What is a pressure ulcer?

A pressure ulcer is an area of damage to the skin and underlying tissue. They are sometimes known as bed sores, pressure sores/injuries or decubitus ulcers.

What can cause a pressure ulcer?

It is usually caused by sitting or lying in one position for too long without moving (unrelieved pressure) or by rubbing or dragging your skin across a surface (shear/friction)     

A pressure ulcer can develop in only a few hours. It will usually start with the skin becoming slightly redder, warmer or darker than usual. This can go on to become blister- like or an open wound. Over a longer time period this can become larger and cause serious harm in extreme cases.

Pressure ulcers.png

 

Who is at risk?

Any adult can be at risk; however people at an increased risk of developing a pressure ulcer are those who:

  • Have problems moving and are unable to change their own position
  • Cannot feel pain over part or all of their body
  • Have incontinence problems
  • Are seriously ill or undergoing surgery
  • Have had pressure ulcers in the past
  • Have a poor diet or don’t drink enough
  • Are very old or very young
  • Suffer with anaemia
  • Have poor circulation
How can you protect yourself?

There are several ways you can reduce the risk of pressure ulcers:

Keep moving

One of the best ways of preventing a pressure ulcer is to reduce or relieve pressure on areas that are vulnerable to pressure ulcers (bony parts of the body) by frequently changing position, at least every 4 to 6 hours or as directed by your health care professional.
This can be as simple as standing up for a few moments, or being assisted in a new lying position dependent upon your needs.

A good diet

Make sure you eat a well-balanced diet and drink plenty of fluids. Extra protein may help if you have an existing pressure ulcer.

Have a skin check up

Ask your relative or carer to regularly check your skin for signs of pressure ulcer damage. If you have concerns, please contact your nurse or GP.

Protect your skin

Wash your skin using warm water or pH neutral skin cleansers. Do not use heavily perfumed soap or talcum powder, as these can soak up the skin’s natural oils leading to vulnerable dry areas. If you suffer from incontinence, please inform your health care team as they can assess the best way to deal with the problems.

Things to look out for      
  • Bluish/purplish patches on dark- skinned people
  • Red patches on light-skinned people
  • Discomfort or pain
  • Patches of hot/cold skin
  • Blisters or damage to skin
  • Patches of hard skin
What can you expect from your healthcare professional/nurse?

An assessment when you are first being seen will be used to identify your risk of developing a pressure ulcer (Waterlow score).

 If we think you could be at risk, we may implement some or all of the following:

  • Pressure-relieving bed mattresses and chair cushions. 
  • Regular reassessment of your skin and any changes in your health.
  • Advise you on how often you need to move or be moved.
  • Establish a repositioning routine with you.
  • Offer advice/placement of correct sitting and lying positions for you.
  • Assessment of your nutritional requirements.
  • Discussions of your concerns/needs.

Further reading and useful websites: European Pressure Ulcer Advisory Panel Guidelines www.epuap.org/guidelines.  National Institute for Clinical Excellence (NICE) www.nice.org.uk

 

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For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302