We’re finishing our discussion this week about how to identify and manage various pressure ulcers on people who are most susceptible to them, such as people required to be at bed rest, people with disabilities and people dealing with paralysis caused by a spinal cord injury.
Last week, we discussed what pressure ulcers are, how they can occur and how they can be identified, managed and even cured. Read previous article: Spinal cord injuries may lead to pressure sores
This week, we want to discuss a host of other things that anyone susceptible to pressure ulcers should be aware of. Trust me, when it comes to pressure ulcers, an ounce of prevention is worth a pound of cure.
There is no secret to preventing or healing pressure sores. The ways to do so are basic and, if you haven’t been doing so and have escaped — so far — having a pressure ulcer, start using these techniques.
Check your skin completely twice a day, once in the morning and once at night.
Carefully look for skin damage or redness, especially on bony areas. If you have a low level of injury, you can use a mirror to inspect areas you cannot easily see. If your injury is at a higher level, you can have a family member or personal care attendant check your skin.
Know the places on your body that are more likely to get a pressure sore. The four most common areas for a pressure sore to develop in individuals with SCI are on the sacrum (or tailbone) the heel of the foot, the ischium (which is at the base of the buttocks) and the bony areas of the foot. The trochanter or hip is another area at high risk.
If you are paralyzed with an SCI but are otherwise mobile — with a wheelchair, for example — you must always be sure to use the proper equipment when seated or lying down. Have a qualified professional recommend what type of specialized equipment is needed to protect your skin.
For example, your seat cushion needs to fit your body and your chair. It needs to be properly adjusted to offer the best protection against pressure areas. Your mattress needs to provide proper support and protection. You may also need to use pillows or sheepskins to protect areas of the body that get too much pressure.
You should also move often. Sitting or laying in the same position for too long causes the flow of blood to be cut off from certain parts of the body. The skin or underlying tissue begins to die, and it results in a pressure sore. Get in the habit of doing weight shifts (pressure relief) at least every 15-20 minutes when sitting in your wheelchair for extended periods of time. While in bed, it is also usually recommended that you change position at least every two hours.
Keep your skin clean and dry. Wet skin can become soft and inflamed and is less resistant to damage. Moisture also weakens the skin and causes it to break down more quickly. Use lotions instead of powder on your skin.
Also, you should always eat a well-balanced diet. In particular, foods that are high in protein, vitamins and minerals help your skin stay healthy and heal more quickly. Be sure to drink the recommended amount of fluids to help your skin stay softer and hydrated (that translates to at least eight to 10 glasses of water per day).
Avoid clothes and shoes that are too loose or too tight fitting.
Take special caution when doing transfers into and out of your wheelchair and participating in new activities or sports.
Do not smoke. Smoking decreases oxygen to the skin and can make it more difficult for skin to heal. Also, do not abuse drugs or alcohol, because both can damage your skin and can also lead to other health problems as well.
By the time you realize there is a problem, damage to the skin has already occurred. Once you see signs of a pressure sore, stay off the area and contact a doctor immediately for advice on treatment. Once that ulcer has gone beyond Stage 2, you are looking at surgeries needed to get them healed. If the pressure sores have gotten bad enough, recovery time from their needed surgeries can be quite extensive.