Pressure Ulcers - Prevention

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Pressure ulcers: prevention

In the case of people at risk, the risk of a pressure sore can be reduced by various preventive measures such as correct positioning techniques and regular skin checks. Tips can be obtained from health and nursing staff or from medical supply stores. Find out which measures can be taken to reduce the risk of pressure ulcers.

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• Support of independence and mobility
• Lowering the risk of falling
• Body and skin care
• Favorable sitting and lying positions

Support of independence and mobility

• Do not spare the affected person too much. It is better to leave them to their usual activities, even if they take time and effort.
• A varied daily routine promotes mental and physical agility.
• If possible, maintain the usual sequence of movements even with restricted mobility.
• Moving all body parts and joints regularly, actively or passively (by a carer), especially to prevent joint stiffening.
• Keep the joints in the most natural position possible when lying down for long periods. For example, the weight of the feet or the blanket can stiffen the ankles ("equinus"). This makes it impossible for the feet to roll normally while walking. A soft cushion between the end of the bed and the feet, which keeps the feet in a straight position, can prevent this.

Lowering the risk of falling

• If you have visual disorders, ensure that you have the best possible glasses supply
• Use a walker if necessary.
• Wear flat shoes with non-slip soles.
• Reduce the risk of dizziness and unsteady gait: Avoid drugs that impair your ability to react, such as sedatives or sleeping pills (in consultation with your doctor).
• Have diseases such as circulatory disorders, diabetes, etc. adjusted optimally, take the prescribed medication exactly as directed by a doctor.
• Keep a small supply of food so that you don't have to leave the house when it is wet, snowy or black ice.
• Eliminate tripping hazards and ensure more safety in the household, for example with grab bars and non-slip mats in the bathroom, railings as well as non-slip and level steps on stairs, sufficient lighting, removal of slipping carpets.

Body and skin care

Body and skin care tailored to the needs of those affected should protect the skin and tissue and avoid unnecessary stress or irritation

The following "skin and tissue-friendly" measures are recommended:

• Body care with mild products or only with pure water to protect the skin's natural protective layer;
• gently dabbing dry areas of the skin at risk;
• Skin care products to add moisture to dry skin;
• Regular change of linen and suitable incontinence care for increased sweating or urine and stool loss;
• nutritious skin protection products against excessive moisture;
• special mattresses or seat cushions adapted to the individual needs of the person concerned to reduce pressure;
• Regular hand and foot care prevents excessively long nails or calluses from exerting damaging pressure on the surroundings.

The following harmful measures are to be avoided:

• Vigorous rubbing or "rubbing dry" skin prone to pressure ulcers;
• "Blood circulation-enhancing" massages;
• Disinfectants or alcohol-based rubs (e.g. rubbing alcohol);
• Positioning on parts of the body that are still reddened from temporary pressure;
• Wrinkles in sheets and incontinence products (smooth out several times);
• Crumbs etc. on loungers and seats;
• Furs, water pillows, cotton wool bandages, etc.: mostly these products do not provide pressure relief, but on the contrary increase the contact pressure selectively.

Favorable sitting and lying positions

• Lateral positions: The affected person is turned about 30 to 60 degrees on one side. Now a larger cushion is embedded in the back and buttocks area and the legs are brought into a slight step position. The upper leg is also placed on a cushion in the knee and ankle area, the foot should not hang down. Instead of the pillows, a rolled up blanket can be placed from the head down behind the back and buttocks between the legs.
• Sitting position in the care bed : The person concerned is placed very far towards the head end. A small cushion or a rolled up towel is placed across the fold of the buttocks to prevent it from sliding down when you sit down. Now the backrest and the foot end are "set up". If the entire bed is tilted and brought into an "inclined plane" (head end up, foot end down), a comfortable sitting position can be achieved. The heels should be bedded slightly above the mattress with a cushion under the calves.
• Changes in position: By regularly changing the lying or sitting position, the pressure on areas of the skin that are particularly at risk (e.g. buttocks, heels) can be reduced. Often, even small changes in position, such as turning your head or placing small pillows underneath, are sufficient.

Both overweight and underweight are associated with an increased risk of bedsores. For more information on diet recommendations for overweight or underweight, see Diet for overweight and danger: malnutrition and malnutrition.