Pressure Ulcers

By: Section 006

Overview of Pressure Ulcers

A pressure ulcer is an area of skin that is usually damaged by staying in one position for too long. They commonly occur in areas where bone is close to your skin, such as your lower back (sacrococcygeal area), buttocks, hips, ankles, elbows, and heels. They are caused by constant pressure, friction or shear. Constant pressure- pressure on underlying tissues that are trapped between bone and a surface such as a wheelchair or a bed. This prevents the proper blood flow to that area, and causes lack of oxygen and nutrients your skin needs. This can damage or even kill skin cells and tissues. Friction- the resistance to motion and occurs when the skin is dragged across a surface, such as when you change position or are moved by a care provider. Moist skin can increase the amount of friction when moved. Shear- when two surfaces move in the opposite direction. For example, when a hospital bed is elevated at the head, you can slide down in bed, but your skin may stay in its original position. This motion may injure tissue and blood vessels, making the site more likely to form a pressure ulcer.

Stages of Pressure Ulcers

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Risk Factors

You are at a higher Risk of developing a pressure ulcer if:

You spend most of your day in a bed or a chair, are overweight or underweight, not able to control your bowels or bladder, have decreased feeling in an area of your body, or spend a lot of time in one position.

Cultural and Ethnic Considerations

  • A higher percent of African Americans have pressure ulcers compared to Caucasians.
  • Dark pigmented skin can make it difficult to diagnose pressure ulcers, especially in stage 1.
  • Hydrocolloid contains Bovine gelatin, which may be a concern to vegans and Hindus. There are other alternatives that can be used for treatment.

Self-Care to Prevent Pressure Ulcers

  • Check your skin daily, especially in common pressure ulcer areas.
  • Wash your body with a sponge or cloth and make sure not to scrub too hard.
  • Use moisturizer to protect your skin from drying out.
  • Clean and dry your body and pay special attention to the groin area and underneath the breasts.
  • Drink plenty of water.
  • Avoid tight clothes or clothes that rub against your skin.

When you are in Bed

  • Use a foam mattress for cushioning.
  • Place an absorbent pad under your bottom if you can't get to the bathroom in time.
  • Put a pillow between your knees and ankles when laying on your side.
  • When laying on your back rotate putting a pillow under your tailbone, heels, under your shoulders, and under your elbows.
  • Do NOT put pillows under your knees.
  • Do NOT drag yourself when getting out of bed or into a new position. If a health care provider moves you make sure they use the sheet under you to lift you up when they move you.
  • Reposition every 1-2 hours.
  • Removes objects from your bed.
  • Do NOT raise your bed more than 30 degrees.

When to Call the Doctor

If you notice a sore, redness, or any other change in your skin that last for more than a few days or becomes painful, warm, or begins to drain pus call your doctor. These are signs of a pressure ulcer.