Experts all agree that it is far easier to prevent bed sore than to treat them. However, easier does not necessarily mean easy. With the appropriate measures, patients and medical staff can significantly reduce the risk of developing pressure ulcers.
The Mayo Clinic, USA, recommends that patients and medical staff develop a plan that all can follow; this must include position changes, supportive devices, routine skin inspections and good diet.
- Position changes – the prevention of bed sores depends largely on regular position changes. It does not take long for a pressure ulcer to start developing. That is why experts say positions should change every 15 minutes or so for those on a wheelchair and at least once every two hours for people in bed, even during the night-time hours (if the patient spends most of his/her time in bed). Patients who cannot do this unaided will need help.
- Best positions in bed – a qualified physical therapist should advise the patient on the best positions. These may include:
- Hip bones – lie on your side at a 30-degree angle, do you lie directly on your hipbone. Make sure your legs are suitably supported – if you are lying on your back place a foam pad or a pillow under your legs from the middle of your calf to your ankle. Do not use a doughnut-shaped cushion, as it can cut your circulation.
- Knees and ankles – to prevent them from touching each other use small pillows or pads.
- Head of the bed – do not raise the head of the bed more than 30 degrees, to minimize the risk of friction.
- Type of bed – pressure-reducing mattresses or beds are best. This may include foam, air, gel or water mattresses.
- Wheelchairs – pressure-release allow for longer periods of sitting. Patients without a pressure-release chair will need to change their position every 15 minutes, or thereabouts. Wheelchairs need cushions that reduce pressure while providing support and comfort.
- Skin inspections – these should be done daily. Use a mirror if you have to, or ask a family member or caregiver to help you. People who spend long periods in bed should check their hips, spine, shoulder blades, elbows, heels and lower back especially carefully. People on wheelchairs should check their buttocks, tailbone (coccyx), lower back, legs, heels and feet carefully.
- Diet – good nutrition is crucial for skin health and proper healing. It is sad that those who are at high risk of pressure ulcers tend to be more malnourished than other people. Talk to a qualified nutritionist or dietitian about what is most suitable for you.
- Smoking – if you smoke regularly, giving up may be the single best thing you can do to prevent pressure ulcers, and help a more rapid and likely recovery if they do occur.
- Exercise – exercise helps circulation, builds muscle, improves overall health and stimulates a healthy appetite. Talk to a physical therapist about which exercise options are best for you.
