Pressure injury education and prevention

Key facts

• Pressure ulcers develop when skin in a particular area is damaged due to constant pressure or friction.
• They are also known as bed sores, pressure sores or decubitus ulcers.
• Pressure ulcers can form when people are confined to a bed or chair and cannot move due to age, illness, disability or frailty.
• Pressure ulcers are preventable, so it is important to check your skin twice daily for early signs and to treat them quickly.
• Try to move or change position in your bed or chair regularly to prevent pressure sores from developing — ask your carer for help if you need it.

What are pressure ulcers or sores?

Pressure ulcers — also known as bed sores, pressure sores or decubitus ulcers — develop when the skin or tissue beneath the skin is damaged due to constant pressure or friction. Pressure ulcers often occur on bony areas, such as the heels and elbows. However, they can appear on any part of the body that is under pressure for a long time.

Pressure ulcers can be painful and uncomfortable and can take a long time to heal. They can also create sleep and mood disturbances, get infected and affect rehabilitation, mobility and long-term quality of life.

You should try to prevent pressure ulcers from forming if you are immobile or if you care for someone who is confined to a bed or chair.

How can I prevent pressure ulcers?

Pressure ulcers can be avoided, but often you may need help. If you have difficulty moving, preventing pressure ulcers might require a team effort, involving your health team, carer or a family member.

To protect your skin and prevent pressure ulcers, the following will help:

• Keep active and move as much as you can (for example, if you can't move your legs, try and move your upper body frequently).
• Eat a variety of nutritious foods, including plenty of fruits and vegetables.
• Drink plenty of fluids to make sure you are hydrated.
• Avoid smoking because this reduces blood flow to your skin.
• Avoid firm massage, especially over bony areas.
• Keep your skin dry as far as possible.
• If you feel any skin pain or a feeling of burning, tell your doctor.

There are several things that will help you care for your skin:

• Instead of soap, use a mild cleanser and dry the skin gently afterwards.
• Apply moisturisers if the skin is dry, flaky or seems to crack easily.
• Use barrier cream in skin folds.
• Use warm (not hot) water when having a bath or shower.

It is important to move around as often as you are able. Continuous pressure on the same areas can lead to a pressure ulcer developing very quickly. The following may help you avoid this:

• Change positions in bed at least every 30 minutes and, if you can, stand up and walk around.
• If you can’t stand, move as much as you are able — for example, lean forward or move side to side in your chair for 2 minutes to take the pressure off your bottom and hips.
• Try to avoid slumping or sliding forward in your chair.

Your healthcare team may use a range of special equipment to help reduce pressure in specific areas. This may include dynamic mattresses, cushions and heel wedges.

Check your skin twice a day and look for early signs of a pressure ulcer, such as:

• red areas that don’t fade
• blistered or bruised-looking skin
• shiny areas
• warm or hard patches
• broken or cracked skin

Look at your entire body, but pay particular attention to bony areas such as the heels, buttocks (tailbone), elbows and between skin folds, as well as under plasters, dressings, splints or tubes. You may need someone to help you with this, especially if you have reduced mobility.

At Pinnacle Training Hub we offer comprehensive training in both manual handling and pressure injury prevention, this will teach staff the correct techniques of turning the participant as well as recognising and responding to pressure injuries. Preventing unnecessary hospitalization and more time in placement where the participant is happy.