Pressure Ulcer Care
A pressure ulcer is an opening in the skin, usually over a bony area, that could appear as a sore or inflamed area. Other names for pressure ulcers are decubiti or bed sore.
When there is prolonged pressure in a bony area — hip bones, shoulder blades, coccyx (tailbone), hip and heel — pressure ulcers will form. Prolonged pressure causes poor circulation to the area and a lack of oxygen and needed nutrients. Tissue death occurs and results in a pressure ulcer. Bedridden clients, those in wheelchairs and clients who sit in one position for more than two hours are susceptible to getting a pressure ulcer.
Other causes of pressure ulcers are friction when clients slide down in the bed or chair or there is continuous moving of the heels against the sheets. They are also caused by moisture when a client is incontinent and not changed in a timely manner. Clients who are paralyzed from a stroke or injury are prone to get pressure ulcers from not being moved or turned in a timely manner.
Persons over 70 years of age are most prone to pressure ulcers due to changes in their skin as it becomes more fragile, softer or drier; having urinary or bowel incontinence; decrease in mobility, and not eating properly and drinking enough water.
Treatment for pressure ulcers is based on its severity that ranges from Stage 1 to Stage 4 (most severe). Care may be as simple as keeping the area clean with soap and water to using barrier creams and antibiotics. Debridement, a medical procedure, may be warranted to remove dead tissue from the wound to promote healing.
Caregivers can help to avoid pressure ulcers by:
1. Checking the skin turgor daily and ensuring that client is drinking plenty of water. Check urine elimination daily to assess quantity and color. Small amounts of urine and change in color may be a sign of dehydration, retention of urine or urinary tract infection. Notify the clients’ family, primary care physician or go to Urgent Care.
2. Keeping the clients clean and dry.
3. Observing clients daily for signs of skin breakdown, redness or pressure ulcers as you bathe, dress and assist them with toileting. Early identification of changes in the skin can sometimes prevent the development of a pressure ulcer.
4. Maintaining proper nutrition and hydration. Avoid sodas and juices that are loaded with sugars. If clients don’t like water, spice it up with a slice of fruit (lemon, lime, cucumbers, melons).
5. Lifting clients from bed to chair and commode in the proper manner — not sliding but lifting them up and sitting them down on the chair or commode. If assistance is needed, request it.
6. Using anti-pressure supplies such as sheepskin, special mattresses or mattress pads, heel protectors and wheelchair cushions. It is important to have clients’ wheelchairs assessed at least every two years to see if changes in the clients’ physical body warrants a different chair or adjustments to the old one.
Remember that pressure ulcers take time to heal and the best treatment is prevention.
Resource: National Institutes of Health nationalinstutesofhealth.gov
Rev. Jiles Taylor-George, RN, BSN, MSN is a native of Tallahatchie County. She is a Certified Family Caregiver Support Group Facilitator and Certified Grief Counselor.
