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Pressure ulcers

Remember that skin awareness is key to early prevention.

What is a pressure ulcer?

A pressure ulcer is damage that occurs on the surface and underlying tissues of the skin due to the lack of blood and oxygen supply. You may have known them as pressure sores or bedsores, but they are now called pressure ulcers.

What causes pressure ulcers?

The most common cause is due to sitting or lying in one position for too long without moving. This can be a combination of:

  • pressure – caused by the weight of your body pressing down on the skin
  • shearing – this can occur if you slide down in the bed or chair and the skin becomes stretched and tears
  • friction – this can occur when a surface rubs the skin, such as when moving in the bed or poorly-fitted clothing.

What should I look for?

Remember to always keep an eye on the condition of your skin. You may notice some of the following signs:

  • Change in the colour of your skin
  • A darker patch on dark skins, or red or purple/bluish patches which do not go pale when pressed on lighter skins
  • Change in the feel or dryness of your skin
  • Blistering to areas where an object has been pressing on the skin
  • Hard or swollen areas which may be painful.

Are there any common areas for pressure ulcers?

The common areas are shown below, but pressure ulcers can occur anywhere on the body. If you are at risk these skin areas need to be checked regularly throughout the day.

StChris Pressure ulcers leaflet diagram

Am I at risk of getting one?

We are all at risk if we are unable to change our position. However, there are also other risk factors that can lead you to developing a pressure ulcer. So please let us know if:

  • you’re not eating or drinking as much as you did
  • you’re not moving as much as you used to
  • you are sleeping in your chair rather than your bed
  • you have any continence problems
  • you have reduced feeling or sensation anywhere on your skin
  • you think there is a problem with your sleeping position or mattress
  • you have had a pressure ulcer before or
  • you have any sore areas.

What can I do to help?

Inspect your skin as often as possible – at least once a day. Use a mirror to look at areas that are hard to see or get someone else to check for you.

Try to pat rather than rub your skin when drying and apply moisturisers regularly. Moisture such as incontinence or sweat weakens the skin so try to keep it clean and dry.

Try to remove pressure from areas that show any signs of skin damage. Change your position regularly to prevent build up of pressure. If you are unable to do this yourself you will need help.

Make sure that bedding is crease free. Try not to push up with your heels and elbows when in bed as this increases friction. Make sure that shoes, slippers and socks are not too tight as this can restrict your circulation.

If incontinence occurs, please tell us so we can ensure you have continence products that are best suited to you.

Are there any other risk factors I should know about?

Medicines

Taking some medicines can make your skin thin and more fragile. They can increase bruising and lower your response to healing. For example:

  • steroids, such as dexamethasone and prednisolone
  • anti-inflammatories, such as ibuprofen and aspirin
  • anticoagulants that reduce the ability of the blood to clot, such as warfarin and clexane.

Treatments

• Radiotherapy can burn the skin and make it vulnerable to tissue damage. • Chemotherapy can cause dryness and thinning of the skin.

Medical devices

It is important to let someone know if you have poorly-fitting or painful medical devices, such as an oxygen mask and tubing and a urinary catheter and tubing. A pressure ulcer may develop in only a few hours.

How can St Christopher’s help?

We are here to help you in trying to prevent pressure ulcers. Let us know if you have any concerns or want more information.

We may need to do an assessment of your skin to assess any risk factors, and you may require skin barrier creams. We can also give help to assist you to reposition in the bed or chair, if assistance is required.

You may need pressure-relieving equipment such as a special mattress or cushion to reduce the amount of pressure on your body. We can order this equipment for you free of charge to be loaned to you, if you are at home. The use of equipment can help but is only part of the solution in helping in the prevention of pressure ulcers.