Pressure Ulcer Treatment and Prevention
When I was doing my nurse training, many years ago, I was very shocked to find that poor mobility, sitting or lying in one position, even for a comparatively short time, could cause devastating pressure ulcers. The ulcers sometimes developed into very big, deep wounds. The patients must have been in a lot pain.
People with severe Alzheimer’s and those with co-existing medical conditions often spend long periods in bed. Once they cannot move about freely pressure ulcers, also known as pressure sores, can develop and can be a serious health problem.
Doctors at the University of Calgary are researching a new product. They have tested underwear, well pads really, into which electrodes are placed. The pads, one on each buttock, have been used on thirty seven patients. The pads stimulate nerves and muscles to mimick fidgeting. The pads are activated every 10 seconds for 12 hours a day and the results have been good. Their study presented at the Neuroscience 2012 conference reports that none of the 37 patients developed a sore during the month long trial.
Pressure ulcers dramatically increase healthcare costs so prevention is very important for budgets and for good health care. In the United States Gosnell and VanEtten believe that approximately one million pressure ulcers occur each year and that costs add over $1 billion of expenditures and an additional 2.2 million Medicare hospital days in the United States. It is estimated that pressure ulcers cost the Canadian healthcare system $3.5 billion a year.
There are three main causes of pressure ulcers: Pressure-the weight of the body pressing down on the skin compromising blood flow, shear – the layers of the skin are forced to slide over one another or over deeper tissues, for example when you slide down, or are pulled or transferred in bed, chair or wheelchair, and from friction-rubbing the skin. People are also more vulnerable when they old, in poor health, were nutrition is poor and if the skin is unclean.
The areas particularly at risk are the elbows, heels, ankles, buttocks, shoulders, and the back of the head.
Caregivers need to look for the early signs that a pressure sore may be developing:
• Red patches of skin on light skinned people that don’t go away.
• Bluish/purple patches on dark skinned people that don’t go away.
• Blisters, or damage to the skin.
• Patches of hot or cold skin.
• Patches of hard skin.
Any of the above symptoms need to investigated by his or her healthcare provider and be seen by a doctor.
University of Calgary http://www.ucalgary.ca/news/utoday/february3-2012/smart-e-pants
Staas WE Jr, Cioschi HM. Pressure sores--a multifaceted approach to prevention and treatment. West J Med. May 1991;154(5):539-44.