As if it weren’t already enough of an ordeal losing the use of one’s legs, even the most valuable tool to help with your mobility, the wheelchair often leads to another problem: pressure sores.
What are pressure sores?
A pressure sore is a wound to the skin and sometimes to the underlying tissue below the skin. It’s caused by constant pressure to the skin, and most often affects wheelchair users and others who have difficulty changing positions, either in the wheelchair or in bed.
How bad are pressure sores?
Like any type of injury, there is a wide range of severity in pressure sores. But, to answer the question above in a few words: they can get pretty bad and in some cases may even be fatal. There are actually four stages of pressure sores:
- Stage 1 – In this stage, the sores are not open wounds. The skin is not broken, but is red or discolored, and doesn’t blanch, or whiten, when you press your finger on it. The Stage 1 sore may feel hot, and may be either softer or firmer than the healthier skin surrounding it.
- Stage 2 – In stage 2, the skin has broken or worn away, leaving a painful ulcer. At this point, the wound expands into the tissue below the skin, and may look like a blister filled with clear fluid, a scrape, or a crater.
- Stage 3 – At this point, the pressure sore is very deep, extending into the fat tissue, though muscle, tendon, and bone are still not affected.
- Stage 4 – Stage 4 pressure sores are extremely deep, extending to muscle, tendon, and bone. There is often a lot of dead tissue at this point, the patient is at risk of a life-threatening infection, and surgery is likely to be required.
Prevention of Pressure Sores
Experts agree that it’s much better and easier to prevent pressure sores than it is to treat them. Treatments are available, but they’re not always very effective, and the sores themselves provide a serious health risk. There are however, a number of steps that can be taken to avoid having pressure sores develop in the first place. These include:
- Frequent change of position – Since pressure sores are caused by extended periods of pressure on the same spot, the best way to prevent them is by changing positions. Experts recommend that wheelchair users move every 15 minutes, and also that positions should be changed every two hours when in bed.
- Pressure-release wheelchairs – As the name suggests, these alleviate some of the pressure experienced by wheelchair users, without requiring constant change of position. Special cushions are also available to reduce pressure and provide more comfort.
- Diet – Malnutrition has been shown to increase the risk of pressure sores. A proper diet is beneficial for skin health, so consult a dietician.
- Skin Inspections – The skin should be checked on a daily basis, using a mirror, or with the help of a family member or a caregiver, if necessary. All parts of the body that rest on the wheelchair should be checked for the beginnings of pressure sores.

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