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Avoid pressure ulcers during care
If elderly people in need of care remain in one position or sit for a long time, there is a risk of pressure ulcers resulting from prolonged external pressure on the skin, reports the Institute for Quality and Efficiency in Health Care (IQWiG) on its Patient Information Portal. Therefore, when patients are forced to sit or lie down longer, it is necessary to relieve the most vulnerable parts of the body, even if they only stay in position for a few days. By regular repositioning and turning the formation of a pressure ulcer (decubitus ulcer) can be avoided.
Most people are constantly moving while sitting or lying down, but very weak, paralyzed or unconscious patients sometimes remain lying or sitting immobile in a position for a long time, according to the IQWiG. This leads to a significantly increased risk of pressure ulcers, which is why care should be taken to ensure that the affected person regularly takes regular positions. Also, special sitting or lying areas can absorb the pressure somewhat, reports the IQWiG. For example, help a special mattress or a pressure-relieving pad. In addition, critical areas on the body of the person affected should be checked regularly, so that the first signs of a pressure ulcer can react quickly.
Open wounds due to persistent pressure
Pressure ulcers, as open wounds caused by prolonged pressure on the skin, almost always occur in places where bones are directly under the skin, reports the IQWiG. For example, they are increasingly found on the coccyx, on the heels, hips, shoulder blades, ankles, elbows, ears and back of the head. If the body weight constantly presses on these areas when lying or sitting, the skin can no longer be sufficiently supplied with blood and supplied with oxygen and nutrients. This makes them thinner and, in the worst case, begins to die, according to the IQWiG communication. The result is open wounds that can be very painful and often difficult to heal.
Regular changes of position are urgently to be observed during the care in order to avoid the development of pressure ulcers. (Image: Gina Sanders / fotolia.com) Diabetes is a risk factor
According to the experts, people with paralysis are particularly at risk because they often feel no pressure at all and no pain in the affected body parts. Also, patients who have been suffering from diabetes for years sometimes show a limited "pain sensation, so they do not notice when a job is stressed too long," reports the IQWiG. At the same time diabetes could lead to disturbances of the blood circulation. Such circulatory disorders such as, for example, due to altered, constricted blood vessels (atherosclerosis) reinforce according to the experts, the undersupply of pressure-loaded skin. Another risk factor is malnutrition, since people who have little flab and little food and drink, have a thinner, less well-perfused and less resistant skin. Last but not least, the development of decubitus ulcer is favored if the skin is exposed for hours to urine, feces or sweat.
Regular checks of the skin appearance required
According to the IQWiG, patients can sometimes even take control of the skin themselves. A mirror is a good tool here. However, people who can not turn around on their own, but rely on the help of others, also because most vulnerable places are on the back of the body. Although not every wound or skin injury develops into a pressure ulcer, caution is urgently needed in view of the imminent complications. In order to assess the severity of a pressure ulcer, nurses, doctors and physicians are usually based on a classification into four different stages, according to the IQWiG. In the first stage, the skin is only slightly reddish and overheated. In the second stage superficial damage, for example in the form of a blister or abrasion, is evident. In the third stage, all skin layers are destroyed and there is a deep wound that can reach the muscle layers. The fourth stage is characterized by extensive destruction of the tissue with associated necrosis, which damage can also include muscles and bones. (Fp)