Preventing Pressure Sores

Preventing Bed SoresPressure sores or decubitus ulcers, come from staying motionless for extended durations. These ulcers are a result of inadequate blood supply,  and occur when the blood re-enters tissue. They can happen to anyone – even healthy individuals may be familiar with a dull ache that occurs from remaining in the same position for too long. As you can guess, this phenomenon poses a legitimate concern to people who live with limited mobility. Although bed sores can be experienced by anyone of any age, they are most common in elders in wheelchairs and confined to beds.

So what can you do about pressure sores? It is far easier to prevent pressure sores than to treat them when they appear, but the rigorous process will still require daily effort.

As home health care experts, we recommend the following:

  • Position changes
  • Skin care
  • Good nutrition
  • Staying active
  • Absolutely no smoking

Frequent position changes and relief of pressure, are the most effective part of this five-part strategy for avoiding bed sores. The weight of the human body itself is enough for bed sores to develop in vulnerable areas.

For people in wheelchairs, it may be possible to perform wheelchair push-ups, which means raising your body off the seat by pushing on the arms of the wheelchair. This maneuver will require a bit of upper body strength. Alternatively, there are pressure-release wheelchairs available for purchase, which are adjustable so that you can redistribute the pressure on your body, as well as cushions filled with foam, gel, water, or air, which can be strategically placed in various locations. We recommend changing position without assistance at least every fifteen minutes and with assistance at least once per hour.

For those confined to bed, we recommend repositioning once every two hours. With the use of a trapeze bar or similar devices, people with sufficient upper body strength can reposition themselves easily. Special mattresses or pads can also provide relief, as well as adjustable beds like those found in hospitals. It’s important to protect bony areas as pressure can build up very quickly there. Cushions can be used to protect bony areas, especially near hips, knees, ankles and heels.

Putting an emphasis on your skin care efforts is the best way to identify stage 1 sores before they get worse. Daily skin inspections, lotions, and managing incontinence are the best ways to protect skin from excess moisture or dryness as well as bacterial exposure.

Pressure sores are described in four stages:  They can range from mild reddening of the skin to severe tissue damage—and sometimes infection—that extends into muscle and bone. The four stages are listed below:

  • Stage 1 sores are not open wounds. The skin may be painful, but it has no breaks or tears. The skin appears reddened.  In a dark-skinned person, the area may appear to be a different color than the surrounding skin, but it may not look red. Skin temperature is often warmer.
  • At stage 2, the skin breaks open.  It can look like a scrape (abrasion), blister, or a shallow crater in the skin. Sometimes this stage looks like a blister filled with clear fluid.
  • During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater.  Full thickness tissue loss.  Subcutaneous fat may be visible.
  • At stage 4, the pressure sore is very deep, reaching into muscle and bone and causing extensive damage. Damage to deeper tissues, tendons, and joints may occur.  Full thickness tissue loss with visible bone, tendon, or muscle.

Lastly, it’s important to embrace the three most common pieces of advice when it comes to staying healthy: eat nutritious food, stay active, and no smoking allowed! Make sure your diet includes the right balance of hydration, calories, protein, vitamins and minerals. Talk to your doctor for recommendations on how to improve the health of your skin or how to quit smoking. 

The staff here at Metropolitan Home Health Services, Inc. are always on the lookout for concerns involving skin and relief of pressure.

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