Yes You Can - Fourth Edition - 19

[ Table 1.b.B ] Time and Process for a Pressure Ulcer to Heal STAGE First Stage of Healing Second Stage of Healing WHAT HAPPENS IN THIS STAGE The wound area gets red and hard to the touch. This happens because red and white blood cells are sent to the area to clear away dead tissue and fight infection. New blood vessels are formed to provide oxygen and nutrition to the area. This looks like bumpy, red tissue. At the same time, new cells are laid down at the bottom of the wound. After the first layer is formed, other cells grow underneath, filling in the wound. This is an extremely slow process. The sides of the wound are building layers in the same way. The wound gets smaller, and scar tissue forms on the skin surface. In deep wounds, it is very important that the sides do not close in first. If they do, a pocket may remain in the middle of the wound and form an abscess. This space can become larger and may reopen the wound from the inside out. Scar tissue becomes stronger and may fade in color. The tissues “remodel,” but scar tissue is never as strong as skin. The remodeling can take up to two years. down faster than normal skin because scars have poor blood supply. Scar tissue is also less elastic and may not stretch enough as your body gets into diﬀerent positions. Scarring of the skin and soft tissue can even decrease your range of motion in nearby joints. The best way to avoid scarring is to prevent deep pressure ulcers altogether. It’s important not to let a superﬁcial pressure ulcer [which is likely to heal without a scar] turn into a deeper one. Third Stage of Healing Complications of Pressure Ulcers Pressure Ulcer Worsens The pressure ulcer can get longer, wider, and deeper. In deep wounds, tunneling or “tracking” between layers of muscle, fat, or bone can occur. You can usually keep a pressure ulcer from getting worse by immediately getting oﬀ it and following the guidance of your health-care provider. A pressure ulcer will not heal if pressure is still being applied. Healing Skin Breakdown Healing a pressure ulcer can take from just a few days for a very superﬁcial wound to many months for a deep wound. All ways of treating pressure ulcers require keeping pressure oﬀ the area [SEE TABLE 1.b.B]. Infection Skin and wound infections can occur with pressure ulcers. In deep wounds, the bone can also become infected. This bone infection is called osteomyelitis; it can spread into your bloodstream and make you very sick. Symptoms of wound infection include increasing redness around the wound, pus draining from the wound, and fever. Follow the recommendations of your health-care provider to prevent such infections. Pressure Management The most important part of treating a pressure ulcer is removing the cause. To treat a pressure area at any stage, remove pressure and shearing. For example, if the pressure ulcer is on an area that gets high pressure when you’re sitting, don’t sit until the ulcer heals. If your ulcer is on a pressure area related to lying down [like the tailbone or hip bones], don’t lie in that position Scarring All but the most superﬁcial ulcers heal by forming scar tissue. In the future, this scar tissue will break Section 1: How SCI Aﬀects Your Body! | [ 19 ]

Yes You Can - Fourth Edition

Table of Contents for the Digital Edition of Yes You Can - Fourth Edition