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Pressure sores, also known as bed sores and pressure ulcers, are quick to develop but can take a long time to heal. They can be debilitating, extremely painful and, if left untreated, could be fatal. However, with proper nursing care they can also be prevented. Pressure sores as a result of medical negligence are, unfortunately, all too common.

Causes of pressure sores

Pressure sores occur as a direct result of unrelieved pressure and distortion of the skin and underlying tissue.

The extra pressure disrupts the flow of blood through to the skin and, without adequate blood flow, the area of skin becomes starved of oxygen and nutrients. The skin can then begin to break down and an ulcer forms.

People with health conditions which limit their mobility are most at risk of developing pressure sores. The elderly can often be at risk of developing sores due to a lack of mobility, and so pressure sores occur in care homes as well as in hospital.

Grades of pressure sores

Pressure sores are divided into four different grades, depending on the severity of the sore:

  • Grade 1: Discolouration of the skin.
  • Grade 2: Partial thickness skin loss, presents like a blister.
  • Grade 3: Full thickness skin loss, but damage of subcutaneous tissue, presents like a deep crater.
  • Grade 4: Full thickness skin loss with extensive necrosis extending to the underlying tissue.

Prevention of pressure sores

Pressure sores can be easily prevented through good nursing care. Every patient who has or is going to have reduced mobility should undergo an assessment, whether in hospital or a care home.

Pressure sore treatment

By risk assessing patients then putting in place appropriate care plans the risk of pressure sores developing is reduced, and could mean that they do not develop at all.

It should be realised that sometimes (despite a high level of nursing care) some patients will still develop pressure sores due to irreversible tissue hypoxia (where the tissue is deprived of adequate oxygen). However, in our experience, most of our clients have developed pressure sores in situations where they could have been prevented.

Once a pressure sore has been identified, a further assessment of the patient should be undertaken, and a revised repositioning plan put into place to avoid the sore worsening.

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Pressure sore negligence claims frequently asked questions

What is a pressure sore?

A pressure sore or bed sore is an area of damaged skin that becomes an open wound.

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What causes a pressure sore?

Pressure sores begin when the weight of your body presses down on the skin beneath you. Your blood cannot circulate properly to that area, and so skin cells break down and die.

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Who can get a pressure sore?

People of any age can be affected by bed sores or pressure ulcers. In particular, people with poor mobility who have to spend long periods of time in bed or sat in a chair are at greater risk of a sore developing. People who are unable to change their position are also at higher risk.

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How do I spot a pressure sore?

The first sign that a pressure sore might be forming is a change in the colour of the skin.

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Where do pressure sores occur?

The most common places for pressure sores are over the bones that are close to the skin.

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Are there risk factors associated with pressure sores?

There are a number of risk factors associated with pressure or bed sores, such as:

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What is a Waterlow assessment?

This is a risk assessment tool, used by nurses/carers to assess which patients are most likely to develop a pressure sore or ulcer.

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Can bed sores be prevented?

In most cases, the answer is yes. The most important factor in preventing sores is to avoid prolonged periods of pressure on any one area of the skin. This can be achieved by encouraging a person to change their position regularly throughout the day. People who cannot reposition themselves should be moved at regular intervals, and at least every two hours for those lying down and every hour for those sitting upright.

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What are the NICE guidelines relating to pressure sores?

NICE is the National Institute of Clinical Excellence. In 2005, NICE issued guidance on the prevention and treatment of pressure sores, following a collaborative review with the Royal College of Nursing. The guideline gives guidance on the management of pressure sores in both primary and secondary care. The key priorities identified in the guidance are:

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How can you tell if a pressure sore is healing?

As a pressure sore heals, it will slowly get smaller. Less fluid will drain from it and new healthy skin starts growing at the bottom of the sore.

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How do you treat a pressure sore?

It is essential is that the sores do not become infected. For those who suffer less severe pressure sores, they can be successfully treated by trying to relieve the pressure on them using equipment like a pressure relieving overlay system mattress, cleaning the affected area regularly and applying an appropriate dressing. The wound should be kept clean and moist and the area around it clean and dry.

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What are the consequences of pressure sores?

Serious pressure sores can be very painful and difficult to heal, as the wound has to heal from the inside out. Heels are particularly vulnerable to pressure sores and the sores can cause permanent difficulty with walking as the skin becomes tight and is vulnerable to breaking down. If there is a failure to recognise and treat the most serious of pressure sores, the necrotic tissue can extend over a larger surface area, and can invade the bone. This in turn can lead to  amputation  of the affected area.

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Can I bring a claim for medical negligence as a result of sustaining a pressure ulcer?

If you or a family member or friend has suffered with a bed sore as a result of a medical professional failing to prevent a pressure sore developing, it may be possible to bring a claim.

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Our specialist Pressure sore negligence claims team are considered leaders in the field and have a significant amount of expertise.
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Susan Brown

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Julie Marsh

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Richard Money-Kyrle

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Sita Soni

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Vanessa Wand

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Rachel Makore

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Tara Pileggi-Byrne

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Alpa Rana

Associate - solicitor

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Fran Rothwell

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Ben Ireland

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Alice Carley

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Audrey Elmore

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Nicky Melville

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