Pressure ulcers are lesions resulting from a prolonged stay in the same position, with one side of the body pressed against a solid surface. They generally occur when you are forced to stay in bed for a long time, but not only.
Most pressure ulcers can be avoided with simple precautionary measures. As a result, in several countries the appearance of these injuries has legal implications for those who work as a caregiver.
Pressure ulcers can cause a variety of complications that, in severe cases, can be life-threatening. These lesions tend to occur between 71 and 90 years of age, with a higher incidence among women.
What are pressure ulcers?
Pressure ulcers are a form of necrosis (or tissue death) that affects the skin and subcutaneous tissue. They occur when the skin is under pressure from two things: the person’s bones and a solid surface, such as a bed or chair.
This constant pressure reduces the supply of oxygen and nutrients to the affected skin area because the blood vessels get pinched. When the skin does not receive the oxygen and nutrients it needs for some time, the tissue dies. The consequences are one or more pressure ulcers.
In addition to long periods in bed, a difficult wound healing process is another cause of pressure sores. They severely compromise a person’s quality of life and require special care.
Causes and types of pressure ulcers
When you are forced, for whatever reason, to remain immobile for a long time, it is necessary to take the necessary precautions to prevent the appearance of skin lesions. If not, there are four types of pressure ulcers depending on their appearance and severity :
- Grade I. They appear about two hours after the start of compression. With an erythema-like appearance or skin redness that does not go away easily.
- Grade II. They damage the epidermis and the dermis. They have the appearance of blisters or tears.
- Grade III. They damage the dermis, epidermis and subcutaneous tissue. They have a serous liquid. If infected, they drain purulent fluid.
- Grade IV. They affect the muscle, bones, cartilages and bowels. The very thick fabric is visible to the naked eye.
The condition of the skin should be checked at least once a day. The areas most subject to pressure are the back, buttocks, heels, nape and elbows. The skin must always be clean and dry.
Cleaning should be done with a soft sponge or a clean cloth. In case of dirt, it is necessary to clean the affected area with mild soap and warm water. Products that contain alcohol should be avoided.
Following cleansing, a moisturizer is applied and the skin is expected to absorb it. Likewise, it is recommended to wear pajamas in natural fabric and always dry and clean clothes. Furthermore, it is advisable to use special bandages to protect the area subject to compression.
If a person is forced to stay in bed for a long time, we will need to help him move or change position every two to three hours. If she has to sit, the position should be changed every 12-30 minutes.
It is important to avoid rubbing of the bony prominences (knees, ankles, etc.). When this happens, it is recommended to use a pillow, protector or similar to keep the two parts separate. It is not recommended to drag the person to make him move.
The area subject to pressure must never remain humid. In the presence of sweat, urine, faeces and suppuration, the skin must be cleaned and dried by tapping it to avoid friction. In case of incontinence, diapers, catheters or sleeping vessels should be used.