Pressure Sores Exceptional healthcare, personally delivered
Did you know that: Pressure sores are often known as bedsores or pressure ulcers. Pressure sores are an area of damaged skin and tissue that develops when constant pressure on a part of the body shuts down the blood vessels feeding that area of skin. Pressure sores usually occur when someone sits or lies in one position for too long. Pressure sores usually develop below the waist, although they can occur anywhere on the body such as the hips, buttocks, the base of the spine, knees, heels, ankles and shoulders and the back of the head. Anybody who sits or lies down for prolonged periods of time is increasing their risk of developing pressure sores. There is a website designed to help answer some of the questions you might have about pressure sores, whether you are at risk yourself or if you know of somebody who might be at risk. www.your-turn.org.uk is a useful resource that could prove invaluable. For specific questions about your personal circumstances please ask the Ward Sister, Charge Nurse or healthcare professional in North Bristol NHS Trust who is caring for you, a relative or friend. What are the symptoms of a pressure sore? A pressure sore may initially appear as a red area of skin that does not disappear after a few hours and it may feel tender. For people with darkly pigmented skin a reddened area will not be visible. Look for signs of skin change, heat, swelling and pain. The area may become painful and purple in colour. Continued pressure and poor circulation can cause the skin and tissue to break down. 2 Pressure Ulcers
Who is affected? Pressure sores can affect people of any age, particularly those with poor mobility who spend prolonged periods in bed or in a chair or are unable to change their position. Older people are more likely to develop pressure sores which can also be caused by poor nutrition, anaemia, recurrent infection and poor circulation, incontinence and dehydration. How do you treat pressure sores? Treating a pressure sore is much more difficult than preventing one. Treatment includes relieving pressure and keeping the area clean. Dressings are used to encourage healing and antibiotic therapy can treat infection. Can pressure sores be prevented? In many cases, yes. The most important factor in preventing sores is avoiding prolonged pressure on an area of the skin. This can be achieved by encouraging a person to change their position regularly throughout the day. Those unable to do this themselves should be moved at appropriate intervals at least every two hours for those lying down and every hour for those sitting upright. Special mattresses, such as air filled alternating pressure mattresses, specialist foam mattresses and cushions that redistribute pressure help reduce pressure on sensitive areas. Regular inspection of high risk pressure areas is important to detect early signs and prompt medical care should be provided. It is also important to keep skin healthy, clean and dry. Use a mild soap and warm (not hot) water. Apply moisturisers so the skin doesn t get too dry. If you must spend a lot of time in bed or in a wheelchair, check the whole body every day for spots, colour changes or other signs of sores. Pressure Ulcers 3
Diet and Pressure Ulcers Good nutrition makes the skin healthier and more resistant to ulcers. Eating a healthy, balanced diet may help to prevent pressure ulcers and promote wound healing: Protein (meat, fish, cheese, eggs, pulses) is the main building block for skin formation. Aim to have a source of protein at every meal. Vitamin C (citrus fruits, vegetables, tomatoes, berries) helps form new tissue. Zinc (red meat, milk and dairy products, eggs, green leafy vegetables) promotes cell generation. Iron (red meat, green leafy vegetables, dried fruit, fortified cereals) prevents iron deficiency anaemia which can reduce the transport of oxygen to tissues. Vitamin C helps increase absorption of iron, tea however reduces it. Energy - being under/overweight increases your risk of pressure ulcers. If you are underweight, have unintentionally lost weight, or have a poor appetite then aim to eat little and often and choose high energy snacks (ask your nurse for the No Appetite leaflet for more information). If you are aiming to lose weight then try reducing your portion sizes and cutting down on your fat and sugar intake. Fluid dehydration reduces the skin s elasticity and makes it more susceptible to breakdown. Fluid also helps to carry nutrients around the body to where it is needed. Aim to drink 6-8 glasses (2 litres) everyday. What about Diabetes? As well as good nutrition, good blood glucose control will reduce your risk of pressure ulcers. 4 Pressure Ulcers
How can you prevent developing pressure ulcers (bed sores)? Think SKIN Surface Keep Moving Incontinence Nutrition Staff will assess you for specialist equipment such as air mattresses, cushions and foot protectors. Change position regularly whether in bed or in a chair. Staff will help if needed. Keep your skin dry and clean. Let staff know if clothes or bedding are damp. Eat healthily and drink plenty. Pressure Ulcers 5
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www.nbt.nhs.uk If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published May 2014. Review due May 2016. NBT002474