Prevention and treatment
It is always prudent to have a 'prevention is better than cure' ethos. Pressure sores can be difficult to treat especially the more severe so preventing a pressure sore developing in the first place is the best policy.
Pressure Sore Prevention
According to the 'NHS Stop The Pressure Campaign' there are 5 simple steps that can be taken to prevent pressure sores and they are known by the acronym SSKIN.
Support. Make sure you have the right sort of support.
Skin. Early inspection means early detection.
Look for change of colour and damage.
Keep Moving. This is imperative to ensure blood supply to the skin is not interrupted.
Incontinence/Moisture. It is important to keep skin dry and moisture free.
Nutrition/hydration. Good diet and having plenty of fluid reduces the risk of pressure sores developing.
The National Institute for Health Care Excellence, NICE, illustrates ways in which the number of pressure sores can be reduced.
It is vital for good pressure sore administration to carry out a risk assessment on each patient.
Risk assessment tools allow the caregiver to assess the risk of the patient developing a pressure sore.
The patient is assessed for:
Taking the above into account will assist in assessing how likely the risk to that patient in then developing a pressure sore and what steps need to be taken to reduce that risk.
Pressure relieving devices
There are a number of devices designed to reduce pressure.
A pressure relieving mattress is a really useful device. Although they can be expensive they are well regarded as a key weapon in the battle to stop pressure sores developing.
A pressure relieving cushion is important to reduce the risk of pressure sores for those who are wheelchair users or spend lots of time sat down.
A pressure relieving overlay is a cover which is placed on the top of a mattress. The benefit to the patient is the overlay helps to reduces forces known as shear and friction, both which can be contributors to the development of pressure sores.
Pressure Sore Treatment
If a pressure sore develops the treatment depends on the severity of the injury.
It is important to keep pressure away from the affected area so careful positioning of the patient is needed.
Constant re-positioning will help reduce the risk of developing further pressure sores and this should be outlined in the risk assessment.
Mattresses and cushions can help reduce the risk of exacerbating the wound or developing additional pressure sores.
Specially designed dressings are available to protect skin, especially open wounds and also to speed up healing.
Two common dressings used are alginate and hydrocolloid.
You may be also offered a cream or ointment which helps to promote healing.
If a pressure sore becomes infected it may be necessary for the patient to be given
antibiotics to eradicate the infection and help to stop it from spreading further.
Antibiotics can be administered in tablet form or applied directly as a cream.
In severe cases it may be necessary to remove dead skin tissue and this process is called debridement. This can be carried out by a number of methods:
Maggot Therapy is an alternative form of debridment. Although many people are sceptical this is a recognised and effective method.
Surgery may be required in the most severe cases involving grade 3 and 4 pressure sores.