Pressure Care Information Leaflet
Dept. of Occupational Therapy
Bon Secours Hospital
Contact Details – (021) 4801630
What are pressure ulcers?
A pressure ulcer (also called a bed sore, pressure sore, or decubitus ulcer) is an area of injured skin and tissue. They develop from sitting or lying in one position for too long. When a person does not change positions often enough, extra pressure is put on certain areas of the body. Pressure ulcers also can develop from sliding down in a chair or bed, or being dragged across a bed sheet - movements that result in what is called "shearing and friction."
What do pressure ulcers look like?
Like other wounds, pressure ulcers may hurt, weep, bleed and get infected. Look for signs of skin damage, like a discoloured patch i.e. redness. Other signs include swelling, blisters, hard or cracked skin, and patches of skin that are shiny, too warm, cold or dry.
Who is most likely to get pressure ulcers?
People at greater risk of getting pressure ulcers are those who spend a lot of time in a bed, chair, or wheelchair.
Others at risk include:
· People who cannot move or change positions without someone else’s help.
· People who have problems controlling their bowel or bladder functions
· People with reduced sensation and circulation
· People who have a lowered overall health status
How to prevent Pressure Ulcers
Position changes
Changing your position frequently and consistently is crucial to prevent pressure ulcers, as it will help to increase blood flow and circulation to the buttocks. This reduces the risk of a pressure sore forming. A pressure ulcer can begin to form after only a few hours of immobility. To prevent this it is advisable to shift position every 15 minutes if you are sitting or lying in one position for a prolonged period of time. If you can't move on your own, ask a family member or caregiver to help you.
Some wheelchairs have a tilt function. This helps to redistribute pressure and make sitting for long periods easier. If you don't have a chair like this, you will need to manually change position every 15 minutes.
Weight Shifting
There are a number of methods of shifting your weight while sitting in one position. They are written in order of effectiveness for pressure relief.
1. Place hands on the arm rests and lift the body off the chair. If possible, hold for 10 seconds.
- Press elbow on one arm rest to lift that side of body off chair, hold for 10 seconds; repeat on opposite side, or do both at same time.
- Shift your weight by leaning far over to one side and repeat on the opposite side.
All wheelchairs need cushions that reduce pressure and provide support. There are foam, gel, and air-filled cushions available. These do help to relieve pressure, but do not prevent pressure sores from forming or reduce the need to change position as recommended.
Skin inspection.
In order to prevent pressure sores it is important to inspect your skin regularly and thoroughly using a mirror if necessary. A family member or caregiver can help you with this inspection if you cannot do it yourself.
If you are confined to bed, pay special attention to your hips, spine and lower back, buttocks, shoulder blades, elbows and heels.
If you are in a wheelchair or spend a long period of time in sitting, pay special attention to your buttocks and tailbone, lower back, heels and feet.
What to do if you notice a red area developing?
If you see skin damage such as redness, warmth in surrounding skin and increased tenderness, or if you notice a red area changing, the formation of a blister on the skin, further skin break down or increased weeping from a wound apply the strategies outlined above and contact your GP or Public Health Nurse immediately.
Keep the skin clean and prevent it from drying out
Use a gentle cleanser, not soaps, which dry the skin out. After washing dry the skin by patting not rubbing. Apply a cream moisturiser immediately after bathing to seal in the moisture.
Protect the skin from too much moisture.
When skin gets too wet, it is at incresed risk of breaking down. Skin can become too moist when sweat, urine, feces, or wound drainage remain in direct contact with the skin. If the problem is caused by a bowel or bladder control problem, make sure:
· The skin is cleaned as soon as it becomes soiled
· Absorbent pads or underwear with a quick-drying surface are used to help keep moisture away from the skin
Lifestyle changes
Although you may need assistance with many aspects of your care, you can control of some important preventive measures, including:
Eating a healthy diet, to prevent skin breakdown and to aid healing.
Quitting smoking as it decreases oxygen to your skin and slows the healing of wound.
Taking daily exercise as it improves circulation and builds up vital muscle tissues.