A pressure sore is a skin lesion of ischaemic origin caused by compression between soft tissue, a hard surface (e.g. floor or mattress) and a bony projection (Figure 13). By definition, such sores develop in areas of pressure such as on the heels, and on the lower part of the back and hips (e.g. sacrum and ischium). Many factors trigger pressure sores including malnutrition, poor vascular condition (especially in heel pressure sores with lower limb arteriopathy), and progressive cancer.
Healing pressure sores is dependent on the management of these triggering factors and offloading pressure from the wound. Healing can be slow in patients with multiple comorbidities, and more rapid in young subjects in an acute setting (e.g. prolonged immobilisation due to voluntary drug intake).
Pressure can be offloaded using a range of devices such as special mattress, mattress topper, pressure-relieving/offloading boots, etc.
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Figure 13. Pressure sore in the sacral region.
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