Even with the best possible medical care, complications (which can occasionally be life-threatening) can arise from grade three or grade four pressure ulcers. These complications are listed below.
Infection can spread from the site of the pressure ulcer to a deeper layer of skin. This type of infection is known as cellulitis and causes symptoms of pain and redness, plus swelling of the skin.
Left untreated, there is a risk that the infection can spread to the blood (blood poisoning or sepsis) or the membranes that surround the brain and spine (meningitis), both of which are life threatening conditions.
Cellulitis will need to be treated using a course of antibiotics.
If a person with a weak immune system has a pressure ulcer that becomes infected, there is a risk that the infection will spread into their blood and other organs. This is known as blood poisoning, or sepsis.
In the most serious cases of blood poisoning, damage to multiple organs can lead to a large drop in blood pressure, which is known as septic shock. Septic shock can be fatal and symptoms include cold skin and an increased heart beat.
Blood poisoning is a medical emergency and requires immediate treatment in an intensive care unit (ICU) so that the functions of the body can be supported while the infection is treated with antibiotics, or antiviral medication.
Bone and joint infection
Infection can also spread from a pressure ulcer downward into underlying joints (septic arthritis) and bones (osteomyelitis).
Both of these infections can cause damage to cartilage, tissue, and bone, and may affect the function of the joints and limbs. Antibiotics are required to treat bone and joint infections and, in the most serious of cases, infected bones and joints may need to be surgically removed.
Necrotizing fasciitis, commonly known as 'flesh-eating' bacteria, is a serious skin infection that causes rapid tissue death. Necrotizing fasciitis can occur when a pressure ulcer becomes infected with a type of bacteria known as Group A streptococcus bacteria.
Emergency treatment is required and involves a combination of antibiotics and surgical debridement of the dead tissue.
Gas gangrene is a rare, but serious, form of infection that occurs when a pressure ulcer becomes infected with the clostridium bacteria. The bacteria thrives in environments where there is little, or no, oxygen. They produce gases and release dangerous toxins. Symptoms of gas gangrene include rapid swelling of the skin and severe pain.
Gas gangrene requires immediate treatment with surgical debridement and, in the most serious of cases, it may be necessary to amputate the affected body part in order to prevent the gangrene from spreading to the rest of the body.