What is a pressure injury?
A pressure injury, or ulcer/sore, is damage which has occurred to the skin and deeper tissues as a result of pressure.
What causes pressure injuries?
Pressure is caused from the weight of the body pressing down on an area of skin. This reduces blood supply to the area resulting in skin damage, which may appear as a red area, blister, or an open wound.
Shearing forces can also cause skin damage. This is when the layers of skin are forced to slide over one another, for example when you slide down, or are pulled up in a bed or chair.
Who’s at risk?
Pressure injuries can affect anyone, but particularly people:
• With poor mobility and who have problems with changing their position
• Who are acutely ill
• With reduced body sensation
• With incontinence
• With poor nutritional status, reduced appetite/weight loss
• With poor circulation
Common sites for pressure injuries
Pressure injuries usually develop over the bony areas of the body, these include:
• Bottom
• Heels
• Elbows
• Ears
• Spine and hips
Observing the skin
A change in colour is often the first sign of a pressure injury. This may lead to:
• A hard, swollen, warm area
• A blister
• Broken skin
• An open wound
This may or may not be associated with pain or discomfort.
It is normal for a red mark to appear on the skin following pressure. Within 20 minutes of pressure relief this should disappear. With darker skin tones this may present as a darker purple discolouration.
If after 20 minutes the skin marking does not disappear, this may indicate pressure injury.
How to prevent pressure injuries
Skin inspection
Regularly check your skin for signs of early damage, as this will allow action to be taken to prevent a pressure injury from forming.
Be aware of your skin’s normal colour, texture and temperature, this will help you identify any changes that occur due to pressure.
It is particularly important to check the areas that you sit and lie on. If you are not able to do this yourself, ask a carer to do this for you.
Skin care
Keep your skin clean and dry. Wash the skin daily. If your skin requires more frequent washing, for example due to incontinence, use a soap substitute, to prevent stripping the skin of its natural protective oils. Ask your pharmacist for advice on the available products.
Incontinence
If incontinence is a problem this can increase your risk of pressure injuries as your skin will be more vulnerable to damage. Advice can be obtained from a health care professional.
Keep moving and changing position
If you do have any signs of skin damage try to avoid sitting or lying on this area. Contact a health care professional for advice.
Changing your position regularly even by a small amount, will help.
If you are unable to move or change your position alone, your carer may need to help you.
It is good to have position changes as part of your daily routine.
Nutrition
Eating a nutritious diet and drinking plenty of fluids will help keep your skin in good condition. Try to eat regular well-balanced meals and drink plenty of fluids, especially in hot weather.
Holidays
If you have an existing pressure injury or are at risk, please discuss your holiday arrangements with a health care professional. You may need to take pressure relieving equipment with you and a plan put in place for the time you are away. Please inform your health care professional when you return.
Contact
If you are concerned that you may have pressure injury, or are at risk, contact a health care professional for advice.
A healthcare professional will be able to offer advice, assess your needs, and devise an individualised plan of care with you. Telephone: 0300 125 6565
For more information: t: 0300 124 5300*
e: sirona.hello@nhs.net
w: roberth572.sg-host.com
