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Pressure ulcer prevention is  important as they can have a serious impact on the well-being of people with limited mobility and are typically experienced by people over 65 years of age. Young people with neurological impairment or suffering with illness are also susceptible. Pressure ulcers are also known as bedsores, or pressure sores, but the medical term is decubitus ulcers.

If pressure is allowed to develop in specific areas of the body over time, it can lead to the development of pressure sores. Exposure to repeated pressure in these areas leads to the degradation of the skin’s integrity, which in turn leads the skin vulnerable to infection. This is especially the case for people who are in wheelchairs or spend a lot of time in bed, at home or in hospital.

pressure sores from hospital beds

Photo by Sharon McCutcheon via Unsplash

The good news is that pressure ulcer prevention is possible. Here are seven tips you can follow:

Pressure Ulcer Prevention – Keep Moving

The best tip for pressure ulcer prevention is to keep moving as much as possible. Exercise, motion exercises and just walking around are excellent ways to promote circulation. Improving circulation is an important part of pressure ulcer prevention and variety in movement is key. It is not just a case of getting out of bed either, as pressure ulcers can develop on the hips, shoulders, heels or tailbone when a person sits in a wheelchair for long periods of time. Repositioning is also crucial for pressure ulcer prevention when a person is lying down for long periods of time.

Regularly Check for Signs of Developing Pressure Sores

Pressure sores can develop very quickly, so regular checks should form part of any care program. If you are at risk of developing bed sores, be aware of early warning signs like discoloured skin. If you have an underlying condition, like diabetes, you may be numb in certain parts of your body and not feel bed sores developing, which makes regular checks even more important. People who are confined to a bed may not be able to adjust their position without assistance, so regularly helping them to check for sores is essential.

Specialty Bedding, Materials, and Equipment Can be Used For Pressure Ulcer Prevention

air mattress for ulcer prevention

Speciality bedding, materials and Medical Equipment can be very useful for pressure ulcer prevention. Cushioned padding such as heel protectors, for example, can reduce pressure on sensitive areas of the feet. An air cushion or gel cushion can be used when patients are spending long periods sitting in a wheelchair or chair. An air mattress topper can also be used to help reduce the amount of pressure on specific areas of the body when in bed. Another effective way to prevent pressure ulcers is to put pillows between parts of the body that press against each other. For example, under the tailbone, shoulders, heels, and elbows. If the patient is lying predominantly on their side, put a pillow between the knees and ankles.

Skin Should be Kept Dry and Clean 

One of the biggest contributing factors associated with the development of pressure ulcers is incontinence. Urine or bowel movements that stay in contact with the skin cause the skin to degrade faster than normal. Combine this with a person’s inability to reposition themselves and the likelihood of developing a pressure ulcer in the perineal area increases.

If, during a regular check, it is noticed that the area looks as if it has become reddened, a Stage I pressure ulcer may already have developed. This means pressure ulcer treatment is necessary. Barrier creams can be used as part of a pressure ulcer prevention plan. However, it is important that repositioning and movement still take place to prevent the condition from worsening.

Pressure ulcer prevention measures also include moisturising the skin after washing. Scented soaps should be avoided as they can cause dryness. Talcum powder should also be avoided as it dries the skin’s natural oils.

Healthy Eating Is Important For Pressure Ulcer Prevention

healthy diet for ulcer prevention

Photo by CDC via Unsplash

A well-functioning circulatory system can have numerous benefits for the health and well-being of a patient. However, it can only be achieved if the body receives the right nutrients. A healthy, well-balanced diet is important for everyone, but even more so for people at risk of developing pressure ulcers. Successful pressure ulcer prevention is only possible if a patient is eating the right foods. A balanced diet is one that contains plenty of protein and fresh fruit and vegetables. Drinking plenty of fluids is also essential.

Effective Management of Chronic Health Conditions

If a patient has a chronic health condition, it can also increase the risk of developing pressure ulcers. Conditions affecting the cardiovascular system often result in poor circulation, which further increases the risk. Therefore, effective management is critical. It should include regular monitoring of fluid intake for pople with heart failure, making sure medication does not lead to poor circulatory function. For people with kidney disease, the maintenance of dietary restrictions is important.

Take Ergonomics into Account

It is vital to get a good ‘fit’ between your equipment and your immediate environment. Ergonomics also accounts for any issues like mobility so that all aspects of your environment help you to perform tasks. Ergonomics should be considered when choosing furniture such as beds, bed-side chairs and mattresses.

 

Frequently Asked Questions

 

What is a pressure ulcer?

It is an injury to the skin and underlying tissue that is the result of prolonged pressure. They often develop on skin covering bony areas such as heels, ankles, hips, shoulder blades, spine, backs of arms and legs. People most at risk of developing pressure sores have medical conditions which limit their mobility and spend the majority of their time in bed or in a chair. Bedsores can develop in just a few hours or over several days. They can heal when treated correctly.

What are the symptoms of pressure ulcers?

Warning signs to look for include unusual changes in the colour or texture of the skin, swelling, areas of the skin that feel cooler or warmer to the touch than other areas, pus-like draining or tender areas. Damage can range from red, unbroken skin to a deep injury that involves muscle and bone.

What are the causes of pressure ulcers?

There are three contributing factors: pressure, friction and shear. When constant pressure is applied to any part of the body, it lessens blood flow to the tissues. This blood flow is essential as it delivers oxygen and other nutrients to the tissues. When these nutrients aren’t available, skin becomes damaged and can eventually die. When a person’s mobility is limited, pressure often occurs in areas of the body that aren’t too well padded, such as the spine, shoulder blades, hips, tailbone and elbows. Friction is caused by clothing or bedding rubbing against the skin. This in turn makes fragile skin even more at risk of injury, particularly when the skin is moist. A shear occurs when two surfaces move in opposite directions.

How to Prevent pressure ulcers?

Pressure ulcers can be prevented by frequently repositioning to avoid stress on the skin. The chances of developing pressure ulcers can also be reduced by maintaining good nutrition, taking good care of the skin, drinking plenty of fluids, regular exercise and management of stress.

How to treat pressure ulcers?

The first step is to reduce the pressure and friction that has caused the pressure ulcer. This can be done by repositioning to prevent pressure ulcers and using support surfaces such as an air mattress, air cushion, or gel cushion. Cleaning and dressing the wounds is also crucial. To help the wounds heal, damaged tissue can be removed by gently flushing the area with water or cutting out damaged tissue. Drugs can be given to reduce the pain. A healthy diet will promote wound healing. If a large pressure ulcer fails to heal, it might require surgery. This might involve using a pad of muscle, skin or other tissue to cover the wound and cushion the affected area underneath.

How to prevent pressure ulcers in nursing homes?

Pressure ulcer prevention is possible when nursing home patients receive appropriate care. This includes regularly changing the position of residents, providing frequent incontinence care, making sure water is always available, making regular checks of residents skin, providing nutritious meals, providing opportunities for residents to increase their mobility and using the correct bed to prevent pressure ulcers.

How to treat pressure ulcers in hospitals?

The first step is to remove pressure on the affected area. Medicated gauze or some other kind of special dressing can then be used to protect the wound. The wound should be kept clean at all times. Good nutrition is essential. Damaged, infected or dead tissue should be removed in order to aid the healing process. Transplanting healthy skin can be used if the skin is irreparably damaged.

Who is most at risk of developing pressure ulcers?

Those most at risk are people who spend most of their day in bed or in a chair with minimal movement, people who are over or underweight, people who have little or no control over their bowel or bladder movements, people who have decreased feeling in specific areas of their body and those who spend a significant amount of time lying or sitting in one position.