BedSores... Easier to Prevent Than to Heal ©
By: Clare Absher RN, BSN
As a Home HealthCare Nurse, I have spent a considerable amount of time helping families who are caring for loved ones deal with the challenge of preventing bedsores. I will pass on some practical tips and care techniques regarding effective bedsore prevention that I have learned through my own and other’s experiences. The most important step to prevent pressure sores is to avoid prolonged pressure on any one part of the body. The pressure can reduce the blood supply to the skin and the tissues under the skin. When a change in position doesn't occur often enough and the blood supply gets too low, a sore may form. The bedsore is a pressure ulcer that most often develops on a bony area of the body which has little fat to pad it and only a thin covering of flesh, such as the "tailbone", heels, elbows and shoulder blades. Therefore any individual that is immobilized in bed or a wheelchair for extended periods of time, is at high risk for bedsores, also known as pressure ulcers or decubitus ulcers.
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Here are some practical tips on prevention:
- Check the entire body every day for spots, color changes or other signs of sores. Pay particular attention to the pressure points over bony parts of the body that don’t have much padding.
- If you notice a discolored area, check for discomfort, warmness and blanching (whitening) of this area by pressing and then releasing as can be a sign of skin breakdown if does not blanche.
- Keep skin healthy by keeping it clean and dry. Use a mild soap and moisturizers so skin doesn't get too dry.
- Change wet diapers/clothing often to avoid skin contact with acidic-nature of urine.
- Reduce friction (rubbing) by lifting rather than dragging. Avoid use of donut shape cushions.
- Limit raising the head of the bed above 30 degrees, as this can allow the skin to slide over the bed surface causing damage.
- Avoid massaging skin over vulnerable bony areas.
- Change body position at least every 2 hours and more frequently in a chair.
- Place pillows under legs from mid-calf to ankle to keep heels off the bed. Do not place pillows under the knees as it can cut off circulation.
- Encourage and provide diet with adequate calories, protein, vitamin C and other nutrients, as the body will be less susceptible to skin breakdown.
- Reinforce adequate hydration by encouraging frequent intake of fluids throughout the day.
- Control blood sugars levels for those with Diabetes.
- Avoid laying directly on hip bone when lying on side. Use pillows under side so that weight rests on fleshy part of buttock instead of hip bone.
- Use pillows to keep knees and ankles apart. When lying on back, place a pillow under lower calves to lift ankles slightly off the bed.
- When sitting in a chair or wheelchair, sit upright and straight as this position will allow easier movement and shifting to help prevent sores.
- Use pressure-reducing devices. Egg crate foam mattress pads, gel pads, sheepskin pads, wheelchair cushions, and alternating air mattresses can prevent and minimize the risk of pressure ulcers. Keep in mind that using these devices doesn’t eliminate the need to reposition.