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Pressure Ulcers

Pressure Ulcers

Anyone who must stay in a bed, chair, or wheelchair can get pressure ulcers. Fortunately, most can be prevented or kept from getting worse.

WHAT ARE PRESSURE ULCERS?
A pressure ulcer is an injury caused by unrelieved pressure that damages the skin and underlying tissue. Pressure ulcers are sometimes called bed sores and range in severity from mild (minor skin reddening) to severe (deep craters extending down to muscle and bone.)

WHAT CAUSES PRESSURE ULCERS? Pressure on the skin blocks the blood supply. When skin is deprived of nutrients and oxygen for too long. the skin starts to break down, the tissue dies and a pressure ulcer forms. The first sign of a pressure ulcer is redness on the skin. Persons may get pressure ulcers after as little as 1-2 hours.

WHERE DO PRESSURE ULCERS FORM?Pressure ulcers form where bone causes the greatest force on the skin and tissue. For people who must stay in bed, most pressure ulcers form on the tailbone (sacrum), the hip bones, shoulder blades, back of the head, ears, elbows, knees, ankles and on the heels. Pressure ulcers can also form behind the knees, for people confined to chairs or wheelchairs.

RISK FACTORS
Confinement to a bed, chair or wheelchair Inability to change positions, such as with paralysis Loss of bowel or bladder control Poor nutrition Lowered mental awareness from health problems, medications or anesthesia Loss of sensation in lower extremities

STEPS FOR PREVENTION prevention is the key:

These steps can also keep pressure ulcers from getting worse. Take care of your skin o Inspect skin at least once a day. Pay special attention to any reddened areas o Keep the skin clean and dry. Use a soft cloth to clean your skin and wash it as soon as it is soiled. If loss of bowel or bladder control, cleanse thoroughly after each episode. Completely and gently dry area. Apply a moisture barrier cream, a thick "Vaseline-type" protective cream. Prevent dry skin. Take a bath only when needed, using warm (not hot) water and a mild soap. Use cream or oils on you skin that don't contain alcohol which is drying. Protect your skin from injury Avoid cold or dry air. Avoid massage of your skin over bony parts of the body. Keep the bed linens dry and wrinkle free. Change position frequently - at least every two hours - - or have your caregiver change your position. If you are in a chair and can shift your own weight, do so at least every 15 minutes or have someone reposition you at least every hour. Reduce friction by being sure you are lifted rather than dragged during repositioning. Bed sheets or lifters can be used. Use pillows or wedges to keep knees or ankles from touching each other. Place pillows from mid-calf to ankle to keep heels off the bed. Products are available such as water mattresses or gel pads to help reduce pressure. Eat a balanced diet  . Eat foods high in protein and calories. Drink plenty of fluids. If you cannot tolerate a balanced diet. ask your doctor about nutritional supplements. DO NOT sit on a rubber ring. DO NOT use heat on pressure sores. DO NOT sit or lie in one position for more than two hours. You can help prevent most pressure ulcers. If you have questions problems or concerns, be sure to ask your doctor or nurse.

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