Caregiving: How to Prevent Pressure Sores

Posted by MEDPRO Medical Supplies on

Bed sores also known as Pressure Ulcers, are, unfortunately, one of the most common ailments resulting from mobility issues. They are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin.

They can happen to anyone, but usually affect patients confined to bed or who sit in a chair or wheelchair for long periods of time. It's important to begin bed sore treatment at the first sign of any symptoms to prevent further complications. Pressure ulcers are much easier to deal with when they're caught early. Even better, if you understand a risk is present you can take precautions to reduce the likelihood of occurrence.

Who's most at risk of getting pressure ulcers?

    • Being over 70 with mobility problems and skin that's more easily damaged through dehydration and other factors
    • Patients being confined to bed with illness or after surgery
    • Inability to move some or all of the body (paralysis)
    • Obesity
    • Urinary Incontinence and Bowel Incontinence
    • A poor Diet
    • Medical conditions that affect blood supply, make skin more fragile or cause movement problems – such as diabetes, peripheral arterial disease, kidney failure, heart failure, multiple sclerosis and parkinson's disease 

6 Crucial Tips for Successful Bed Sores Treatment

1. Frequent Repositioning

If you are in a chair, wheelchair or bed for a long period of time you need to vary your position at least once every 2hours - This will help to facilitate blood flow and reduce pressure on your boney areas so you are less likely to get a bed sore. It is important to be regularly repositioned so the pressure is dispersed throughout the body.

Wheelchair Repositioning

  • Try shifting your weight by yourself every 15 minutes or so. Go from left to right side of your buttock as well as shifting your position further forward or backward in your chair.
  • Consider a seat cushion to help re-distribute pressure across your bottom
  • The best advice is to change your position regularly. Avoid sitting on a chair for prolong period of time to relief the pressure off the bottom. Try transferring back to lie down on the bed after every 4hours of sitting out of bed.

Bed Repositioning

  • Adjust position at least every 2 hours.  Adjust between your left side, right side and back.  Ideally switching positions every 2-3 hours.
  • Consider a bed side rail to assist you with repositioning if you are unable to change positions without assistance.
  • For patients who needs moderate to maximum assistance in moving and turning, consider a pillow wedge to be placed at the back of the body so that they can support their side for optimum comfort and pressure relief
  • If possible, adjust the elevation of your bed.  Do not raise it to more than 45 degrees to avoid too much pressure on the tailbone or possibility of shearing. The cuff cushion is a new alternative to the traditional heel protectors.
  • Alternating pressure mattresses provide automation to constant repositioning. Air compartments inflate or deflate (usually in 6-minute intervals) to reposition pressure areas across the body.  Alternating pressure mattresses is commonly used in the hospital and also acts as a body massager to improve blood flow.
  • The best advice is to change your position regularly. Avoid lying on the bed for prolong period of time to relief the pressure off the bottom. If you do not have a hospital type recliner bed, you may like to try using a manual backrest, or simply sit out on a chair at least once a day.

    2. Proper Dressings and Wound Care

    Proper dressing and cleaning of the pressure ulcer is essential.  Open wounds are particularly prone to infection. Appropriate care and use of dressings will promote healing and shield bacteria.

    (Always avoid using hydrogen peroxide as it can further damage the skin.)

    Proper care for bed sores is determined by the stage of the pressure sore:

    • Stage 1: If the skin of infected area is still intact the most important thing you can do is offload pressure immediately. Gently wash area with mild soap and water and consider asking your doctor about recommended moisturisers.
    • Stage 2: Be sure that area is kept clean and dry.  Use a saline rinse to rid of loose and dead tissue surrounding the bed sore. 
    • Stage 3 & 4: Pressure sores that reach these stages are typically monitored and cared for by your health provider who will provide specific instructions for at-home care.

      **Special treatment gels, foams, and dressings are available off the counter but please discuss with your doctor or wound nurse first on which would be best for the condition of your bed sore.

      3. Proper Nutrition

      Making good food choices will help facilitate healing and help prevent future bed sores. Foods rich in Vitamins A, C and E are ideal. Consider oranges, strawberries, tomatoes, broccoli, cauliflower, nuts and olive oil for cooking as a good starting point.

      Vegan or Plant-based Nutritional drinks, such as Almond Milk, Oats Milk, Soya Bean Milk support wound healing and can be incorporated into your bed sore treatment. Vitamin C, Zinc, and Omega-3s are also great supplements to include in your diet for tissue repair. 

      Maintaining a healthy weight is is frequently overlooked. In many cases, bedridden patients loses bodyweight.  This means less protection between skin and bone. Conversely, with excess weight there will be more pressure on the body creating a higher risk. 

      4. Prevent Further Injury or Shearing

      Pressure ulcers and sensitive skin are susceptible to further injury with very minor force. You are at increased risk of damage from friction during repositioning or other basic movements.

      Use the right tools for lifting and transferring on the bed, between bed to chairs and vice versa. Do not engage in unnecessary exposure to pressure in sore areas.

      Keep your skin as moisturised as possible by staying hydrated and clean.

      5. Incontinence Management

      Limited mobility combined with incontinence makes for a heightened risk of infection, particularly with open wounds.

      To improve wound healing on the bottoms, we proposed a solution using two hourly potting for incontinent patients capable of reducing diaper usage. Assisted or Self potting means using a urinal for urination every 2 hourly. This method is frequently used in the hospital for patients who find it impossible or difficult to get out of bed for toileting, or for training to weaning off diapers. It is helpful as it keeps patients from soaking the diapers and in turn, causing skin breakdowns.

      Diapers needs to be changed regularly and bed incontinence pads (soaking up the urine) can be used to reduce bacteria exposure to the skin. Protective lotions can also be used to shield the skin.

      In severe cases, urine catheters or rectal tubes may be necessary while promoting wound healing. Please consult your healthcare provider for advise.

      6. Change Bedding and Clothing Frequently

      A fresh set of clothes and sheets makes everyone feel better. A clean environment is especially important when bed sores or a risk of bed sores are present. During daily checks of the skin, make sure to change clothes and sheets to limit the ability for bacteria to spread. Bed bath can be done to increase comfort and keep the skin microbiome healthy and flourishing.

      Try to time body inspection with clothing and sheet changes to avoid exposure to additional shearing or friction.

      **Sheets and clothes should be made of cotton or breathable fabric.

      Bed - Most vulnerable parts of body for pressure ulcers

      • Tailbone
      • Back of Head
      • Buttocks
      • Shoulders
      • Heels
      • Backs of arms or legs
      • Spine
      • Ankle
      • Knee

        vulnerable pressure points laying down

        Wheelchair - Most vulnerable parts of body for pressure ulcers

        • Shoulder Blade
        • Buttocks
        • Heel
        • Ball of Foot

          vulnerable pressure points in wheelchair

          Complications:

          Ignored or improperly treated bed sores can lead to some very bad complications.

          • Pressure ulcers that advance to stage 3 & 4 can become life threatening and require immediate attention
          • Lack of treatment may lead to gangrene and amputations of affected areas
          • Infections can spread to other areas of the body such as your blood, heart, bones and organs

          What's next?

          It's important to follow a routine bed sore treatment plan eg. 2 hourly turning and positioning, sitting out of bed, regular urine potting, keeping good hygiene.

          Take the time to consistently apply the regimen you and your healthcare provider have put together

          Use our tips and recommended bed sore treatment products. Remember, knowing how to treat bed sores will help to prevent future ones. Prevention is better than cure!

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          For other caregiving enquiries, feel free to write in to us at admin@medprosg.com!