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Pressure sore definitions
The medical language associated with pressure sores can be complicated and difficult to understand. We have identified some of the key terms in use every day in relation to pressure sores.
Amputation is the surgical removal of a body part and can occur in the most extreme cases involving pressure sore negligence.
A bed sore is a change to an area of the skin caused by unrelieved pressure on soft tissues over a particularly bony area; otherwise known as pressure sores or pressure ulcers.
Bone infection refers to when bacteria invade the bone and can often happen if the area is exposed to the outside environment.
A care home is an establishment that provides accommodation together with nursing care or personal care for persons who are or have been ill, have or had had a mental disorder, are disabled or infirm, or are or have been dependant on alcohol or drugs – Care Standards Act 2000.
Cellulitis is a common skin infection caused by bacteria. One of the common symptoms of cellulitis is skin inflammation or redness.
A medical negligence claim for compensation can be brought if you or a loved one has sustained a pressure sore as a result of negligent care.
Compensation is awarded if you can show that negligent nursing care, either in hospital or in a care home, has resulted in a pressure sore developing or becoming worse. The amount of the award depends on the severity of the injury.
Debridement is the removal of dead tissue from an infected area. Debridement may also refer to ‘surgical debridement’ which is the removal of tissue by surgery, or ‘chemical debridement’ which is the removal of the necrotic tissue by using certain enzymes.
Dehydration is when the body does not have enough water or as much fluid as it should.
Friction is the resistance to motion in a parallel direction. The occurrence of friction is an important consideration when assessing whether someone is likely to develop a pressure sore.
Gangrene is the death of tissue in part of the body.
Grades of pressure sores
Grades of pressure sores refers to the grading system used to diagnose pressure sore severity, these are:
- 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 the third layer of skin, presents like a deep crater.
- Grade 4: Full thickness skin loss with extensive necrosis extending to the underlying tissue.
Maggot therapy is an alternative method of debridement . The maggots are mixed into the wound, and the area covered with gauze. The maggots eat the dead tissue but leave the healthy tissue intact.
Death of cells or body tissue through injury or disease; dead tissue.
NICE is an acronym for the National Institute for Health and Clinical Excellence. The standards laid out by NICE in their pressure sore guidance help healthcare professionals to understand what high quality care of pressure sores should look like. NICE have published specific guidance on the management of pressure ulcers in primary and secondary care.
Pressure is a force per unit area. This is another important consideration (along with friction) in assessing whether someone is at risk of developing a pressure sore.
Pressure redistribution surfaces seek to reduce the body's pressure over one particular area. Pressure redistribution surfaces include specialist foam mattresses or an air mattress.
Pressure relieving overlay system
A pressure relieving overlay system is a mattress made up of a number of cells that are pumped full of air. The cells sequentially inflate and deflate to gently alternate the surface interface pressure.
The moving air flow means a patient's weight is distributed differently as the cycle of air flow continues, avoiding the concentration of pressure over one area, which can result in a pressure sore developing.
A risk assessment is an evaluation of the risks to a patient during their stay either in hospital or in a care home.
In respect of pressure sores, it is acknowledged in both the NICE Guidelines and the Health and Social Care Act 2008 Regulations 2010, that a patient or "service user" in the case of care homes, should undergo an assessment at the time of admission and the assessment should be ongoing to assess any changes.
Sacral pressure sore
A sacral pressure sore is an ulcer that develops over the sacrum, the triangular bone at the base of the spine.
Surface interface pressure
The surface interface pressure is the pressure exerted over the point where a body meets a mattress.
Tissue viability nurse
A tissue viability nurse is a specially trained nurse who offers advice and support in complex wound management.
The waterflow assessment is a risk assessment tool that is used to assess each individual on arrival at a hospital or a care home, to categorise the risk of them suffering a pressure sore or, if they already have an ulcer or possibly the beginning of a sore, the risk of making a pressure sore worse.
This can then lead to more specific treatment, like the use of a pressure reducing mattress to try to avoid a sore developing or getting worse.
Wound documentation is a detailed description of a wound, including the location, size, health of surrounding tissues, signs of infection, and often outlines the proposed care and treatment plan.
Wound vac or vac pump
A wound vac or vac pump is a machine that uses negative pressure to help heal an open wound and draws out fluid, increasing blood flow to the area.
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