Preventing Pressure Sores (Pressure Ulcers)
Pressure sores can develop quickly, even in healthy skin. That’s why taking steps to prevent them is so important. Taking pressure off your skin is the first step. That means changing positions often, supporting your body, and not rubbing and sliding. Keeping your skin clean, eating well, and stretching your joints and muscles can also help prevent pressure sores. Be sure to check your skin daily, too.
Change positions often
Changing positions often allows blood to get to your skin and keep the tissue healthy.
In a chair
Shift weight from side to side at least once an hour—every 15 minutes if possible.
Ask about pads and cushions that can reduce pressure on your skin.
Change positions at least every 2 hours, more often if possible.
Use lightweight sheets and blankets to reduce pressure from above.
Ask about special pads and mattresses that spread pressure over a larger area of your body.
Support your body
Supporting your body spreads pressure over a larger area.
In a chair
Lightly cushion your back and buttocks. Don’t use doughnut-type cushions. They can cut off the blood supply to your skin.
Lightly pad the footrest on your wheelchair.
When lying on your back, put pillows under your lower calves and ankles. Keep your elbows slightly bent.
When lying on your side, put pillows behind your back, between your legs, and between your ankles. Keep elbows and knees slightly bent.
Don't rub or slide
Rubbing (friction) and sliding (shear) cause the skin to break down more easily.
In a chair
Keep your feet on a footrest, so your thighs are horizontal. This keeps your buttocks from sliding forward.
Support your shoulder blades and back with a pillow.
Keep your sheets smooth, dry, and free of crumbs. Use a sheepskin pad to prevent rubbing.
Keep your feet and head slightly raised to avoid sliding. When on bed rest, don’t raise your head more than 30 degrees, except when needed for some medical conditions or for eating.
Keep your skin clean
Keeping your skin clean and dry also helps prevent pressure sores.
Keep your skin free of sweat, urine, or wound drainage.
Apply protective creams and use absorbent pads if you don't have bladder or bowel control.
Check your skin twice a day for signs of breakdown.
Eat healthy and move around
If you are in a bed or a wheelchair most or all of the time, you need to:
Eat enough calories to stay at a stable weight.
Get plenty of protein, vitamins, and iron, and drink lots of fluids each day.
Get out of your bed or chair as much as possible.
Check your skin twice a day
Do skin checks each day as part of your daily routine. Skin breakdown starts with slight changes, but can progress very quickly.
Look for redness, bruises, cuts, and other irritations, especially over bony areas.
Look for scabbing, blistering, or open areas on the surface of your skin. These are more serious and must be treated right away.
September 16, 2017
Prevention of pressure-induced skin and soft tissue injury, Up To Date, Zack, Amy M. MD, FAAFP, 5-Minute Clinical Consult 2016, The - 24th Ed.
Sudheendra, Deepak, MD,Taylor, Wanda, L., RN, PhD