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Pressure ulcers
Pressure ulcers, also called pressure injuries, are damage to the skin and underlying tissue caused by pressure or shear. They can develop quickly and lead to discomfort and complications.
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Causes of Pressure Ulcers
How Pressure Ulcers Develop
- Pressure: When body weight presses against a surface for a long time, reducing blood flow.
- Shear: When the skin moves in one direction while underlying tissue moves in another, such as when a person slides down in bed.
- Friction: When the skin rubs against a surface, damaging the outer layer.
- Moisture and Heat: Increased humidity and temperature weaken the skin’s resistance.
Commonly Affected Areas
Pressure ulcers often occur where bones are close to the skin, such as the heels, sacrum, and hips.
Risk Factors
Factors That Increase Risk
- Reduced circulation or oxygen supply.
- Malnutrition or low fluid intake.
- Older age.
- Reduced sensation or consciousness.
- Abnormal blood values (e.g., low hemoglobin or albumin).
- Elevated body temperature.
- Use of medical devices, such as urinary catheters.
Preventive Measures
Key Interventions
- Risk assessment: Should be carried out upon admission, ideally within 24–48 hours.
- Skin inspection: Daily checks, focusing on areas over bony prominences.
- Repositioning: Regularly changing position to relieve pressure points.
- Pressure-relieving aids: Use special mattresses, cushions, or seating devices.
- Skin care: Keep the skin clean and dry, use moisturizers and barrier creams.
- Nutritional assessment: Ensure adequate nutrition and fluid intake.
- Pain management: Assess and treat pain associated with pressure ulcers.
Classification of Pressure Ulcers
Categories
- Category 1: Intact skin with non-blanchable redness.
- Category 2: Partial-thickness skin loss, such as a blister or shallow wound.
- Category 3: Full-thickness skin loss where fat tissue is visible, but not bone, tendon, or muscle.
- Category 4: Deep full-thickness skin loss with exposed bone, tendon, or muscle.
- Unstageable: Full-thickness loss where the base is covered by dead tissue, making depth unclear.
- Suspected deep tissue injury: Discoloured skin or blood-filled blister indicating underlying tissue damage.
Documentation and Follow-Up
Importance of Follow-Up
- All findings and measures must be carefully documented.
- Use standardized assessment tools.
- Monitor the service user’s status regularly to ensure effective treatment and prevention.
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