May 05th, 2020

Skin injuries caused by pressure
 
For those of us caring for people who barely move or rely on others to move them, it is important to know how to best look after their skin. Pressure injuries, otherwise known as pressure areas, ulcers or bedsores, are among the negative effects of immobility.
 
What is a pressure injury?
 
A pressure injury is damage to an area of skin, usually around a bony part of the body, which has been under pressure for some time. The pressure stops the blood flow feeding the skin in the area and if the pressure is not removed the skin will break down and eventually become an ulcer.  Friction from chaffing, or rubbing over these bony areas can also cause sores and ulcers.
 
What areas are prone to pressure injuries?
 
The diagrams below indicate where most pressure injuries generally occur, however people with unusual posture may develop them elsewhere.

Who is likely to develop pressure? 
 
Anyone who is immobile or can’t feel any sensations are at serious risk, especially those who:

• are bedridden after surgery or during a long illness
• have a health condition such as diabetes, stroke, chronic obstructive airways disease and malnutrition
• have had pressure injuries before
• sit or lie in one position for hours because they can’t move themselves 

 
 
How will I know someone is developing a pressure injury?
 
The skin area around a bony part of the body may:

• be discoloured - dark or red 
• feel hard
• be warm
• not go white when pressed with your finger
• have a blister, blood blister, crack or open wound

 
How can I prevent pressure injuries?
 
A pressure injury is serious, can take a long time to heal, and many are preventable.
 
We can help prevent pressure injuries by relieving direct pressure on the bony areas, taking good care of the skin and having a healthy diet and adequate fluids.  Here are a few tips:
 
Avoid direct pressure

• change position regularly, at least two hourly
• use special pressure-relieving mattresses and cushions
• don't drag heels or elbows when moving, bathing or dressing 
• make sure the bed sheets and clothesare smooth, not wrinkled 
• use cotton or silk like fabric sheets and clothing

 
Skincare 

• keep skin clean and dry
• avoid scented soaps as they can be more drying
• moisturise skin thoroughly after washing and keep well moisturised
• avoid using talcum powder as this dries the skin’s natural oils

 
Diet

• provide a well balanced diet
• give at least 2 litres of fluid a day 

 
What should I do if you think a pressure injury is developing?
 
Immediately reposition the person to completely take all pressure off the affected area and follow all the prevention tips above.  Seek help from:  

• their GP, who may refer to the community therapy or nursing team if required
• Therapy Professionals Physio, Occupational Therapists and Dietitians.

 
How can Therapy Professional’s Therapists can help?
 
Our therapists can help with:

• education on pressure injury prevention 
• manage current or recurring injuries

 
Dietitians:  advise on:

• nutritional requirements to aid wound healing. 

 
Occupational Therapists: advise on: 

• pressure relieving products e.g. cushions, mattresses, heel protectors
• positioning for pressure relief

 
Physiotherapists:  advise on:

• moving and turning people in bed safely to avoid friction on the skin
• changing position and movements to prevent staying in one position for too long.

 
If you require education on prevention and management of pressure injuries, our friendly Physio and Occupational Therapists and Dietitians can help, just contact us at Therapy Professionals. 
 
Ph:                  03 377 5280
Email:             admin@tpl.nz
Website:        therapyprofessionals.co.nz