Pressure sore prevention

Pressure Sore Prevention What is it?

Pressure sores develop when prolonged pressure impedes blood flow to an area of skin, resulting in skin damage.

Risk factors •

Limited mobility, which may cause difficulty in changing body position while seated or in bed.

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Shearing forces caused by friction between the body and the bed during lifting or transferring, which may result in skin tear.

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Prolonged exposure to moisture such as sweat, urine or faeces.

Stages in pressure sore development

Stage 1 • Areas of redness on the skin which may itch or feel warm, spongy or firm.

Stage 2 • Some skin loss occurs. The wound is now an open sore similar to a blister / abrasion. The surrounding skin may appear red or purple.

Stage 3 • A deep, crater-like wound with damage extending to tissue beneath the skin.

Stage 4 • Large scale skin loss occurs with damage to muscle, bone and supporting structures such as tendons and joints.

Common sites for pressure sores Pressure sores usually develop over bony prominences on the body where the skin is the thinner.

Recommendations General well-being: • Eat a well-balanced diet which includes food high in protein, vitamins and minerals. Consult a dietitian if there are special dietary requirements.

• Ensure adequate hydration.

• Limit caffeine containing beverages such as coffee, tea and soft drinks.

Exercise: • Encourage active exercise or passive range of motion exercise in order to maintain good blood circulation, joint flexibility and prevent muscle contractures.

Tips for caregivers Reduce Pressure and Friction: • Avoid clothes and shoes that are too loose, too tight fitting or with thick seams, buttons or zippers as they put pressure on skin.

• Use slide sheets instead of pulling on clothing to position a person in bed.

• Alternate between sitting and lying regularly at least once every 2 hours. Bedbound persons should be turned regularly at least once every 2 hours.

• During transfers, reduce friction between the body and the bed or chair by avoiding movements that rub, scratch or cut the skin.

Skin Care: • Check regularly to look for any skin damage or redness over common pressure sore sites.

• Keep skin clean and dry. Wash and dry the surrounding skin after urination and defecation.

• Moisturise dry skin and use barrier cream over common pressure sore sites if needed.

Assistive Devices: • Use a pressure relief mattress or cushion to distribute body weight evenly.

• Avoid sitting on donut-shaped cushions / water-based cushions.

• Other useful devices include hospital beds, heel protectors and adjustable bed backrests.

Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group.

Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg REHAB PE OT 008/2018 Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.

REHAB.PE.OT.008.0320