Stop the pressure

14 November 2022

On 17 November, the Spinal Injuries Association (SIA) is using the annual global awareness campaign on pressure ulcers, to highlight the potentially devastating impact that they can have. Stop The Pressure Day is one of the SIA’s key campaigns.

Older people are the group most likely to suffer from pressure sores, but people with spinal injuries are a distinct at-risk group. NHS figures show that 20 to 30 percent of people with a spinal cord injury have pressure ulcers one to five years after their injury.

Pressure ulcers are a concern because, if untreated, they can lead to serious infection and life-threatening complications. Having a pressure ulcer can lead to a significantly extended stay in hospital, and in people over 70 they are associated with a fivefold increase in mortality.

What is a pressure ulcer?

Also known as a pressure sore or bed sore, pressure ulcers can develop when pressure is applied to an area of skin over a period of time. Pressure disrupts the flow of blood through the skin and without a good blood supply, the affected skin becomes starved of oxygen and nutrients and begins to break down leading to the formation of an ulcer. They generally develop gradually but can sometimes occur in a matter of hours. The most common areas for pressure ulcers to form are on bony parts of the body such as heels, elbows, hips and at the base of the spine.

As noted above, the spinal cord injury community is particularly susceptible to pressure ulcers, however they can happen to anyone, of any age. Expectant mothers during labour, people confined to bed after surgery, care home residents, people with obesity, and those with medical conditions such as diabetes are all at increased risk.

Types of pressure ulcer

  • Grade 1: The affected area of skin appears discoloured – it is red in white people, and purple or blue in people with darker-coloured skin. Grade 1 pressure ulcers do not turn white when pressure is placed on them. The skin remains intact, but it may hurt or itch.
  • Grade 2: partial skin loss involving epidermis, dermis, or both. The ulcer looks like an abrasion or blister. Surrounding skin may be red or purple and resemble a blister.
  • Grade 3: full skin loss involving damage to or necrosis (tissue death) of subcutaneous tissue.
  • Grade 4: extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures with or without full-thickness skin loss. Extremely difficult to heal and liable to lead to a fatal infection.

Treating and preventing pressure ulcers

Treatment for pressure ulcers includes the use of dressings, creams and gels designed to speed up the healing process and relieve pressure. The use of antibiotics and/or surgery may be recommended for the most serious cases.

Preventing sores happening in the first place is relatively simple and inexpensive. The risks can be  reduced by taking simple measures such as regularly changing position, using mattresses and cushions to support vulnerable parts of the body, ensuring continence pads are regularly changed, keeping vulnerable areas such as the bottom clean and dry and maintaining a healthy, balanced diet.

What to do if you are concerned about pressure ulcers

If you are confined to bed or sit in a wheelchair for long periods of time, you should tell a nurse, doctor, or carer as soon as you notice any symptoms of a pressure sore.

If you or a loved one has developed a pressure ulcer because of substandard care or neglect, talk to us. We are experienced in handling sensitive cases. We understand you may reservations about reporting your concerns, particularly if your loved one remains in the care of the nursing staff you are reporting.

Call us confidentially and without charge on 0808 163 6264 or fill in a contact form and we will get back to you.



This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024

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