Ask the Nurse: How To Prevent and Treat Pressure Sores

Pressure sores (or bedsores) are areas of damage to the skin and underlying tissue ultimately resulting in lesion and ulceration. They are commonly formed over the bony areas on the back, hips, heels, sacral area, or ankles and they’re much easier to prevent than to treat. Their main causes include:

  • Unrelieved pressure: skin and tissue directly compressed between the bone and a hard surface such as a chair.
  • Friction: occurring when skin rubs against a surface, for example heels rubbing against the sheets of a bed.
  • Shear: occurring when skin and tissue are pulled in opposing directions, for example when a person slips down or is dragged along a bed.
 
 

 

What can I do to help prevent pressure sores?

Position changes are key to preventing pressure sores. These changes need to be frequent, avoid stress on the skin and minimise pressure on vulnerable areas.

Your health team can help develop a good strategy, whether it's at-home assistance or in a hospital. Here’s our basic guide to the prevention or pressure sores.

1. Skin care

      • Clean the affected skin. Use moisturising, unscented soaps and warm (not hot) water to clean their skin. They shouldn’t use excessive force as this causes friction and should only pad the site dry.
      • Protect the skin. Make sure your skin is dry. Use talcum powder sparingly. Apply lotion or cream to dry skin. Change soiled bedding and clothing as required.
      • Inspect skin daily. Check for red or broken skin regularly. Use a mirror for hard to see areas.
      • Keep skin dry. If you have urinary or bowel incontinence, take steps to prevent exposing the skin to moisture and bacteria. Your care may include frequently scheduled help with urinating, changing of pads or soiled clothing or using protective lotions on healthy skin
      • Change soiled bedding and clothes: Change sheets, pads, and bedclothes if soiled.
 
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2. Nutrition

      • Maintain a healthy diet. Foods that are high in protein may help prevent skin breakdown. Examples are meat, beans, and milk. Nutritional shakes and dietary supplements may also provide extra calories, vitamins and protein if deficient in the diet. Ask your caregiver or a health professional for more information about the right foods for you. 
      • Drink enough to keep the skin hydrated. Good hydration is important for maintaining healthy skin. You should drink at least eight glasses of fluids each day, unless a medical professional tells you not to. Healthy liquids include water, skimmed milk, and juice.
 
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3. Lifestyle

      • Change your position often: Change your position every 2 hours if in bed all day or every 15-30 minutes if they’re in a wheelchair all day. Have a regular turning schedule. If you are helping a person move in bed, lift them. Do not slide them. An alternative is to use lifting equipment or an overhead trapeze. This may help prevent damage to the skin from sliding down in bed.
      • Staying active. Limited mobility is a key factor in causing pressure sores. Daily exercise matched to your abilities can help maintain healthy skin. A physiotherapist can recommend an appropriate exercise program that improves blood flow, maintains vital muscle tissue, stimulates appetite and strengthens the body.
      • Quit smoking. If you smoke, quit. It reduces the amount of oxygen in the blood. Smokers tend to develop more severe wounds, and their wounds heal more slowly. Talk to your doctor if you need help. 

4. Products & Equipment

      • To protect skin over bony areas: Use pillows or foam wedges to keep bony areas from touching one another. Put a foam pad or a pillow under your legs to keep your heels from touching the bed. Remove extra sheets or bedding from underneath you.
      • Special equipment and pads: A slide and turn sheet may help others move around in bed. An overhead trapeze can help change positions. Special mattresses and overlays may relieve pressure. Examples include a foam mattress pad, or special air or water mattresses.
      • Cushions that relieve pressure. Select a cushion that relieves pressure. Use cushions to help ensure your body is well positioned in the chair. Various cushions available include such as foam, gel, water-filled and air-filled. An occupational therapist or physiotherapist can advise you on how to place them and their role in regular repositioning. Protect boney areas with appropriate postitioning and cushioning. Lie at an angle with cushions supporting the back or front. You can also use cushions to relieve pressure between the knees and ankles.
 
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Independence Australia offers over 2000 wound care products to help, including dressings, skin care, tapes and compression.

For more product advice, contact our Customer Service Representatives on 1300 788 855. Alternatively, click here to select your home state and locate your nearest wound clinic through the Australian Wound Management Association (AWMA).

·         take steps to prevent exposing the skin to moisture and bacteria. Your care may include frequently scheduled help with urinating, changing of pads or soiled clothing or using protective lotions on healthy skin.