PRESSURE SORE AND ITS MANAGEMENT AND PREVENTION

Pressure sores or bed sores are painful skin ulcers that form when constant pressure on a part of the body shuts down the blood vessels feeding that area of skin. The resulting damage first appears on the skin surface as a red or dark patch. As the pressure sore progresses, the skin will break down to form blisters, dead skin, and ultimately infect underlying tissues, bones and joints. As little as two hours of sustained pressure will trigger skin damage. Skin damage can also be exacerbated by friction and moisture. The surface damage is just the tip of the iceberg; the real damage lies beneath the skin. In the early stages, pressure sores can be treated at home by relieving the pressure, cleaning the sores and applying the appropriate dressing. In the later stages of severity, professional medical treatment, possibly, surgery, will be necessary. Pressure sores are especially prevalent on the lower back and buttocks, and on bony protruding areas, such as shoulders, hips, knees, heels and ankles. People who are bed-bound or in wheelchairs are particularly susceptible. Things You Should Know Pressure sores are caused by pressure, friction and moisture prolong the amount of time a person spends in the hospital increase risk of infection increase mortality represent an extra $10,000 a year in medical and nursing care costs, per person Top Risk Factors for Pressure Sores age immobility incontinence malnutrition and dehydration diseases and disorders that slow healing or lessen mental awareness diseases and disorders such as confusion or dementia that lessen mental awareness and may prevent a person from feeling the discomfort of a harmful body position medications, particularly sedatives Top Things to Look For Warning signs of pressure sores discoloured, torn or swollen skin, especially over bony areas signs of infection — skin warmth, swelling, odour, pus Seek professional care and treatment immediately for sores that are getting worse, not healing, or showing signs of infection. Top Four stages of severity of pressure sores reddened or darkened skin that will not turn white when firmly pressed partial skin loss that may appear as an abrasion, blister or shallow crater full skin loss extending to underlying tissue full skin loss extending beyond the underlying tissue to muscle and bone Next page
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	How to Care: Pressure Sores

Questions to Ask What is causing the pressure sores to develop? Is mobility a problem? Incontinence? Diet? Disease? Or medication? What can be done to relieve the sources of pressure, friction or moisture? What strategies and techniques can be used to prevent or lessen skin breakdown? What professional and community services are available to assist with personal and nursing care? Steps to Take Know the warning signs of pressure sores and the four stages of severity of pressure sores. Learn how to prevent pressure sores and how to treat them. Alert a doctor or nurse to any sores that are getting larger, not healing, or showing signs of infection. Arrange for a risk assessment by a family physician, nurse or specialist. Risk assessment general health nutritional status mobility incontinence illness medications level of consciousness past history of pressure sores Discuss treatment options with the physician, nurse or specialist. Contact health professionals who can assist with specific situations: mobility problems: physiotherapist or occupational therapist nutritional advice: dietitian Incontinence: urologist alternative medications: pharmacist Contact community agencies that can provide assistance with care at home. Learn at-home coping strategies to prevent, manage and treat pressure sores.  Learn about helpful products and devices for pressure sores. At-home Coping Strategies Be meticulous about skin care. Examine skin daily for signs of sores. Protect vulnerable areas from pressure, friction and moisture. Ask a health professional how to clean, dress and bandage pressure sores properly. Alert a doctor or nurse immediately, if you notice signs of infection. Assist healing by ensuring proper nutrition. Discover helpful products to relieve and treat pressure sores. Encourage a balanced diet with extra protein to keep tissues healthy. Top Wound management Clean the pressure sore by irrigating the wound with a saline solution (available from drug stores) or other cleaning solution recommended by a health care professional. Remove all dead tissue and scabs. A health professional can recommend the best approach, depending on the severity of the pressure sore. Pat the wound dry. Bandage the wound with a dressing that keeps the pressure sore moist while keeping surrounding tissues dry. Clean skin with warm water and minimal friction. Apply lotion often. Avoid direct pressure to bony areas such as ankles and hips. Use pillows and padded protectors to support arms, legs and vulnerable areas. Change the position of a bed-bound person every two hours. Handle and move carefully to avoid skin tears and scrapes. Change the position of a chair-bound person hourly. Discourage the bed-bound or chair-bound person from sitting with the head elevated more than 30 degrees, except for short periods of time. Check and change bed linens as often as necessary Use continence management products if necessary to reduce exposure to moisture. Padded supports, such as doughnut cushions may, themselves, become a source of pressure. Do not massage bony areas of the body. Do not massage pressure sores. Do not use remedies such as iodine, peroxide and cornstarch that may further irritate the skin. Top Helpful Products Helpful products for pressure sores can be purchased from hospitals, pharmacies, medical equipment and supply stores and catalogues. Lotions, moisturizers special lotions for pressure sores Supportive devices pillows air cushions/pillows foam wedges and pads padded protectors special beds and mattresses Wound care products saline solutions irrigation equipment, such as, syringes dressings bandages, tape