Here, in addition to pressure relief, dry saline or hydrocolloid dressings like comfeel or duoderm will need to be applied under medical guidance. If the sore is infected and dirty, surgical cleaning must be done before regular daily dressings are applied. Grade 4 pressure ulcers would involve the muscle layer and deeper tissues and once infected, surgical treatment is usually necessary and may be extensive. Even with surgery and dressings and good care, once a skin is broken, it will take an average of a week for one centimetre of new healthy skin to grow back and heal. And after healing the same discipline of pressure relief must be done in all areas of the body to prevent further bedsores and to protect the precious skin.
Prevention is much better than curing a pressure ulcer once it is formed.
The skin is made up of different layers. The outside of the skin, called the epidermis, is a layer of flat, dead cells. These contain keratin to make the skin waterproof and tough. The cells are constantly being worn away. But they are replaced by new cells which move toward the surface and harden.