Prevention & Care of Pressure Ulcers

Pressure Ulcers

Pressure ulcers are one of the most common conditions that affect hospitalized and chronic care patients.

A pressure ulcer occurs when an area of skin is “pinched” between a bone and a surface, like a bed mattress or the seat of a wheelchair.  As such, pressure ulcers often occur in the lower back, buttocks, or on the backs/bottom of the feet. When the skin is pinched (compressed), it does not get an adequate supply of blood. Without blood flow to provide oxygen and nutrients, the skin and any tissue that is pinched start to die. Over time, this process causes the skin to break down, leaving an open wound.

Pressure ulcers can be serious

Pressure ulcers cause a considerable amount of suffering. Not only are they painful, but they put patients at risk for other illnesses. For instance, pressure ulcers can and often do become infected. This infection can stay in and around the ulcer, or it can spread to the bloodstream. Tissue that is starved of oxygen and nutrients will die, leaving black, necrotic tissue. Indeed, patients with severe pressure ulcers may need one or more surgeries to treat the affected area. Therefore, anyone who cares for someone at risk for pressure ulcers (e.g. immobile patients) should look for pressure ulcers diligently and treat them aggressively.

Pressure ulcers range from mild to severe

Pressure-induced skin or soft tissue injury can vary in severity, progressing from mild to extremely severe. In the mildest form (Stage 1), the skin stays intact; however, the affected area is pink/red. The area remains reddened for over an hour even after the pressure is relieved. A person with a Stage 2 pressure ulcer may have either a blister or break in the skin. By Stage 3, the skin over the wound is completely gone and the underlying muscle is affected. In stage 4, the most severe stage, the pressure ulcer may extend to bone, tendons, or joints. 

Stop pressure ulcers before they start: Preventing pressure–induced injury

Pressures ulcers are difficult to treat, so prevention is always the most important goal. The most effective way to prevent pressure ulcers is to not let patients stay in one position for too long. Lying patients should occasionally sit or stand, sitting patients should occasionally lie down, etc. Repositioning allows blood to flow to the compressed area, which prevents skin breakdown and ulceration. 

Unfortunately, many patients with mobility issues, paralysis, and severe cognitive problems cannot move on their own; they require assistance to reposition themselves. Experts recommend that people who are confined to a wheelchair should reposition themselves or (should be repositioned) at least once an hour. Ideally, the patient should reposition every 15 min. For people who are confined to a bed, experts recommend repositioning at least every two hours (though repositioning more often is better). 

Even in a hospital setting, staff members may be unable to ensure every patient is repositioned as often as needed. Fortunately, various devices can reduce skin compression and/or reposition people without manual assistance. Patients who spend most or all of their time in a wheelchair or in bed should have specially designed support surfaces that minimize tissue compression. The surfaces may contain specialized foams, air, gel, or even sand. In some cases, the beds can be motorized to move patients to different positions on a timer. The goal of these surfaces and devices is to prevent any area from being pinched for too long and starved of oxygen and nutrients.

A covered pressure ulcer heals faster

Pressure ulcers generally take a long time to heal—longer than most wounds. The healing process is even slower if the patient has diabetes, circulation problems, or blood clotting disorders. Making matters worse, a skin infection is possible any time there is a break in the skin. When a pressure ulcer becomes infected, it slows down the healing process even further and greatly complicates the situation 

According to the National Pressure Ulcer Advisory Panel (NPUAP), pressure ulcers should be kept covered with appropriate dressings. The reason: a covered wound heals faster than an uncovered wound. The NPUAP recommends covering pressure ulcers of all stages and severities. Stage 1 pressure ulcers should be covered to reduce the risk that the skin will break down. Covering the wound helps maintain a moist environment in Stage 2 pressure ulcers. Experts recommend covering non-infected Stage 2 pressure ulcers with moist dressings. On the other hand, infected Stage 2 pressure ulcers should be covered with a dressing that removes excess fluid from the wound. A wound care nurse or physician should manage Stage 3 and Stage 4 pressure ulcers; however, even these severe wounds should be kept covered with the correct dressings.

Hy-Tape is the right tape for pressure ulcers

Hy-Tape is the ideal tape for covering pressure ulcers. Hy-Tape (also known as the “pink tape”) can be used with almost all types of pressure ulcer dressings. Hy-Tape offers the perfect balance between gentleness and strength. Its adhesive holds strong, even in moist environments. This is especially important since pressure ulcers occur in areas with a high degree of moisture. Hy-Tape stands up to sweat, bodily fluids, and secretions. On the other hand, when it is time to remove Hy-Tape it comes off safely and cleanly. Hy-Tape is less likely to tear the delicate skin that surrounds pressure ulcers then tapes with more aggressive adhesives.

Pressure ulcers do not always form discrete circles. More often, caregivers must size and cut the dressing to meet the shape of the wound. Hy-Tape offers caregivers the flexibility of affixing dressings to any shape of skin wound. Pressure ulcers also tend to happen in skin with natural creases, bends, and folds. Hy-Tape is thin and conforms to any wrinkle or bend on the body.

Hy-Tape patches are an excellent choice for most Stage 1 and Stage 2 pressure ulcers. Hy-Tape patches are large and can completely cover a wound and its dressing. This provides a waterproof, occlusive barrier that keeps moisture in and dirt and debris out. Hy-Tape patches are also highly conforming, so they can be used in challenging locations, such as the heel of the foot. 

If you provide care for someone at risk of a pressure ulcer, or who has a pressure ulcer, remember to keep it covered with the appropriate dressing and use Hy-Tape to keep those dressings clean and secure.