Pressure Ulcers: Care And Advice
Pressure ulcers are lesions that are caused by staying in the same position for a long time, when some part of the body is compressed against a solid. The most common is that they occur in people who have been in bed for a long time, but they also occur in those who are in other positions.
It is very important to note that most pressure ulcers can be prevented. It is enough to follow basic rules of care and care. So much so, that in various parts of the world the presence of this type of injury has legal implications for those who work as a caregiver.
The presence of pressure ulcers can lead to a series of complications that, in the most severe cases, are life-threatening. Women suffer from these types of injuries more frequently, which are also more prevalent in people between the ages of 71 and 90.
What are pressure sores?
Pressure ulcers are necrosis, or tissue death, that affects the skin and subcutaneous tissue. They take place when some part of the skin is subjected to pressure between two planes. These planes are the person’s bones and a solid surface, such as a bed or chair.
This continuous pressure leads to a decrease in the supply of oxygen and nutrients to the area of the skin that is under pressure. This is because the blood vessels are crushed. When the skin does not receive the oxygen and nutrients it requires, the tissue dies. The consequence is one or more pressure sores.
These lesions appear mainly in people who remain immobilized for a long time or in those who have difficulties to generate spontaneous healing processes. They severely affect a person’s quality of life and require specialized care.
Causes and types of ulcers
The main cause of these ulcers is the lack of care and preventive measures to avoid them. When a person, for whatever reason, must remain immobilized for a long time, the necessary precautions must be taken so that these types of injuries do not appear.
Based on their appearance and the depth of the lesions, pressure ulcers are classified into four types:
- I grade. They appear approximately two hours after the onset of pressure. The appearance is of an erythema or redness on the skin, which does not fade easily.
- Grade II. It compromises the epidermis and dermis. It looks like a blister or laceration.
- Grade III. It compromises the dermis, epidermis and subcutaneous tissue. There is drainage of a serous fluid. If it becomes infected, it drains a purulent fluid.
- Grade IV. They come to compromise the muscle, the bones, the cartilage and the viscera. Dead tissue is often visible to the naked eye.
Pressure ulcer care
The most important thing is to check your skin frequently, at least once a day. If erythema or redness is found, it is important to be aware of what is happening in that area of the skin. Typical areas of pressure are: back, buttocks, heels, back of head, and elbows.
The skin must always be clean and dry. Cleaning is usually done with a soft sponge or clean textile. Whenever there is any dirt, cleaning is necessary. It is advisable to use soaps that do not irritate the skin and warm water. No type of alcohol should be used.
It is necessary to apply moisturizers regularly and wait for the skin to absorb them. Likewise, use bedding made with natural fabrics and dry and clean clothes. In the same way, it is very convenient to use padded or protective dressings in pressure areas.
Additional tips
If a person must be on bed rest for a long time and cannot move on their own, they need to be moved or helped to change position every two to three hours. If the person is sitting, changes should be made every 12 to 30 minutes.
It is important to avoid rubbing the bony prominences against each other. For example the knees, ankles, etc. In these cases it is convenient to use a pad, some protective element or simply keep these areas separate. It is not appropriate to drag the person to move him.
Another very important recommendation is to avoid humidity. If there is sweat, urine, feces or discharge, it is appropriate to clean the skin without further delay. Then dry it by tapping it and avoiding friction. If there is incontinence, diapers, catheters, or catchers should be used.
