Living with pressure sores is never an enjoyable experience. If you are at risk of developing them, or you are taking care of someone who might be at risk, get informed about pressure sores to avoid developing these unpleasant injuries. This guide will tell you the best ways to prevent and care for pressure sores. What are pressure sores and what causes them? Pressure sores are also described as bed sores, pressure ulcers or decubitus ulcers. They are formed when constant pressure on part of the skin causes the blood vessels feeding that part to shut down. At first, this causes a red or dark patch on the skin. As further pressure is applied, the skin continues to deteriorate, breaking down to form blisters and dead skin, and then going on to affect underlying tissues, bones and joints. Pressure sores can appear on any part of the body, but will usually develop on parts most susceptible to pressure when sitting or lying down, e.g., the lower back, buttocks, shoulders, hips, heels, knees and ankles. In general, people who are bed-bound or in wheelchairs are particularly susceptible to developing bed pressure sores. Other factors that increase the likelihood of developing these sores include old age, immobility, incontinence, malnutrition and dehydration, diseases that slow healing, mental disorders that result in a lack of awareness about the bodys condition and the taking of certain medications such as sedatives. How will I know if I have a pressure sore? There are four stages of severity in the development of a pressure sore. - Initially, you may find it appears as a red area of skin (or a darker area of skin than normal on darker skins). It is a mark that doesnÂt disappear after a few hours and may also feel tender. Sometimes, the initial appearance of a pressure sore may appear like a bruise  purple in color and painful to touch. - The second stage may include a partial loss of skin that may appear as a blister, shallow crater or abrasion. - The third stage of severity involves a full skin loss which extends to the underlying skin tissue. - The last stage involves a total skin loss and the sore extends to the underlying tissue, muscle and bone. How do I treat existing sores? Properly caring for your existing pressure sore is the best way to promote healing and prevent it from becoming more severe. You might be caring for your pressure sores yourself or have a caregiver who cares for them, but it is always best to be informed about the process. Here are four main steps that need to be followed: 1. Pressure relief Continuing to place pressure on an existing pressure sore will aggravate the sore and prevent it from healing. Instead, it is essential to relieve the area from any form of pressure. If possible invest in a pressure-reliving mattress or pressure relieving aids such as cushions to help you. 2. Cleaning Pressure sores will heal well if they are kept clean and it will also ensure the prevention of infection. This means they should be free of dead tissue, have excess fluid drained away from the sore and should also be clear of any other debris. A healthcare professional should show you how to clean or rinse the sore and also how to wipe away any loose material. The right equipment and methods should be used too. If too much force is used, it can aggravate the sore or if not enough force is used, the wound may not be cleansed properly. 3. Removing dead tissue Dead tissue which is present in the pressure sore can lead to infection and prevent the sore from healing. Your healthcare professional will usually carry out the process of removing the dead tissue. Since it may be painful, a pain-reliever may be taken beforehand. Procedures that may be used can range from simply rinsing the sore to applying enzyme medications to dissolve the dead tissue. In rare cases, surgery to remove deeply embedded dead tissue may be required. 4. Dressings It is important to choose the right dressings to care for your pressure sores. Speak to your healthcare professional about the different types available. You will require different types depending on the type that will best aid healing, how often the dressing needs to be changed and whether or not the sore is infected. Dressings are normally required to keep the sore moist and the surrounding skin dry. What else should I know? When cleaning your sores, it is a good time to check for signs that it is healing well. Ideally, you should see signs of a sore healing within 2 to 4 weeks. This includes seeing a decrease in the size and depth of a sore and a decrease in drainage. Also, you should look out for any signs that the sore has become infected as the infection can spread to the underlying tissues, bones and even to the rest of the body. Signs of infection include having think green or yellow drainage, a foul odor, redness, warmth or tenderness surrounding the sore and swelling. Watch out for signs of fever, chills, weakness, confusion, difficulty concentrating and rapid heart beat that can indicate the infection might have spread throughout the body. If you are concerned and experience any of these symptoms, contact your healthcare provider immediately. To manage the pain that pressure sores cause, changing your body position is often a factor that helps. In addition, some patients may choose to take an over-the-counter pain reliever or ask their doctor for a prescription. How can I avoid developing pressure sores? There are many ways to prevent pressure sores from occurring. Try to incorporate the following tips into your daily routine: - Examine yourself very carefully ever day for any signs of sores developing. Recognizing you have a sore developing at an early stage will help you take care of it and prevent it from becoming more severe. - Eat a nutritious and balanced diet, with extra protein to help keep your skin tissue healthy. A good diet will ensure your body has what it needs to heal itself well and cope with infection. - Use barrier creams or protective creams to protect areas that are susceptible to becoming moist. - Protect vulnerable areas of your body from pressure, fiction and moisture. If you are in a wheelchair or undertaking bed rest, it is essential that you change your body position every two hours (or it is recommended that those sitting down change positions every hour). Your caregiver or physician can give you guidance on which positions are best to use. - Keep you skin clean, dry and well-moisturized. Moisturize your skin thoroughly after washing as skin can be weakened when it dries out. Avoid using talcum powder which depletes the skinÂs natural oils. - Make sure any existing sores are cleaned, dressed and bandaged properly. - Drink at least 2 liters of fluid a day. - Make sure there are no wrinkles or crumbs on your bed sheets or chair. - Go to great lengths to avoid rubbing areas of your skin that could get sore. This includes avoiding dragging your heels or elbows when moving around in bed. - Invest in pressure-relieving aids such as pillows, sheepskins and foam pads. The best investment patients can make to prevent pressures sores is buying a good pressure mattress. These mattresses are designed to relieve any pressure that is exerted on a patient when lying down. Some designs even help reposition the patientÂs weight every few minutes, meaning there is no need to continually reposition them. Pressure-relieving mattresses are one of the best tools used to prevent the development of pressure sores. Rachel Clarkson is a bed sores specialist and a big fan and promoter of "The Volkner Turning Mattress": http://www.Volkner.com

I have seen 2 seemingly healthy trees fall victim to borers. One a Sycamore about 6 inches in caliper, it was planted as a whip. It had a v shape I got rid of one side of the V, hoping for a 1 leader tree. The borers attacked the pruning site where I got rid of the other side of the V. The other was my mom's large Tulip tree (liriodendron tulipfera) Missplelled I know. It was 3 ft diameter at least. Borers attacked the lower trunk, where I would bet if I had money, my dad ran into it with the tractor. This happened before I was the primary grass cutter of the family, so i am off the hook. So both of these things in my yard, I can guess there was injury or at least stress involved. But with the Dutch Elm thing, that happened to many likely not injured or stressed trees. I just think or darn well hope that there must be the situation where most trees aren't dying when there is no previous problem. But not to get into a whole "messy thing" but healthy people can get Ebola if exposed. This is a tool to get my point across ONLY. I know nothing specific about that whole mess. But, I had figured that the bugs were natures cleanup crew, and good wood would not fall prey to disease and/or insects unless there was/is an underlying problem that is just how nature is. There are some surviving Dutch Elms (or Elms) in the UK according to a book I have. The disease never reached those few trees.

Scrape isn't healing or great pain walking? Is wound infected? If you don't have much money go get some zinc diaper rash ointment & put on it a few days.(Unless it is pus filled)That healed my burn where all the skin came off to point it has faded out & I think by Christmas you won't be able to see where it was. I got Dr. Scheffield's for $1 at a Dollar store(made in U.S.) but any would work, I use it on my dad's foot as he rubs it on bed(I added piece of ridged foam to ease pressure on feet also) since he had stroke year ago. It hasn't broken open or gotten infected so it is working well for him also. Friend had leg wound that wouldn't heal & they did some kind of oxygen therapy & it healed fast after that. Another friend had to go to a pain center to get her painful leg healed. Don't use iodine on it, that will make the wound larger if you use it daily as it actually eats away at the flesh. My little brother was getting worse from a finger injury & dad didn't have money to take him to dr. so asked druggist & he told him methylate ?( cost 15cents & dad came back on payday & paid it-that's what druggist's did back then!) also orange stuff used many years ago, that healed it. Now the antibiotic creams are much gentler & safer. Zinc in diaper rash creams heals very sore little bottoms but works great for adults & you don't get allergic to an antibiotic that way either.

I don't really think it's greening, as I tried the fruit and it was sweet and fairly uniform in color, and the chlorosis on the leaves seems pretty symmetrical. I do agree with John as far as the insect, and lack of nutrient problems. I'm not really worried about the lichen, just the wounds. Any possible identification on the insect/fungus/nutrient needs? I do need to figure out why it got into this state in the first place, to help prevent it from happening again, and to build on my botany knowledge base. Also I was thinking of trying to spray it with Imidacloprid, removing all that ash and grass around the trunk, laying down a nice thick layer of pine needle/oak leaf/pine bark mulch, and maybe or maybe not applying a slow release fertilizer around the drip line. Not sure about the fert. though because I dont want to further stress the plant out.