How do you prevent pressure ulcers?

Pressure ulcers are very hard to treat, so it is very important to do everything possible to prevent them.

Skin Care (for intact or normal skin)

• Wash skin with warm (not hot) water and use a mild soap. This will reduce irritation and dryness.
• Apply lotion to keep the skin from drying out.
• Keep clothes and bed sheets dry. Protect the skin from sweat and urine.
• Check the skin every day. Look closely at bony areas for redness or temperature changes.
• Gently massaging intact skin may help with circulation and comfort.  Avoid massaging bony areas.

Moving and changing position

• Help the person move as much as possible. If able, the person should move from a bed to a chair and stand and walk. A person who cannot get out of bed or who is in a wheelchair can be helped with range of motion exercises. The doctor or nurse can show you how to do these exercises.
• Turn the person in bed as often as possible (at least every 2 hours).   Use pillows under legs to keep heels off the mattress.
• Help persons who are in a wheelchair to shift their weight every 15 minutes.  (If watching TV, shift weight during each commercial break.)
• Do not raise the head of the bed too high. If the head of the bed is too high, the person will slide downward in the bed, which can cause skin damage to the lower back and buttocks areas.
• Use pillows, special foam cushions, or medically approved sheepskin to reduce pressure and keep bony areas from touching each other.  Do NOT use ‘donut’ cushions.
• Use a bed sheet or other device to help move the person. Do not drag the person across the bed. Use proper techniques to change the person’s position. Your doctor or nurse can show you proper techniques on how to safely change a person’s position.

Support surfaces

• Make sure bed sheets and blankets are dry and wrinkle-free (smooth).
• Use special mattresses or pads that lessen pressure against the skin. These include foam pads or cushions filled with gel, fluid, or air.  You can get them from medical supply stores.  They vary in cost and in how easy they are to use.  The doctor or nurse can help you choose the best surface for the person’s needs.
• Remember that support surfaces do not completely get rid of pressure. So, the person must be turned regularly.

Nutrition and Hydration

Make sure the person eats good food and gets enough fluids.  A healthful diet should include protein (e.g., poultry, fish, dairy, or soy products), as well as vitamins and minerals.