Put simply, a pressure ulcer usually appears as an open wound due to the skin becoming so badly damaged that it breaks down or dies.  The problem can present itself as a simple nuisance or as a life-threatening condition.

A number of factors can contribute to the development of a pressure ulcer but the cause is pressure (usually in bony areas such as the heel of the foot, the elbow, the lower back or the shoulders) for an extended period of time because the patient is inactive, confined perhaps to a bed or wheelchair.  Although further details will be given later, the simple reason for the pressure causing the problem is the blocking of blood supply to the area.

In its early stages, a pressure ulcer can appear harmless enough – the color of the skin turns pink or red and does not return to normal after the pressure is removed.  As the condition worsens, the skin eventually becomes cracked, blistered or broken.

In order to better understand the concept, consider what happens when a tourniquet is applied to a badly bleeding wound to reduce the blood supply and prevent massive bleeding.  Pressure on the skin and underlying tissue works like a tourniquet in that it prevents the supply of blood and nutrients from reaching that particular area.  If the situation becomes chronic, cells will die.  In fact, once the skin color turns from red or pink to white, and remains white, deterioration of the skin and tissue has already occurred.

Pressure Ulcer
In medical terms, an ulcer refers to a crater-like lesion.  A peptic ulcer, for instance, has the same characteristics but is found in the stomach and is caused by distinctive factors that differ from those which cause pressure ulcers.

Bed Sore
Skin breakdown often happens to people who are bedridden and not very mobile.  Continuous pressure is exerted on certain parts of the body due to lack of movement.  The condition can be tender and painful.

Decubitus Ulcer
This is the traditional medical term.  Decubitus (pronounced dee-CUBE-i-tus) derives from the Latin word “decumbere” meaning to lie down, referring to its frequent occurrence among people who are immobile and confined to bed.

Leg Ulcer
The leg ulcer differs from other types of skin wounds because of its unique causative factors and requires a more complicated treatment plan, which we will not go into here.

Wound
A wound is a break in the skin, usually associated with physical injury.  This is possibly the furthest removed terms for a pressure ulcer but the medical profession often includes this term in the pressure ulcer category.  It’s fair to note that a normal wound, with none of the high-risk factors such as poor circulation, pressure on the skin of immobility, will generally heal more quickly than a pressure ulcer.

Whenever you hear any of these terms – with the possible exception of wound – you can be assured that they mean the same thing as a pressure ulcer.  Although we have decided to use the term pressure ulcer throughout this book, don’t be confused if your nurse, health care professional or physician calls your condition by any of the other names we have listed.  As we said earlier, it’s often simply a matter of personal preference.

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