In my last two blogs I discussed two of the three most common wounds/ulcers that we see in the lower legs and feet. The last one I would like to discuss is a decubitus ulcer, otherwise known as pressure sores. These are caused by increased pressure on a particular part of the body which leads to breakage of the skin causing a wound or ulceration. The most common areas that we see this in the lower extremity are on the heels. This can be seen in patient's who are bedbound, in nursing homes, in rehabilitation facilities, as well as in patient's with lower extremity paralysis. Other risk factors for pressure wounds include peripheral artery disease, poor hygiene, and deficient nutritional status.
As stated before, these are caused by an increase pressure on one particular area of the body that causes a breakdown of the skin or tissues. As these wounds progress they become very deep and very difficult to treat. The most important aspect of treating these wounds is offloading the area immediately. If these patients are not properly offloaded these wounds will never heel. The second most important aspect of treating these wounds is through good local wound care and preventing infection. If a wound or infection progresses down into bone then surgery must be performed in order to remove the infected bone.
If you have a loved one or family member that is currently bedbound or paralyzed it is important that somebody monitors them throughout the day and evening. If they are placed in one position for too long they will develop a decubitus ulcer. Another common area of developing these wounds are in the sacral or buttocks area. It is not uncommon to see decubitus ulcers in both the heels and sacrum simultaneously. Different ways to offload these areas are with air mattresses, pillows and other foot offloading devices.
These take many months and even up to a year to heal. The best way to treat these wounds is to prevent them. I hope this is helpful, and will prevent you or a loved one from having any these wounds in the future. If you need more information, please contact Atlantic Foot & Ankle Associates with locations in Palm Coast, Daytona Beach, Port Orange, and Orange City.