Pressure ulcers, also known as bedsores or decubitus ulcers, are localized injuries to the skin and underlying tissue caused by prolonged pressure. They are particularly dangerous for individuals with chronic conditions such as diabetes, where reduced circulation, nerve damage, and slower healing significantly increase the risk of complications.
For more information on pressure ulcer care and prevention, visit the Merkaz Sukeret website, which offers professional resources for diabetic foot health and wound management.
What Are Pressure Ulcers?
A pressure ulcer is a skin and tissue injury that occurs when there is constant pressure on a specific area of the body, usually over bony prominences like the heels, ankles, hips, and lower back. When blood flow to the area is reduced for extended periods, tissue begins to break down, leading to painful and sometimes infected wounds.
Pressure ulcers are classified into four stages:
- Stage 1: Red, non-blanching skin without open wound
- Stage 2: Partial-thickness loss of skin with blistering or shallow ulcer
- Stage 3: Full-thickness skin loss, exposing fat tissue
- Stage 4: Severe tissue damage with exposed muscle, bone, or tendons
Why Are Diabetic Patients at Higher Risk?
Peripheral Neuropathy
Many diabetic patients develop peripheral neuropathy, a condition that reduces the ability to feel pain or discomfort. This means they might not feel the initial signs of pressure, such as discomfort or irritation, allowing the damage to progress unnoticed.
Poor Circulation
Diabetes often leads to peripheral vascular disease, which restricts blood flow, especially to the lower limbs. Reduced oxygen and nutrient supply makes skin tissue more susceptible to breakdown and slows the healing process.
Weakened Immune Response
Chronic hyperglycemia impairs the immune system’s ability to respond to infections. Even minor ulcers can become seriously infected, requiring hospitalization and advanced medical care.
Early Detection and Warning Signs
Early intervention is critical in preventing the progression of pressure ulcers. Signs to look out for include:
- Unusual redness or discoloration on pressure-prone areas
- Swelling or warmth at the site
- Skin that feels firmer or softer than surrounding tissue
- Pain or discomfort in localized spots
- Blistering, open sores, or drainage
Daily skin checks—especially in areas like the heels, hips, and sacrum—are essential for diabetic patients, particularly those with limited mobility.
Prevention Strategies
Repositioning
One of the most effective prevention methods is frequent repositioning. Patients who are bedridden or wheelchair-bound should be moved at least every two hours to relieve pressure.
Support Surfaces
Specialized mattresses, cushions, and overlays can help distribute weight evenly and reduce pressure points.
Skin Care
Keep the skin clean, dry, and moisturized. Use pH-balanced cleansers and avoid harsh soaps. Inspect feet and pressure points daily.
Nutrition and Hydration
Proper nutrition supports skin health and wound healing. Ensure adequate intake of protein, vitamins (particularly A, C, and E), and fluids.
Diabetes Control
Tight glycemic control reduces the risk of neuropathy, vascular issues, and impaired wound healing—all of which contribute to pressure ulcer formation and severity.
Treatment Approaches
When a pressure ulcer does occur, timely treatment is crucial. Steps include:
- Wound cleansing and debridement: Removal of dead or infected tissue
- Moist wound healing: Use of advanced dressings to maintain ideal wound environment
- Infection management: Topical or systemic antibiotics if needed
- Offloading pressure: Use of devices or supports to prevent further pressure on the ulcer
- Multidisciplinary care: Involvement of podiatrists, nurses, nutritionists, and diabetologists
In severe cases, surgical intervention such as flap reconstruction may be necessary.
Conclusion
Pressure ulcers in diabetic patients are a serious but preventable complication. With early detection, regular skin monitoring, and appropriate management, the risk of severe outcomes—including hospitalization or amputation—can be dramatically reduced.
Don’t wait for symptoms to appear—be proactive. For professional guidance and tailored care information, visit Merkaz Sukeret.