Minneapolis VA Health Care System. Pressure Ulcers. Let Us Work Together to Protect Your Skin and Prevent Pressure Ulcers

Transcription

1 Minneapolis VA Health Care System Pressure Ulcers Let Us Work Together to Protect Your Skin and Prevent Pressure Ulcers

2 What Are Pressure Ulcers? Pressure ulcers are also called pressure sores or bed sores. Pressure ulcers, or damaged tissue, occur when pressure on the skin cuts off the blood supply. This causes the skin and the tissue below the skin to break down. Signs of damaged skin are: Rediless that does not go away Cracked, blistered, or broken skin Red, shiny skin that is painful or warm to the touch, or that feels spongy or hard Skin that lacks feeling Pressure ulcers usually occur when a person lies or sits one way for too long. They can be painful and slow to heal. Who is at Risk? Anyone who can't move about freely for a long period of time is at risk for pressure ulcers. Staying in one position without moving keeps oxygen and other nutrients from their cells. The biggest risk factors are: Being confined to a bed or wheelchair Being unable to change positions without help from someone else. 1

3 Poor nutrition and skin irritation from loss of bladder or bowel control add to the above risks. A person with skin luade fragile by age or disease who camlot move is at even greater risk. This skin heals more slowly. Pressure from braces, casts or assistive devices, can also cause pressure ulcers. Check these areas and devices and, if the doctor allows it, move or reposition the device. Some examples are a nasal cannula, a knee immobilizer or a breathing mask. 2

4 A nasal cannula can injure the back of the ears or the inside of the nose. Pressure ulcers can occur on the bridge of the nose if a mask is too tight or on legs if a brace does not fit. 3

5 Where Pressure Ulcers Occur Pressure ulcers form where the bone presses the skin against the bed or chair. This is most likely to happen where there is less padding between the skin and the bone--such as the head, feet and around the joints like the shoulder, hip and knee. The pictures below show areas where support for your skin is needed, or pressure ulcers could occur. supine position 1. OC iput 2. scalpllla 3. sact'i.ifn 4..heels lateral position 1. ear 2.. acromion process a.elbow 4. trocl'larner 5. medial 8. lateral comiyle 6. medial 8. lateral mal[eq1u$ 7. heels prone position 1. elbow 2. ear, cheek, nose 3. breasts (female) 4..genitalia (male) 5. iliac crest 6. patella 7.109S 4

6 How Pressure Ulcers Form Even a healthy person can begin to develop a pressure ulcer in less than a day if left in one position. Pressure ulcers occur when pressure on the skin cuts off the blood supply. This breaks down the skin and the tissue below the skin. Unrelieved Pressure Healthy Skin The suhcnta "enus I coutal vesseb cushioning glands tate the skin. The epidermis i:'i the ('mter protective covering. Fragile Skin protrude. The dermis produces cell InOre slowly. epidermis dry and h)ses cellinyers:. 5

7 Shear and Friction Two forces contribute to pressure ulcer formation. Sliding motions (shear)-like bone moving down and the skin moving up-compress blood vessels. This can damage the skin. Surfaces rubbing against other surfaces (friction) can also cause skin to break down. 6

8 Moisture Buildup Skin overfilled with fluid is fragile. Certain kinds of fluid-sweat, urine and feces-can provide a place for bacteria to grow. Too much moisture can increase friction and cause skin to break down. Poor Nutrition For pressure ulcers to heal you need new cells to rebuild skin. New cells reproduce slowly if they do not receive good nutrition. New cells reproduce even more slowly in a person with an illness or tissue injury. Loss of body weight from poor nutrition makes skin thin and fragile. ~T 1..f)(:41..'

9 During Your Hospital Stay While you are in the hospital the tealll of healthcare providers will do everything they can to make your stay more comfortable. The nursing team will check your skin often to make sure that you do not have ulcers or the beginning of skin breakdown. ' They may reposition you or place pillows behind you or under your legs to prevent pressure to your back or heels. They may also apply lotions or creams to your skin. This protects and llloisturizes your skin and helps to prevent skin breakdown. The staff will also encourage you to change your position in bed, sit up if possible,,. and walk when it is appropriate., l 8

10 Your Role To help prevent pressure ulcers from forming, you will need to: Change positions often, every one to two hours. Support your body. Avoid rubbing or sliding. Keep your skin clean and moisturized. Check your skin twice a day for signs of redness or open sores. Have a healthy diet and drink plenty of water. Be sure to reposition every two hours and check your skin over bony areas such as: Heels Buttock Ball of foot Elbows and back 9

11 At the first sign of: Redness that doesn't go away after the source of pressure is removed Cracked, blistered, or broken skin Red, shiny skin that is painful or warm to the touch, or that feels spongy or hard Skin t~at lacks feeling Call your health care provider _ at or the Primary Care Call Center at (612) or toll- free at , extension 1100, Monday- Friday, between 7:30 a.m. and 6:00 p.m. At any other time, call the VANurse Line at (toll-free). For other health information log onto My HealtheVet at 10

12 Making a difference Pressure ulcer prevention is hard work but it can make a real difference on your path to healing. Let us work together to keep your skin healthy and to help you on your road to recovery. Minneapolis VA Health Care System This information is not intended as ~ substitute for professional medical care. Always follow your health care provider's instructions. 11