Pressure Sores - a Preventable Injury

Pressure sores, also known as pressure ulcers or bedsores are a common, but often preventable, injury suffered by patients in care homes and hospitals in the UK.

Pressure sores develop when pressure against the skin limits blood flow to the surface of the skin. All patients are at risk of developing pressure sores but that risk is higher for those who have significantly limited mobility and who are unable to take steps themselves to prevent a sore from developing.

Stages of a pressure sore

The first sign of a pressure sore developing is usually reddening of the skin over the affected area; it may also appear bruised. This is Stage 1. It is vital that steps are taken at this stage to treat the pressure sore before the condition of the patient’s skin deteriorates further.

At Stage 2, the skin breaks open and wears away.

At Stage 3, the deeper layers of the skin wear away and a shallow crater forms in the skin.

By Stage 4, there has been a serious loss of skin, fat and muscle right down to the bone.

The sight of a pressure sore is quite frankly, shocking and they are understandably extremely painful for the patient. Whilst often described as a complication of inpatient care, they can carry their own complications which in the short term include an extended hospital stay and/or surgery and in the long term severe deformity, amputation and even death where an infection develops.

How can pressure sores be prevented?

In theory, pressure sores should be relatively easy to prevent by:

  • Regularly repositioning the patient or mobilising the patient where they are able e.g. through exercises;

  • Keeping the skin clean and dry; 

  • Using a specialist foam mattress or other device to offload the pressure on the skin; for example, a pillow can be used between parts of the body that press against each other such as the legs.

Clinical negligence

Sometimes, a pressure sore cannot be avoided despite these steps being taken. However, we often come across cases where the following failures have occurred:

  1. Failure to evaluate a patient’s condition (skin assessment) and to identify the risk of them developing a pressure sore (risk assessment).

  2. Failure to plan the care needed to prevent a pressure sore from developing.

  3. Failure to put that plan into effect (by not repositioning/mobilising the patient, keeping the skin clean, failing to provide a specialist mattress (which can happen when a patient moves wards) etc.). 

  4. Failure to recognise the development of a Stage 1 pressure sore and/or to take appropriate action to prevent the sore from developing to a Stage 2, 3 or 4.

In these circumstances, where a pressure sore develops beyond a Stage 1, the care provided has often been found to be negligent.

If you or someone you know has suffered a pressure sore that you think could have been prevented, please do not hesitate to contact our clinical negligence team for advice.