PREVENTING PRESSURE ULCERS - Oxford Healthcare

A pressure ulcer is an injury to
the skin that occurs as a result
of constant pressure. The pressure
on the skin results in reduced
blood flow to the area
and may eventually cause skin
breakdown, cell death, and
the development of an open
wound.
Pressure ulcers most often occur
in persons who are wheelchair
or bed bound, but may
also occur in persons who are
able to walk but spend most of
their time sitting or lying down
in the same position every
day.
If the conditions leading to a
pressure ulcer are not rapidly
corrected, the localized skin
damage will spread to deeper
tissue layers, affecting muscle,
WHAT SHOULD YOU DO IF
YOU DEVELOP A PRESSURE
ULCER
Notify your doctor or home
health nurse right away. With
proper treatment, most pressure
ulcers will heal. Healing of pressure
ulcers depends on your
general health, diet, relieving
pressure on the ulcer and careful
cleaning and dressing of the
wound. Healing wounds require
a team effort that includes you,
your caregiver and your healthcare
providers. The treatment
plan ordered by your doctor will
be based on the results of the
wound assessment, a physical
exam, and health history.
TAKE TAKE THE THE PRESSURE PRESSURE OFF OFF: OFF
PREVENTING PREVENTING PRESSURE PRESSURE ULCERS
ULCERS
PREVENTING PRESSURE ULCERS
tendon and bone. Open pressure
ulcers are painful, disabling,
and can lead to a serious
infection.
If you spend long periods of
time in a bed, chair or wheelchair,
or have lost feeling in the
lower part of your body, you
are at increased risk for pressure
ulcers!
For people who are limited in
their ability to move, these
other factors heighten their risk
for pressure ulcers:
• being over- or under-weight,
• not eating a balanced diet,
• not eating enough protein
rich foods,
• having poor circulation
• loss of bowel or bladder control
The first sign that a pressure ulcer
is developing is an area of
reddened skin on a fair skinned
person or bluish discoloration
on a darker skinned person. The
area may not be painful at this
stage.
Persons who are confined to
bed may develop ulcers on areas
that they lie on such as the
tailbone, buttocks, heels, hips,
ankles, shoulder blades, back
of the head, ears, elbows, and
between the knees. Pressure
ulcers may develop on the buttocks,
back of the knees or
heels of persons who sit in a
chair or wheelchair for long periods
of time.
Tips to Prevent Pressure
Ulcers
• Check the skin carefully
every day for pressure areas.
• Keep skin clean, dry, and
moisturized. Use a mild
cleansing product when
bathing and after every incontinence
episode.
• After cleansing, use a moisturizing
skin protector
product to provide a moisture
barrier to the buttocks
and area around the
genitals. These products
(lanaseptic, etc.) are available
from any pharmacy or
medical supply company.
• Eat a balanced diet that
includes good protein food
sources. Drink plenty of fluids
(at least 2 quarts a day).
If you cannot tolerate a
balanced diet, talk to your
doctor about adding nutritional
supplements to your
diet (Ensure, etc.) and multi
-vitamins.
• Avoid massaging directly
over bony areas.

What You Can Do to Prevent or Reduce the Risk of
Developing Pressure Ulcers
If you are confined to bed:
• Change your position at least every 2 hours (alternate
right side, back, left side, etc.). If you cannot move on
your own, ask someone to assist you.
• Tilt your body at no more than 30 degrees when on your
side. Avoid the side-lying position when the head of your
bed is elevated. This increases pressure on your hipbones.
• Avoid lying directly on your hipbone. Instead, turn to
your side and support your weight with pillows behind
your back.
• When lying on your side, use pillows or foam wedges to
avoid contact between bony areas such as your ankles
and knees.
• When sitting in your bed, avoid postures that increase
pressure on your tailbone or lower back
• Use heel protectors to reduce the pressure on your heels
and ankles. If you do not have heel protector devices,
use a pillow under your calves to “float” your heels.
• Using a mattress support surface, such a covered foam
mattress pad, will help reduce pressure to body surfaces.
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TAKE TAKE THE THE PRESSURE PRESSURE OFF OFF: OFF
PREVENTING PRESSURE ULCERS (CONTINUED)
If If you you you are are confined confined confined to to a a chair
chair
or or wheelchair:
wheelchair:
• Shift your weight every 15 minutes.
If you cannot shift your
weight, have someone help you
at least every hour. . Concen- Concen- Concen-
trate trate on on relieving relieving relieving and and re-
re
distributing distributing pressure pressure to to the
the
lowerlower back, back, tailbone tailbone and and butbut-
tocks.
tocks.
• If you are sitting with your legs
elevated, use a pillow under
your calves to “float” your
heels.
• Use pillows or covered foam
on armrests to lessen pressure
on your elbows.
• Use a chair seat support surface,
such as a covered foam
or gel seat pad to reduce pressure
on the buttocks.
If you are the caregiver of a
person who needs help repositioning:
• Talk to the doctor, nurse or
physical/occupational therapist
about proper ways to reposition
and transfer the person.
Done improperly, repositioning
and transfers will
increase the risk for skin injuries,
and may cause injury to
the caregiver.
• Talk to the doctor, nurse or
physical/occupational therapist
about how to obtain special
lift devices and pressurereducing
devices such as
mattress and chair pads, heel
and elbow protectors, etc. ,
etc.
• Caution: The use of pressurereducing
devices does not
substitute for an appropriate
turning / re-positioning
schedule!