Pressure ulcers: care and advice

Pressure ulcers are injuries that occur from staying in the same position for a long time, when any part of the body is compressed against a solid. The most common is that they occur in people who have been in bed for a long time, but also take place in those who are in other positions.

It is very important to note that most pressure ulcers can be avoided. Simply follow basic rules of care and care. So much so, that in several parts of the world the presence of these types of injuries has legal implications for those who act as caregivers.

The presence of pressure ulcers can lead to a series of complications that, in the most serious cases, are life-threatening. Women suffer more frequently these types of injuries, which are also more prevalent in people between 71 and 90 years.

What are pressure ulcers?

Pressure ulcers appear frequently in patients who remain immobilized for a long time.

Pressure ulcers are a necrosis, or death of tissue, that affects the skin and subcutaneous tissue. They occur when some part of the skin is subjected to a pressure between two planes. These planes are the bones of the person and a solid surface, such as a bed or a chair.

This continuous pressure leads to a decrease in the supply of oxygen and nutrients to the area of ​​the skin that is pressed. This is because the blood vessels are crushed. When the skin does not receive the oxygen and nutrients it requires, the tissue dies. The consequence is one or several pressure ulcers.

These lesions appear mainly in people who remain immobilized for a long time or in those who have difficulties in generating spontaneous healing processes. Severe impact on the quality of life of a person and require specialized care.

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Causes and types of ulcers

The main cause of these ulcers is the lack of care and preventive measures to avoid them. When a person, for any reason, must remain immobilized for a long time, the necessary precautions must be taken so that these types of injuries do not appear.

Depending on their appearance and the depth of the lesions, Pressure ulcers are classified into four types:

  • Grade I. They appear in approximately two hours after the onset of pressure. The appearance is of an erythema or redness in the skin, which does not fade easily.
  • Grade II. Commit the epidermis and dermis. It looks like a blister or a laceration.
  • Grade III. It compromises the dermis, epidermis and subcutaneous tissue. There is drainage of a serous liquid. If it becomes infected, it drains a purulent liquid.
  • Grade IV. They get to compromise the muscle, the bones, the cartilage and the viscera. Dead tissue is often observable with the naked eye.

Care for pressure ulcers

To avoid complications from pressure ulcers it is important to keep the patient's skin clean and dry.

The most important thing is to check the skin frequently, at least once a day. If erythema or redness is found, it is important to be aware of what happens in that area of ​​the skin. Typical areas of pressure are: back, buttocks, heels, back of the head and elbows.

The skin should always be clean and dry. Cleaning is usually done with a soft sponge or a clean textile. Whenever there is any dirt it is necessary to do the cleaning. It is advisable to use soaps that do not irritate the skin and warm water. Do not use any type of alcohol.

It is necessary to apply moisturizers regularly and wait for the skin to absorb them. Also, use bedding made with natural fabrics and dry and clean clothes. In the same way, it is very convenient to use padded or protective dressings in the pressure zones.

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Additional tips

If a person must stay in bed for a long time and cannot move on their own, it is necessary to move it or help it change position every two or three hours. If the person is sitting, changes should be made every 12 to 30 minutes.

It is important to avoid rubbing bony prominences with each other. For example knees, ankles, etc. In these cases it is convenient to use a pad, some protective element or simply keep those areas separate. It is not appropriate to drag the person to move it.

Another very important recommendation is to avoid moisture. If there is sweat, urine, feces or suppuration, it is appropriate to clean the skin without further delay. Then dry it by tapping and avoiding friction. If there is incontinence, diapers, probes or manifolds should be used.