Pressure Ulcer Prevention and Management
Pressure ulcers, also known as bedsores, are injuries caused by prolonged pressure on the skin and underlying tissues. They commonly affect individuals with limited mobility, such as bedridden patients, wheelchair users, and older adults. Preventing and managing pressure ulcers requires a strategic combination of mobility support, skin care, nutrition, and proper wound treatment.
Pressure ulcers develop when constant pressure cuts off blood flow to specific areas, usually over bony prominences like the heels, tailbone, hips, elbows, and shoulders. Without adequate circulation, tissues begin to break down. Prevention focuses on relieving this pressure. Regular repositioning—every two hours for bedridden patients and hourly for wheelchair users—helps restore blood flow and prevents tissue damage.
Support surfaces play a critical role. Specialized mattresses, cushions, and overlays redistribute pressure more evenly, reducing strain on vulnerable areas. Foam, gel, air, or alternating pressure systems provide comfort and protection, especially for individuals at high risk.
Skin care is essential in preventing pressure ulcers. Keeping the skin clean, moisturized, and free from excessive moisture reduces the risk of breakdown. Sweat, urine, or wound drainage can cause irritation, so gentle cleansing and barrier creams are used to protect the skin. Inspecting high-risk areas daily helps detect redness or early-stage ulcers before they worsen.
Nutrition supports both prevention and treatment. Adequate protein intake strengthens skin and tissues, while vitamins and minerals support immune function and repair. Hydration helps maintain elasticity and resilience, making the skin less prone to injury.
Once a pressure ulcer forms, treatment depends on the severity. Early-stage ulcers may only require pressure relief, gentle cleansing, and protective dressings. More advanced ulcers may involve debridement to remove necrotic tissue, specialized dressings to manage moisture, and infection control measures. Foam, hydrocolloid, and alginate dressings help maintain moisture balance while protecting the wound bed from friction and external contaminants.
Advanced therapies, such as negative pressure wound therapy, can accelerate healing by drawing out fluids and improving blood flow. In severe cases, surgical intervention may be needed to close deep wounds or repair damaged tissue.
Education for patients and caregivers is essential. Understanding how to position the body, maintain skin hygiene, choose proper bedding, and monitor for early warning signs empowers families to participate actively in care and prevention.
Pressure ulcer management is ultimately a collaboration between healthcare providers, caregivers, and patients. Through consistent care and preventive strategies, pressure injuries can be significantly reduced, improving comfort, promoting independence, and supporting overall quality of life.