The pressure sores are a major health problem, both for the people who suffer from them, since they worsen their condition and therefore their quality of life, and for their environment (caregivers and family). The Web offers us a series of interesting tips and procedures to avoid them.
The pressure ulcers, also known as bedsores or sores, are lesions that occur on the skin by staying in the same position for long periods of time. Therefore, the risk of pressure ulcers is greater in people with reduced mobilityfor example, people who remain bedridden for long periods of time, people in wheelchairs or who cannot change position.
Zones at risk of pressure ulcers according to the position of the person
They usually appear in those areas of the body where the bone is closest to the skin, such as the ankles, heels, hips, elbows, sacrum (coccyx, tailbone area), etc.
However, most pressure sores can be prevented. But, how to prevent them? Specialists recommend following this procedure:
1. Examining the skin at least once a day, paying special attention to:
• Bony prominences: heels, hips, ankles, elbows, sacral area.
• Areas exposed to incontinence. Urine, feces, sweat, stomata, etc. They can injure the skin and cause injury.
2. Keeping the skin clean and dry.
Use soaps or cleansing substances that are respectful of the skin and with low irritating power.
• Wash the skin with lukewarm water, rinse and dry thoroughly, but without rubbing.
• Do not use alcohol or colognes as they dry out the skin.
• Apply moisturizing creams ensuring that they are well absorbed.
• If we have a problem with incontinence or excessive sweating, use barrier products, such as products with zinc oxide that protect and isolate the skin from moisture.
3. Performing a good pressure management:
To reduce the effect of pressure on our body we have to consider 4 elements:
• Mobilization: ask your healthcare professional to draw up a care plan that encourages and improves the person’s mobility and activity.
• Postural changes: postural changes should be performed every 2-3 hours following a rotating program of changes.
• The use of mattresses, mattress toppers, cushions and other pressure relief devices.
• Local protection with dressings of different shapes that adapt to the shape of the body (the most common are heel pads to protect the heels).
Postural changes should be performed every 2-3 hours following a rotating schedule.
postural changes
When making postural changes keep in mind some considerations:
• If the patient is sitting and has autonomy to make changes in posture, do them every 15 minutes.
• Avoid supporting the patient directly on their injuries.
• Avoid dragging the patient, if we drag the patient we can aggravate the injuries he has.
• Avoid direct contact between bony prominences. Example: if we have the patient on his side, we will put a pillow between the 2 legs so that the knees and ankles do not contact each other.
• Avoid raising the head or foot of the bed, only and if necessary a maximum of 30º.
pressure relief devices (mattresses, mattress toppers, cushions…)
There is a whole series of devices on the market designed to manage pressure; They are known as mattresses or mattress toppers or anti-decubitus cushions.
There are many types, although the most common are alternating air systems; although what will decide what type of mattress or cushion will be the risk that the person has of suffering or suffering from pressure ulcers.
Your healthcare professional will advise you on the most appropriate type of mattress for your case. However, we can make a classification according to the risk of suffering from pressure ulcers:
Low risk: people who have not suffered any pressure ulcer but whose mobility is increasingly limited. The type of surfaces that we will use will be memory foam mattresses, static air mattresses or alternating air mattresses (small cells).
Medium risk: people who have already suffered pressure ulcers or other types of injuries and whose mobility is very limited. Here the surfaces that we will use will be mattresses or overlays of alternating air (medium cells) or surfaces of continuous low pressure.
High Risk: people whose mobility is practically nil. We will use alternating air mattresses (large cells) or continuous low pressure.
It is necessary to use dressings of different shapes that are specifically adapted to areas of special risk
Local pressure protection
We must protect those areas of special risk: heels, sacrum, ankles, hips, etc. For this we use dressings of different shapes that are specifically adapted to these areas of the body. One of the most common are heel cups to protect the heels.
But these dressings have to meet a series of requirements:
• They must allow us to inspect the skin once a day, otherwise we will not know if an injury may be occurring under the dressing.
• If we use adhesive bandages, we must ensure that they do not injure the skin when we remove them. We must use dressings with silicone gel or with a soft adhesive.