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Short/long term illnesses
Pressure ulcers or bedsores

Pressure ulcers or bedsores as they are more commonly known, can develop when you are confined to a bed or chair.
When you are not moving as much as you normally do, the weight of your body restricts good healthy blood flow to your arms, neck, legs, back and buttocks. 

The lack of blood flow may cause tissues to deteriorate, weaken and even die off and a sore appears.

Sometimes these can develop into long term deep chronic wounds and can even lead to death if untreated.

Pressure areas are usually the parts of the body that have taken the majority of the body weight when lying down or sitting for a long period. 

Those most prone to developing a pressure sore are paralyzed or unconscious patients, end stage terminal patients, the elderly, diabetics and  cardiac patients, incontinent, very thin or very overweight patients
Do you perhaps have a bedsore - how will you know?

Many people of unaware that they have a bedsore. Often the sore becomes quite severe before one even becomes aware of it. 

I often see patients who have been hospitalized for a period and return home quite well but complain of a sore tender bottom. 
I have taken a look during the nursing asssessment, only to find that the skin has broken down completely and have even had
cases where the wound is smelly, infected and the underlying tissues are exposed and damaged.

Things you may notice:

  • Painful areas such as the skin on your back bone, bottom, heels, elbows, back of neck and even ears
  • Pink, purplish patches over bony areas that don't blanch (turn white when touched)
  • Blisters or open sores on the pressure areas
  • An offensive smell around from the patient
  • Fever, chills and a discharge from the skin at a pressure area
  • Infection and possibly confusion.

How can I avoid getting a bedsore?

Move move move......  If you are in hospital or have to sit too long in one position, move yourself from side to side. Lift your bottom and change position as often as possible.

Keep the skin dry and use a good barrier cream on your "wet areas" especially if wearing a nappy or incontinent.  I recommend Cavilon durable barrier cream (3M).
        Keep the rest of the body's skin supple by applying aqueous cream after the bath.

Avoid eating in bed.  One crumb on the sheets rubbing under your skin can causes a small scratch in the skin which can cause a pressure sore.

Try not to slide and drag a patient up in the bed.  This action causes shearing which rubs one tiny layer off the skin at a time.  Rather fold a sheet in half and make a draw sheet. Lay it under the patient from shoulder area to below the buttocks and use this with the assistance of another person on the opposite side of the patient to pull the person up in the bed.

If you are caring for someone who is bedridden, assist with care to the pressure areas at least every 4 hours.
turn them on their left side for a few hours, then change to right side and then to flat on their back.
wash pressure areas with warm unscented soapy hands, massaging, gently patting and stimulating blood flow.

Buy and use a 100% genuine sheep skin.  They are not cheap but are comfortable to lie on, prevent shearing and relieve pressure.

Hire or buy an inflatable pressure relieving air matress if it looks like you will need to spend over a week in bed.  Most medical aids will cover this if it is motivated by a doctor.

Watch the pressure area for redness.  If you notice the skin is getting  red/purple and the redness does not go away within a few minutes when changing position, seek a medical opinion.  Do not waste time.

Pressure sores are always worse below the surface and what you can see is only 20% of the tissue damage

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