Pressure Ulcers

If you use a wheelchair or you need extended bedrest, it can reduce blood flow to the area that’s in contact with the chair or bed. Lack of blood supply can cause the skin tissue in this area to become damaged or die, which can lead to a pressure ulcer.

Pressure ulcers can form on the:

• Back of your head
• Ears
• Shoulders and shoulder blades
• Spine
• Elbows
• Hips
• Tailbone area
• Knees
• Heels and ankles

Pressure ulcers can develop quickly — in as little as a day without movement. People with conditions that affect blood circulation (such as diabetes or peripheral artery disease), who smoke, or who have fragile skin are at greater risk for developing pressure ulcers. That’s why it’s important to take precautions to prevent them and recognize the symptoms in the early stages, before they can become serious.

Prevention

You can lower your risk of pressure ulcers with a few simple habits:

• Take care of your skin. When you wash, use a soft cloth or sponge. Make sure you clean and dry areas that don't get a lot of air circulation, such as under your breasts or around your groin and upper-leg area.
• Moisturize. Use lotion or skin protectants on your skin every day. Avoid strong soaps and talc powder. And, try not to take a bath or shower every day, which can dry out your skin.
• Choose clothes carefully. Don't wear clothes that have thick seams, buttons or zippers that press on your skin. Wear loose-fitting clothes, but make sure they don't bunch up or wrinkle in a way to create pressure points on your body.
• Help your body heal. Drink eight to 10 glasses of water each day to improve circulation. Don’t smoke, since smoking reduces blood flow and can slow healing.

If You Use a Wheelchair

When you sit in a wheelchair, it’s important to maintain good circulation. You should:

• Get a proper fit. Have your doctor or physical therapist make sure your wheelchair is the right size, and have them check it every year. If you feel pressure or irritation anywhere, talk to your doctor or physical therapist.
• Use a cushion. Sit on a gel or foam cushion that's fitted to your wheelchair. Ask your doctor or physical therapist what's right for you.
• Shift your weight often. You or your caregiver should change your position every 20 minutes to take pressure off certain areas and allow blood flow. Lean to each side, then lean forward.
• Get in and out properly. Make sure you lift or lower yourself with your arms — don’t drag yourself. You or your caregiver should know how to transfer in and out of the chair properly.

During Bedrest

You can minimize your risk of developing bedsores when you spend an extended time lying down:

• Keep your skin dry. Put pads under your bottom to absorb any wetness and keep your skin dry.
• Use cushioning. Use a soft pillow or foam between areas of your body that press against each other. If you lie on your side, put it between your knees and ankles. When you're on your back, you can move cushioning to different areas to relieve pressures, such as under your heels, tailbone, shoulders or elbows.
• Change your position. To keep pressure off of any one spot, change your position every one or two hours.
• Check your bedding. Make sure your sheets and your clothes are dry and smooth. Check your bed for anything that can cause irritation, such as hair clips, pens, pins, coins or other loose items.

At El Camino Health, we take special care to prevent pressure ulcers while you’re in the hospital. Your care team pays close attention to the health of your skin and uses the latest techniques to prevent pressure ulcers.

Symptoms

Call your doctor if you notice any of the early signs of pressure ulcers, such as:

• A red or purplish colored patch of skin.
• Warm or painful areas on the skin.
• Spongy or hard skin.

Treatment

It's important to treat pressure ulcers right away because they can become more serious quickly. If your sore is in the early stages, your wound care team will monitor your sore very closely and give you self-care and infection-prevention instructions.

If your pressure ulcer requires more advanced care, your doctor may use one or more wound healing techniques to improve healing, such as special bandages and dressings. In the most serious cases, you may require hospitalization or minimally invasive surgery to treat the ulcer.