pressure sores

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Pressure sores may develop rapidly in patients at risk. Once established, they are very difficult to treat so that preventive measures are of utmost importance.

  • pressure ulcers are caused when an area of skin and the tissues below are damaged as a result of being placed under pressure sufficient to impair its blood supply. Typically they occur in a person confined to bed or a chair by an illness and as a result they are sometimes referred to as 'bedsores', or 'pressure sores'

  • pressure ulcers are more likely to occur in people who are seriously ill, have a neurological condition, impaired mobility, impaired nutrition, or poor posture or a deformity
    • also, the use of equipment such as seating or beds which are not specifically designed to provide pressure relief, can cause pressure ulcers

Pressure ulcers are to be expected if erythema appears at a site of pressure which does not blanch on application of pressure by the clinician.

  • use finger palpation or diascopy to determine whether erythema or discolouration (identified by skin assessment) is blanchable (1)
  • start appropriate preventative action in adults who have non-blanching erythema and consider repeating the skin assessment at least every 2 hours until resolved (1)

The Waterlow Score provides a means of assessing the likely risk of pressure sores.

Repositioning of patients (1):

  • encourage adults who have been assessed as being at risk of developing a pressure ulcer to change their position frequently and at least every 6 hours. If they are unable to reposition themselves, offer help to do so, using appropriate equipment if needed. Document the frequency of repositioning required

  • encourage adults who have been assessed as being at high risk of developing a pressure ulcer to change their position frequently and at least every 4 hours.If they are unable to reposition themselves, offer help to do so, using appropriate equipment if needed. Document the frequency of repositioning required

Reference:

Last reviewed 01/2018

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