Avoiding Pressure Injury
Individuals have a higher risk of developing pressure injuries if they are immobile or have decreased sensation. As body weight is placed on the inside of the skin, small capillaries that carry blood to the tissues of the body can become closed. Lack of blood flow temporarily or longer does not allow the nutrients or oxygen to reach all the cells.
Pressure injury begins within the body where you cannot see it happening. The pigment change of a pressure injury is usually over a pointy bone prominence close to the surface of the body as there is little protection in these areas.
You can reduce your risk of pressure injury by following these guidelines:
Perform pressure releases.
Move or lift your body to allow for blood circulation to be uninterrupted. This can be accomplished by turning frequently when in bed, doing wheelchair push-ups, weight shifts, or tilting a powerchair when sitting every 10 minutes. Your time for pressure releases may be less.
Use a watch with a timer or take cues from your environment to remember to move your body.
Use medical-grade pressure dispersing equipment.
This helps spread pressure in a wider area but cannot completely eliminate it. This equipment should be used in conjunction with pressure releases. Check your equipment to ensure it is properly filled, working, and protecting your skin. Pressure mapping by a therapist can ensure your equipment is correct for you.
Avoid constricting, tight, or ill-fitting clothing which can add to poor blood flow.
Keep clothing or bed linen free of wrinkles as these add to pressure injury risk.
Maintain hydration by drinking water as your bladder program limits if you have them.
Water best hydrates the cells in your body for function.
Hydrate your outer skin by using an emollient lotion.
Keep your skin clean and dry.
Moisture or secretions adds to skin breakdown.
Follow a healthy diet to maintain the nutrients your skin and body tissues need.
Maintain a healthy weight.
Fat does not serve as a cushion for body tissues. It collapses leading to increased pressure. So, thinking you are well-padded due to fat is not true. Being too thin also increases pressure injury risk.
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Monitor your skin using a mirror or camera.
Checking your skin where you can see, and where you cannot, using a mirror will help you catch any pigment change early. Chronicling your pigment change with your personal camera will keep an accurate record of pigment change.
Move your body gently and carefully, fully picking it up off surfaces.
This avoids bumps, bruises, broken bones, and skin injuries from shearing and friction.
Check your skin carefully each time new equipment is added to your treatment regimen.
Review your medications.
Research demonstrates that the more medication you take, the higher your risk of pressure injury. If a pigment change appears, stay completely off that area until the pigment has returned to your normal.
Do not increase pressure on boney prominence areas by message or rubbing.
This adds more pressure, it does not stimulate blood flow.
If a pressure injury does occur, talk with your healthcare professional about the treatment that is right for your specific needs.
A pressure injury can disrupt your life by leading to infection, autonomic dysreflexia (AD) episodes, time in bed as well as possible surgical repair. A healed pressure injury results in a scar that does not have the elasticity of non-injured skin. Prevention of a pressure injury is the best plan.
Pediatric Consideration:
Monitor your child’s skin until they are ready and responsible to check their skin themselves. When your child is younger, involve them in the ‘hunt’ for pigment changes. Talk through each step and let them look in a mirror. Early involvement helps develop a habit. Older, responsible children may check themselves with just a pop-in check by the parent or caregiver.