Most pressure sores are preventable. It is much better to prevent pressure sores than to treat them. Here are 5 tips to prevent pressure sores.
Change position frequently
One of the best ways to prevent pressure sores is to reduce or relieve direct pressure on the areas at risk by moving around and changing position as much as possible. People who spend most of their time in bed are advised to change position every 2–3 hours, even during the night. People who use a wheelchair are advised to shift position within their chair about every 15 minutes, by leaning forward or moving side to side. If you can't move, ask your carer to reposition you regularly.
Don't drag your heels or elbows when moving
Don't drag your heels or elbows when moving in your bed or chair. Chafing or friction caused by your skin rubbing against the sheets or other surfaces can remove top layers of skin and cause pain. Instead its best to lift your limbs up. If you are unable to do this, ask your carer for help.
Use pillows, cushions or special mattresses
Using pillows or cushions as soft buffers between your skin and the bed or chair can be helpful. No two skin surfaces should rest against each other, eg, while lying in bed, place a pillow between your knees and ankles to prevent them from touching each other. If you are confined to bed, ask your healthcare provider about the use of heel and knee protectors or pressure relieving mattresses.
Take care of your skin
Taking care of your skin and doing regular skin checks are important in preventing pressure sores. Check your skin at least once a day for redness, changes in colour, blisters, bruises, cracked, scraped or dry skin. Closely inspect areas that are at especially high risk for pressure sores. The highest risk is where your bones are close to the surface and your skin is directly over bone. Use a mirror to inspect skin in hard-to-see areas or ask your caregiver to help you. If you notice a discolored area, stay off the area until it returns to normal skin colour.
Keep your skin at the right moisture level, as damage is more likely to occur if your skin is either too dry or too moist. Use moisturising products to keep your skin supple and prevent dryness, but avoid massaging bony areas where the skin is too delicate. Immediately wash and dry skin and change clothing after any leakage of stool (poo) or urine (pee). Avoid harsh soaps, skin agents with alcohol and antibacterial or antimicrobial soaps.
Eat healthily and drink plenty of fluids
Eating a healthy and nutritious diet and preventing dehydration by drinking enough liquid is important in preventing pressure sores. Being obese or having severe weight loss can increase the risk of getting pressure sores. A poor diet can affect the health of your skin and your immune system. Likewise, hydration plays a vital role in your skin's health and helps to repair injured skin. Adequate fluid intake is necessary for wound healing, to support the blood flow to wounded areas and to prevent breakdown of your skin.
The following links provide further information about pressure sore prevention. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
How to prevent pressure injuries at home NZ Wound Care Society, Ministry of Health, NZ, ACC, NZ & Health Quality & Safety Commission, NZ
Pressure injury prevention and treatment NZ Spinal Trust
Pressure ulcer DermNet, NZ
Helping prevent pressure injuries ACC, NZ
Bedsores (pressure ulcers) Mayo Clinic, US
- How to prevent pressure injuries at home NZ Wound Care Society, Ministry of Health, NZ, ACC, NZ & Health Quality & Safety Commission, NZ
- Pressure ulcer DermNet, NZ
- Pressure injury prevention Health Quality & Safety Commission ,NZ
- The care for a quality improvement programme to reduce pressure injuries in NZ KPMG, NZ, 2016
- Skin care and pressure sores University of Washington, US, 2009
Information for healthcare providers
Repositioning for pressure injury prevention in adults Cochrane Database of Systematic Reviews, 2020
How to classify and document pressure injury NZ Wound Care Society, HQSC, NZ, ACC, NZ & Ministry of Health, NZ, 2019
Pressure injury prevention procedure Canterbury DHB, NZ, 2021
Guiding principles for pressure injury prevention and management in NZ HQSC, NZ, ACC, NZ & Ministry of Health, NZ, 2017
Pressure injury prevention Waitemata DHB, NZ
Microbiological assessment of infected wounds – when to take a swab and how to interpret the results BPAC NZ, 2013
Wound care – a guide to practice for healthcare professionals Ausmed Australia
Prevention and treatment of pressure ulcers – quick reference guide National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel & Pan Pacific Pressure Injury Alliance, 2014
Helping prevent pressure injuries ACC, NZ, 2021
Pressure injury in spinal cord injury – consensus statement ACC, NZ, 2021