Pressure ulcers develop in stages, and often in patients who cannot feel them, so usually the first symptom a patient notices is the presence of a fully formed pressure ulcer. Early warning signs to be alert to before the formation of a pressure ulcer include:
- Changes in skin. Any change in the skin could preface the development of a pressure ulcer; changes in color, in texture, in skin temperature, and in sensitivity all arise. The exact details will depend on how the ulcer has formed; friction will make skin raw and red, while shear-induced ulcers may result in bruising while leaving the surface intact.
- Swelling. Swelling in bony areas of the foot should be taken as a major warning sign, as it typically indicates at least minor damage in the underlying tissues.
- Drainage. Patients or caretakers may only notice ulcers due to the presence of drainage on socks or sheets. Drainage can also preface full ulceration, if the injury begins below the surface.
Each of these should be treated urgently, as doing so can prevent the full formation of pressure ulcers. Even in cases which do not develop later into pressure ulcers, these symptoms should be treated as a warning to maintain better habits of adjustment and inspection.