Pressure ulcers

Written by Jan Smith, Muscular Dystrophy Camapaign Care Advisor at Frenchay Hospital in Bristol.

Contents:

• General information
• Sources of advice
• Conclusion

General information

Pressure ulcers are often referred to as pressure sores bedsores or decubitus ulcer and occur as the result of skin being damaged by too much pressure for too long periods in one place. The commonest areas of concern are elbows, heels and buttocks but they can occur in any area, which is subject to the conditions, which give rise to skin damage.

People who are immobile in bed or sit in wheelchairs or other chairs for long periods must monitor their skin condition regularly for redness or other signs of damage. The most common sign that a pressure sore is beginning to develop is a reddened area or spot on the skin. This would normally disappear within 30 minutes from pressure being relieved. Other signs are: an area of skin that feels warmer to touch, change in texture or for those with dark skin a change in colour, dry or flaky skin texture.

Immediate, thorough and ongoing care is very important to these areas. Pressure ulcers are painful, unpleasant, can give rise to infection and in the worst cases can be life-threatening if left untreated.

Sources of advice

• Talk to the G.P., District Nurse or other care staff about prevention – so much better and easier than a cure.


• Contact your G.P., District Nurse or other medical professional involved in your care promptly if you suspect you or the person/child/you look after have or are developing a pressure ulcer. Do not leave it to see what happens. Carry out the advice given carefully and thoroughly.


• The National Institute for Clinical Excellence (NICE) produce a leaflet: ‘Pressure ulcers: prevention and pressure-relieving devices’, which gives up to date advice but does not mention muscular dystrophy specifically but the advice is the same for everyone no matter their condition.


• NICE also produces a booklet for medical professionals: ‘Pressure ulcer prevention: Pressure ulcer risk assessment and prevention’, including the use of pressure-relieving devices (bed, mattresses and overlays) for the prevention of pressure ulcers in primary and secondary care. Which you could suggest the medical support team obtain.
  Address:
  National Institute for Clinical Excellence
  MidCity Place
  17 High Holborn
  London WC1V 6NA
  Web site: www.nice.org.uk
  Its booklets are free.


• Your local NHS Trust will have a Tissue Viability Service usually staffed by a nursing specialist. You can ask about a referral to them by your G.P. or District Nurse or look on the local NHS Trust website for details.



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Conclusion

Remember your skin is the largest organ in your body and is vitally important for health and well being. Looking after your or your child’s skin well, particularly in vulnerable areas will pay dividends and may prevent hospital stays, special mattresses and garments, even skin grafts and lengthy hospital stays.