient to Lift Themselves (if possible): If the patient has sufficient upper body strength, encourage them to lift themselves often. Build strength with wheelchair pushups. These work when the patient raises their body off the seat using the arms of the chair. Most patients who are a risk of developing pressure ulcers won’t be able to do these, but some will.
  3. Invest in Cushions & Mattresses that Relieve Pressure: Select cushions and specialized mattresses that are designed to alleviate pressure points. Doughnut cushions don’t work because they work by focusing pressure on the surrounding tissues. This could potentially worsen the problem.
  4. Adjust Bed Elevation: If the bed allows for head elevation, raise it no more than 30 degrees. This helps minimize shear forces that contribute to the development of pressure ulcers.

Tips for skin care:

  1. Keep skin clean and dry
  2. Maintain good hygiene – use a gentle cleanser and carefully pat skin dry 
  3. Protect the skin with moisture barrier creams that protect against urine and stool
  4. Frequently change clothing and bedding, if needed
  5. Be aware that buttons on clothing and wrinkles in bedding can irritate sensitive skin
  6. Perform daily skin inspections, looking for any signs of pressure sores or potential problem areas

By following these tips and practicing good repositioning techniques, you will educe the risk of pressure ulcers in your patient. Plus, these tips will help you to maintain the health and integrity of their skin.

In conclusion, understanding the signs of infection in pressure ulcers is crucial for early detection and prompt intervention. Monitor the patient’s skin for wounds, redness, discoloration, darkening of the skin, swelling, or an increase in ulcer size. This will help you identify potential infections. You should also be mindful of pus-like drainage or foul odor at the source of the wound because these symptoms could indicate the presence of an infection. Keep your healthcare provider in the loop because they can give you an accurate assessment and prescribe appropriate treatments, if needed. Timely intervention can prevent the progression of infections and minimize the risk of complications. 

Contact Wound Care OC for wound treatment in Orange County, CA

Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.

To make an appointment

1533 E 4th St,

Santa Ana, CA 92701

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