Pressure sores (or ulcers) are one of the most common issues faced by people with limited mobility, and more specifically, those who are in wheelchairs. It is because without adequate movement and the ability to readjust ourselves, often paired with compromised circulation that these wounds arise. But what actually are they?
It is when you sit or lie down for a prolonged amount of time that the weight of your body on a surface cuts off blood supply to the area, resulting in the death of skin and tissue cells. Common areas of the body affected include tailbone, hips, buttocks, elbows, back or ankles, and is normally where skin is thinnest and closest to the bone. Common causes include moisture (sweat, urine etc) and friction or pulling of the skin against a surface for a prolonged time. If left untreated, these can lead to other complicated illnesses such as cellulitis and septicemia, or become life-threatening.
EARLY SIGNS OF PRESSURE SORES AND TREATMENT
Pressure sores have 4 stages ranging from mildest to most severe, and are treated accordingly.
Stage 1 - Red skin that is often tender, however there is no open wound
Stage 2 - Slightly broken skin, abrasions, rough areas or blisters.
Stage 3 – An open wound that affects the top fatty layer of skin (hypodermis)
Stage 4 - A deep wound that can penetrate the tissue to expose bone, muscle and tendons and is the most serious and severe
Treatment depends on the severity of the sore. The first 2 stages can often easily be managed by monitoring the area, applying skin creams, bandages or padded dressing to prevent any worsening symptoms. Stage 3 may require regular irrigation and cleaning of the wound, and can include antibiotics and/or medicated dressings and ointments if there is any sign of infection. Signs of infection include extreme pain in the affected area, redness and swelling, odor, or pus. Stage 4 will usually require specialist attention and in some cases surgery to close the wound.
PREVENTION, LIFESTYLE AND WAYS TO MINIMIZE RISK OF PRESSURE SORES.
Depending on your personal situation and lifestyle needs, prevention of pressure sores can be tricky, however there are many effective ways to both prevent them appearing at all, or to ensure they do not get worse. Some general tips include:
Regular skin checking for any signs of redness or swelling
Changing position regularly, such as every 15-30 mins for wheelchair users or once every 1-2 hours for those lying in bed.
Skincare such as moisturizers to keep skin from getting too dry and delicate
Using specialised cushions and seating products such as inflatable or gel-based wheelchair cushions to improve circulation.
Regular exercise or physical therapy to improve circulation and posture
Eating a nutritious diet rich in protein, fruit and veggies to assist with skin cells, collagen production and tissue health
Keeping wheelchairs and other mobility/seating equipment clean and sanitized as these come in direct contact with the skin and if not maintained and cleaned regularly can contribute to bacterial infection and germs
Keeping on top of your skin health and maintaining a routine in order to do so should be a part of everyone’s health care plan. However, if you have any concerns, it is always best to consult your local healthcare professional or work with a healthcare team to ensure these issues do not arise.
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