Pressure ulcers
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What is a pressure ulcer?
A pressure ulcer is an area of damage to the skin and underlying tissue. You may have heard them called 'bed sores' or 'pressure sores'.

What causes pressure ulcers?
Pressure
Normal body weight can squash the skin in people at risk and damage blood supply to the area, which can lead to tissue damage.

Shearing
Sliding or slumping down the bed or chair can damage the skin and deeper layers of tissue as a result of shearing.
 
Friction
Poor lifting and moving techniques can remove the top layers of skin. Repeated friction can increase the risk of pressure ulcers.
 
Pressure ulcers can develop anywhere but are mostly found over bony areas such as heels, elbows, hips and buttocks.

Who is most at risk of developing a pressure ulcer?
You may be at risk of developing pressure ulcers for a number of reasons, including:
 
Problems with movement
You may be at increased risk if your ability to move is limited or you are unable to move due to a variety of reasons such as pain or arthritis.
 
Poor circulation
You may be at increased risk if you have poor circulation, for example, as a result of vascular disease or heavy smoking.
 
Moist skin
You may be at increased risk if your skin is damp, due to incontinence, sweat or a weeping wound. It is important your skin is kept clean and dry.
 
Problems with sensitivity to pain or discomfort
Some conditions (for example, diabetes and stroke) may reduce your sensitivity to pain or discomfort so you are not aware of the need to move.
 
Previous pressure ulcer
If you have had a pressure ulcer in the same area before, your skin will have lost some of its previous strength and is more prone to pressure damage.
 
Inadequate diet or fluid intake
Poor diet may cause you to be malnourished. Lack of fluid intake may lead to dehydration. Losing too much weight can lead to loss of padding over bony points.
 
Helpful tips for prevention
Check your skin
If you have known risk factors for pressure ulcers, it is important you check your skin on a daily basis for any signs of pressure ulcers, such as discoloured areas of skin.

This is particularly important if you have an underlying condition, such as nerve damage or diabetes, which may dampen or numb feelings of pain in certain parts of your body.

You can use a mirror to check the parts of your body that are difficult to see, such as your bottom and the heels of your feet. If you notice any damage, contact your community nurse or GP immediately.

Changing position
Making regular and frequent changes to your position is one of the most effective ways of preventing pressure ulcers.

If a pressure ulcer has already developed, regularly changing your position will help to avoid putting further pressure on it and give the wound the best chance of healing. If you are unable to change position yourself, a carer or relative will need to assist you.

Keep moving
Changing your position regularly helps prevent the build-up of pressure. If you have limited movements your carers will need to assist you with regular turns. You will be supplied with specialist mattresses or cushions to help reduce the pressure. If you cannot use them, please discuss it with the nurses as they may be able to offer a different option. Having specialist equipment will not replace turning or moving position to reduce pressure.
 
Protect your skin
Wash your skin every day using warm water or skin cleansers. Avoid using heavily perfumed soap or talcum powder as these can soak up the skin's natural oils leading to vulnerable dry areas of skin. If you suffer from incontinence, please inform your community nurse as they can provide continence advice and barrier preparations to prevent soreness.

How can we help you?
Our Tissue Viability Team in Knowsley works closely with other healthcare professionals providing advice and support to care for non-healing or slow to heal wounds.
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