A pressure sore (or bed sore) is an injury to the skin and tissue under it. Pressure sores are usually caused by unrelieved pressure. They typically form on parts of the body over bony areas such as hips and heels. If you sit or lie in the same position for a long time, the pressure on a small area of the body can squeeze shut tiny blood vessels that normally supply tissue with oxygen and nutrients. If tissue I starved of these “fuels” for too long, it begins to die, and a pressure starts to form.
The seriousness of a pressure sore depends on the amount of damage to skin and tissue. Damage can range from a change in the color of broken skin to severe deep wounds down to muscle or bone.
Healing a pressure sore is a team effort. A team of health care professionals, nurses, doctors, dietitians, social workers, pharmacists and occupational and physical therapists, will work to develop a treatment plan for a patient’s pressure sores.
To develop a treatment plan, doctors and nurses must know about the patient’s general health, illnesses that might slow healing, i.e. prescription or over-the-counter medicines and emotional support and physical assistance from family and friends. The plan will then include specific instructions for taking pressure off the sore, caring for the pressure sore and aiding the healing process.
Pressure sores may be relieved or reduced by using special surfaces to support your body, putting your body in certain positions or changing positions often.
Support surfaces are special beds, mattresses, mattress overlays or seat cushions that support your body in bed or in a chair. These surfaces reduce or relieve pressure. By relieving pressure, you can help pressure sores heal and prevent new ones from forming.
Your position is also important to relieving pressure on the sore and preventing new ones. You need to switch positions whether you are in a bed or a chair.
In bed: Do not lie on the pressure sore. Use foam pads or pillows to relieve pressure on the sore; Change positions at least every two hours; Do not rest directly on your hip bone when lying on your side; When lying on you back, keep your heels up off the bed by placing a thin foam pad or pillow under your legs from midcalf to ankle. The pad or pillow should raise the heels just enough so a piece of paper can be passed between them and the bed; Do not use donut-shaped cushions – they reduce blood flow to tissue; Use pillows or small foam pads to keep knees and ankles from touching each other; Raise the head of the bed as little as possible; Use upright position during meals to prevent choking.
In a chair or wheelchair: When sitting you should have good posture and be able to keep upright in the chair or wheelchair; For specific needs use cushions designed to relieve pressure on sitting surfaces; Avoid sitting directly on the pressure sore; Keep the top of your thighs horizontal and your ankles in a comfortable, neutral position on the floor or footrest; If you cannot move yourself, have someone help you change your position at least every hour; If your position in a chair cannot be changed, have someone help you back to bed so you can change position; Do not use donut-shaped or ring cushions, because they reduce blood flow to tissue.
Finally, change your body position often – at least every hour while seated in a chair and at least every two hours while lying in bed.
Another principle of healing a pressure sore is proper care such as cleaning, removing dead tissue and debris, and dressing the pressure sore.
Pressure sores heal best when they are clean. They should be free of dead tissue, excess fluid draining from the sore and other debris. Cleaning usually involves rinsing or irrigating the sore. Loose material may also be gently wiped away with a gauze pad.
Dead tissue in the pressure sore can delay healing and lead to infection. Under supervision of health care professionals, dead tissue and debris can be removed in the several ways: Rinsing; Wet-to-dry dressing; Enzyme medications to dissolve dead tissue only; and Special dressings left in place for several days help the body’s natural enzymes dissolve dead tissue slowly.
Choosing the right dressing is important to pressure sore care. The most common dressings are gauze, film and hydrocolloid dressings. Clean dressings usually can be used, if they are kept clean and dry. Ask your doctor or nurse how to remove dressings and put on new ones.
A pressure sore (or bed sore) is an injury Good nutrition is also instrumental in the healing process for pressure sores. Eating a balanced diet will help your pressure sores heal and prevent new sores from forming.
To prevent future sores, having healthy skin is a key ingredient. Healthy skin is less likely to be damaged and heals faster than skin in poor condition. To improve your skins health: Bathe when needed for cleanliness and comfort; use mild soap and warm water; and apply moisturizers to keep skin from becoming too dry.
Be sure to inspect your skin at least once a day for redness or color changes or for sores. Pay special attention to pressure points where pressure sores can form. For more information on treating and preventing pressure sores, contact the NSCIA-CT Chapter.