0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Pressure Ulcers FREE

JAMA. 2003;289(2):254. doi:10.1001/jama.289.2.254.
Text Size: A A A
Published online

Pressure ulcers, also known as bed sores or pressure sores, often occur in persons who cannot move around easily. The skin and tissue underneath break down from continued pressure and poor circulation. When the skin breaks down, it becomes red. Open sores develop after the skin changes. In severe cases, the pressure ulcer causes destruction of muscle or even bone underneath the skin.

Pressure ulcers usually occur in persons who have predisposing risk factors, such as poor nutrition, continued moisture (especially from urine or feces), confinement to a bed or wheelchair, and other medical problems (especially spinal cord injury, hip fracture, or dementia). Because older people are more likely to need a wheelchair or to spend more time sitting in a chair or being confined to bed, they need special attention to prevent formation of a pressure ulcer. It is important for anyone with risk factors to discuss pressure ulcer formation with his or her doctor. Even mild skin redness may be the start of a pressure ulcer. The January 8,2003,issue of JAMA includes an article about pressure ulcers.

WHY DO PRESSURE ULCERS FORM?

Continued pressure on the skin from sitting or lying in one position causes poor circulation. Blood and lymphatic fluid have difficulty going to and leaving the pressurized area, causing both a lack of oxygen and swelling. In persons with poor nutrition or inability to move themselves, this lack of blood flow may cause the skin to break down. It becomes reddened and may tear away from the supporting tissue underneath. If the conditions leading to the pressure ulcer are not rapidly corrected, the skin damage may spread to the tissue, muscle, and even bone underneath. Pressure ulcers can become infected. This may make treatment more difficult.

PREVENTION AND TREATMENT OF PRESSURE ULCERS

  • Keep skin free of moisture

  • Improve nutrition

  • Frequently turn or reposition someone who is confined to bed or to a wheelchair

  • Air mattresses may be used for high-risk persons

  • Correct or treat incontinence

  • Special dressings may be used

  • Debridement (cutting away dead tissue)or surgery may be required for severe pressure ulcers

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at www.jama.com. They are available in English and Spanish.

The JAMA Patient Page is a public service of JAMA .The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

Sources: American Academy of Family Physicians, National Institutes of Health, National Pressure Ulcer Advisory Panel

Keyword: SKIN CONDITIONS

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles