Pressure ulcers, which are also known as bedsores, can result when there is constant pressure against the skin. If you or someone you care for is confined to a bed or a chair with limited ability to change position, it is important to prevent pressure ulcers and to know how to care for them.
Risk Factors for Pressure Ulcers
Pressure ulcers happen because the blood supply to the skin is cut off when a person lies in bed or sits in a chair without shifting position for an extended period of time. In addition to immobility or inability to change position, these factors increase the risk of developing bedsores:
- Skin exposed to moisture from things such as bowel issues, bladder incontinence, or perspiration
- Limited ability to feel pain and respond to discomfort from unrelieved pressure
- Decreased mental awareness of pressure-related discomfort
- Poor nutrition or appetite
When to Call the Doctor
Examine the skin from head to toe every day, looking for signs of redness or tenderness and paying close attention to the skin over bones. Call a nurse or doctor right away if you see skin damage.
What does a pressure ulcer look like?
The skin damage can appear as:
- A reddened area on the skin that does not turn white when pressed
- In darker skin tones, a darker area of skin than that around it in the early stages. It may feel warm, hard to the touch, swollen or painful
- A blister filled with clear fluid or blood
- An open sore
How to Prevent Pressure Ulcers
Pressure ulcers are extremely painful and can be difficult to treat, so it’s important to prevent them whenever possible.
Every day, it is very important to examine the skin from head to toe, looking for signs of redness and paying close attention to the skin over boney areas. Avoid massaging these areas. Call your nurse or doctor if you see any changes to the skin. Also, be sure to follow good skin care habits.
For someone confined to bed:
- Keep the pressure off by turning and repositioning at least every two hours to improve the blood supply to the skin. Use a written turning schedule.
- Use pillows or foam wedges to keep bony areas, such as knees and ankles, from having direct contact with each other
- Put pillows under the calf to raise the heels off the bed
- Use special mattress support surfaces to help redistribute pressure; do not use a donut ring as they can actually interfere with blood flow
- Use a lifting device, such as a draw sheet or a trapeze, to move the person’s body instead of dragging, which can cause the skin to tear
- Keep the head of the bed at or below a 30-degree angle, except during meals, to prevent sliding
For someone confined to a chair:
- Shift your weight every 15 minutes or help the person change position every hour
- Use special wheelchair cushions to redistribute pressure
- Do not use a donut or ring-shaped cushion; they can actually interfere with blood flow
Good skin care habits can help prevent pressure sores:
- Keep skin clean and dry
- Clean skin with a mild soap and warm water (or use a no-rinse cleanser)
- Avoid hot water
- Pat skin dry; do not wipe dry
- Change underpads or briefs when they become wet or soiled
- For incontinence, clean and protect skin after each episode. Use a topical barrier ointment, such as petroleum jelly
- For dry skin, use a moisturizer
- Maintain a healthy diet and proper hydration