Pressure Sore

Discovering and treating a pressure sore.

Joy Pape By Joy Pape, RN, BSN, CDE, WOCN, CFCN

As I mentioned in my last article, not all wounds are alike. There are many causes and types of wounds. Treatments depend on the cause and type of wound. And remember, keeping your blood glucose, blood pressure, and lipids as near normal as possible are very much a part of your treatment (and prevention).

The most common type of common type of wound you may have on your feet is called a pressure sore.

Pressure sores
A pressure sore is localized injury to your skin and /or its underlying tissue, usually over a bony area of your body as a result of pressure or pressure in combination with shear and/or friction. There are many causes of pressure sores. It can be from not moving enough, from the shoes you wear, and even the socks or stockings you do or don't wear. (Certain types of socks or stockings can cause a pressure sore to emerge. Not wearing socks or stockings can cause your shoes to rub against your feet, causing friction, then sores.)

There are preventive measures to prevent pressure sores. And there are signs that tell you if trouble is looming. If you have some nerve damage (which is not uncommon in people with diabetes), you may not be able to feel the pain that alerts you to a problem. This is why it is so important that you or a loved one take a good look at your feet every day. If you notice any of the following signs or symptoms, contact your health care professional immediately.

Signs and Symptoms
Pressure sores are categorized from early to late stages. Treatment is also related to the stage. It is best if you can prevent them, but if it's too late, use this when working with your health care provider to identify a pressure sore and choose the correct treatment.

Stages of Pressure Sores*
Stage I – a nonblanchable reddened area on the skin. This means when you press on the reddened area, it does not turn white. It may be painful, soft, hard, warmer or cooler than the surrounding skin. This can be hard to detect in a person of color.

Stage II – a superficial sore or a blister. The skin around it may or may not be reddened. This is not the same as a tear, cut, or other problems where skin may blister, such as an infection or allergy, because the cause of these is not pressure.

Stage III – full thickness tissue loss. This means some of your subcutaneous fat may be affected and visible, but you can't see muscle, tendon, or bone. The depth has to do with the body part affected. For example, a Stage III pressure sore on your ankle won't be as deep as it would be on your hip or buttocks. There may be a tan, yellow, gray, green, or brown color to part of it, called slough.

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Last Modified Date: July 08, 2013

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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