Pressure sores or ulcers may simply be described as a lesion, break, or swelling in the skin that fails to heal and the damaged area then develops inflammation of the area surrounding it. Another description is breaking down of the skin surfaces when something keeps rubbing or pressing against the skin.
Pressure sores occur when there is too much pressure on the skin for too long. This reduces blood flow to the area. Without enough blood, the skin can die and a sore may form. In this article, we are going to look at how one can avoid getting a pressure sore.
Do regular pressure reliefs
Regular pressure reliefs also called weight shifting or pressure redistribution or pressure reduction is a process of relieving pressure by lifting yourself to take the pressure off areas that have been under pressure, usually from sitting or lying in one position, so blood can circulate. This is applicable when sitting in your wheelchair or when bedridden or sitting in a car or on other surfaces such as on sports equipment Regular pressure reliefs is exercised by ensuring you do pressure reliefs every 15 to 30 minutes for a duration of at least 30 to 90 seconds. If you are unable to perform a pressure relief independently, instruct the person who helps you with your daily care (family, attendant) to consistently, routinely move you and reduce pressure over areas at risk for pressure sores.
Check your skin, or have your attendant or caregiver check your skin. This is achieved by ensuring minimum skin check-up twice a day i.e. morning and bedtime. Proper and quality skin check-up to detect pressures sores is done by, looking for any changes in skin color whereby skin can redden or darkened. Look for blisters, bruises, or cracked, scraped or dry skin. Feel for hardness, swelling or warmth that may signal skin breakdown. Closely inspect areas that are at especially high risk for pressure sores e.g. coccyx because in some areas of the body the bones are close to the surface of the skin. Inspect areas of skin that are in contact with casts or braces twice daily.
Padding, positioning and turning in bed
Use a regular schedule of turning at night. Depending on weight and skin tolerance, your turning schedule may vary from every 2 to every 6 hours. If you are a caregiver and your patient s bedridden, look for the best patient turning devices that will reduce the risk of patient falls and difficulties encountered when turning a patient. Use pillows and foam pads to protect bony areas. Ensure that no two skin surfaces should rest against each other. Use cushion for pressure sore on buttocks to reduce any pressure exerted on buttocks.
Personal Hygiene upkeep and nutrition
Bathe daily with mild soap and warm water and rinse and dry thoroughly. Pay particular attention to keeping the genital area and skin folds clean and dry. Avoid harsh soaps, skin agents with alcohol, and antibacterial or antimicrobial soaps. Drink enough water every day to give your body the fluids it needs. Water intake may vary according to your bladder management routine. Avoid caffeinated drinks like coffee, tea, and soft drinks, which are dehydrating and may trigger bladder spasms. Eat a balanced diet that includes adequate protein, fruits, and vegetables. Poor nutrition prevents the body tissue from rebuilding, staying healthy and fighting infection.
Get a proper seating evaluation
This should be done at least every two years or sooner if your health or skin condition changes. Make sure you have the appropriate wheelchair with proper cushion and your seating tolerance one that has been measured specifically for you and is compatible with your level of mobility, activities, work and associated equipment. The therapist doing the seating evaluation should place a pressure map above your cushion and under your buttocks to see where your pressure-sensitive areas are. If at-risk areas on the pressure map are found, then the therapist may try a different cushion; alter the wheelchair seat, back or foot rest; or show you how to relieve pressure on the vulnerable areas by repositioning your body.
Clothing and shoes
Wear properly fitted clothing; avoid thick seams, rivets or bulky pocket and check for folds and wrinkles. Shoes should be 1-2 sizes longer and wider than your pre-injury shoe size to allow for swelling of feet during the day. Use shoes with stiffer toes for protection when you bump into objects with your feet. If you are diabetic consider using the offloading boot for diabetic foot ulcers to prevent foot ulcer development.