skin disorders
Pressure Sores
Prevention of Pressure Sores
Frequent repositioning Meticulous hygiene and care of skin Maintaining movement Prevention is the best strategy for dealing with pressure sores. In most cases, pressure sores can be prevented by meticulous attention from all caregivers, including nurses, nurses’ aides, and family members. Frequent repositioning is the best way to avoid pressure sores. People who cannot move themselves should be repositioned frequently. For example, people who are confined to bed should be repositioned at least every 1 to 2 hours. People who are placed in a chair should be repositioned every hour. If they are capable, they should be encouraged to change position on their own every 15 minutes. Every day, caregivers should closely inspect the skin to look for early signs of redness or discoloration. Any sign of redness or discoloration at pressure areas is a signal that the person needs to be repositioned and kept from lying or sitting on the discolored area until it returns to normal. Repositioning people who cannot move themselves (every hour for those in a chair and every 1 to 2 hours for those in a bed) can help prevent pressure sores. Skin care is vital to preventing pressure sores. The skin must be kept clean and dry because moisture increases the risk of developing pressure sores. Dry skin is less likely to stick to fabrics and cause friction or traction. After cleaning, the skin should be dried by gentle patting (avoiding rubbing the skin). The use of thick creams that act as a barrier to protect the underlying skin from moisture may help prevent sores. For people confined to bed, sheets and clothing should be changed frequently to make sure they are clean and dry. Cornstarch may allow microorganisms to grow and should not be used, but plain talc can be used in areas subject to friction. Bony areas (such as heels and elbows) can be protected with soft materials, such as foam wedges and heel protectors. Protective padding, pillows, or sheepskin can be used to separate body surfaces. Special beds, mattresses, and seat cushions can reduce pressure and offer extra relief to people who use a wheelchair or are confined to bed. A doctor or nurse can recommend the most appropriate mattress surface or seat cushion. It is important to remember that these devices do not eliminate pressure completely and are not substitutes for frequent repositioning. Movement is an important part of pressure sore prevention. People who have difficulty moving or who are immobilized are at risk of developing pressure sores, so activity should be encouraged. Medications that induce sleep ( Misuse of Antianxiety Medications and Sedatives ) should be reduced or avoided because people who are sleepy are less likely to change position. 