Pressure Ulcers
Anyone who must stay in a bed, chair, or wheelchair can get
pressure ulcers. Fortunately, most can be prevented or kept from
getting worse.
WHAT ARE PRESSURE ULCERS?
A pressure ulcer is an injury caused by unrelieved pressure that
damages the skin and underlying tissue. Pressure ulcers are
sometimes called bed sores and range in severity from mild (minor
skin reddening) to severe (deep craters extending down to muscle
and bone.)
WHAT CAUSES PRESSURE ULCERS?
Pressure on the skin blocks the blood supply. When skin is deprived
of nutrients and oxygen for too long. the skin starts to break down,
the tissue dies and a pressure ulcer forms. The first sign of a
pressure ulcer is redness on the skin. Persons may get pressure
ulcers after as little as 1-2 hours.
WHERE DO PRESSURE ULCERS FORM?
Pressure ulcers form where bone causes the greatest force on
the skin and tissue. For people who must stay in bed, most pressure
ulcers form on the tailbone (sacrum), the hip bones, shoulder
blades, back of the head, ears, elbows, knees, ankles and on the
heels. Pressure ulcers can also form behind the knees, for people
confined to chairs or wheelchairs.
RISK FACTORS
Confinement to a bed, chair or wheelchair
Inability to change positions, such as with paralysis
Loss of bowel or
bladder control
Poor nutrition
Lowered mental awareness from health problems,
medications
or anesthesia
Loss of sensation in lower extremities
STEPS FOR PREVENTION
prevention is the key:
These steps can also keep pressure ulcers
from getting worse.
Take care of your skin
o Inspect skin at least once a day. Pay special attention
to any reddened areas
o Keep the skin clean and dry. Use a soft cloth to clean
your skin and wash it as soon as it is soiled. If loss of
bowel or
bladder control, cleanse thoroughly after each
episode. Completely and gently dry area. Apply a
moisture barrier cream, a thick "Vaseline-type"
protective cream.
Prevent dry skin. Take a bath only when needed, using
warm (not hot) water and a mild soap. Use cream or
oils on you skin that don't contain alcohol which is drying.
Protect your skin from injury
Avoid cold or dry air.
Avoid massage of your skin over bony parts of the body.
Keep the bed linens dry and wrinkle free.
Change position frequently - at least every two hours -
- or have your caregiver change your position. If you
are in a chair and can shift your own weight, do so at
least every 15 minutes or have someone reposition you
at least every hour. Reduce friction by being sure you
are lifted rather than dragged during repositioning. Bed
sheets or lifters can be used.
Use pillows or wedges to keep knees or ankles from
touching each other. Place pillows from mid-calf to ankle
to keep heels off the bed.
Products are available such as water mattresses or gel pads
to help reduce pressure.
Eat a balanced diet . Eat foods high in protein and calories.
Drink plenty of fluids. If you cannot tolerate a balanced diet.
ask your doctor about nutritional supplements.
DO NOT sit on a rubber ring. DO NOT use heat on pressure
sores. DO NOT sit or lie in one position for more than two
hours.
You can help prevent most pressure ulcers. If you have questions
problems or concerns, be sure to ask your doctor or nurse.