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Pressure Ulcer (Bed Sore) Care

Review the pressure ulcer care instructions with your healthcare professional on a regular basis. Be sure that you have directions for:

 ·wound cleansing
 ·skin care
 ·wound dressings
 ·turning & repositioning
 ·pressure relief
  • When in bed, turn or shift at least every two hours. Use the free Turning Clocks from WCD to customize your own turning schedule.
  • When sitting, shift weight at least every 15 minutes.
  • Moisturize the skin with body lotion or cream, but avoid massaging bony prominences.
  • Control the factors that contribute to pressure ulcers, such as sweating, incontinence of bowel or bladder, friction and shear.
  • Use turning sheets, pillows, heel elevators, body positioners or other devices to reduce pressure, friction and shear. Use incontinence washes & moisture barriers to protect the skin from breakdown due to urine or stool.
  • When preparing to change the wound dressing, organize and set up all the supplies you will need before you begin.

Wash the skin around the ulcer, the legs and feet regularly with a mild soap and water. Pat the skin dry gently and apply a skin lotion or cream to moisturize the skin.

Avoid the use of drying or cytotoxic agents like povidone-iodine, hydrogen peroxide or Dakin's solution. They can damage new cells and delay healing.

Discard used dressing materials carefully in a plastic bag that ties.

Watch the wound carefully for any changes and report them to your healthcare professional right away. Be especially alert for signs of infection, such as fever, increased pain, increased swelling, warmth, drainage, pus or a change in odor.

Eat a balanced diet. Avoid lifestyle behaviors that impair wound healing, such as smoking.

Avoid products that can cause skin allergies, especially products that contain latex, lanolin, perfumes and dyes. If a rash develops, call your healthcare professional right away. Don't scratch!

Be patient and gentle. It may take weeks or months for a deep pressure ulcer to heal.
 
Infection Control
 
  • Wash your hands thoroughly before and after your treat the wound. Wear gloves to protect the patient and the caregiver from germs.
  • Gather together all of the materials you will need for a dressing change before you start.
  • When doing a sterile dressing change, set up the sterile field first. Keep the sterile supplies away from the clean supplies.
  • Discard old dressing materials carefully. Place the soiled wound dressings in a plastic bag, tie and dispose of according to your community regulations.
  • Store solutions and dressing products carefully, according to the specific recommendations from your healthcare professional. Ask about refrigeration to prolong product shelf life.
  • Discard used solutions and dressing products according to the recommendations from your healthcare professional. Ask about reusing certain products.
  • If any dressing products become wet or dirty, discard the entire package (AHCPR, 1994).
  • Use each dressing only once (AHCPR, 1994).
Caution:
Sometimes water supplies become contaminated. If the health department warns against drinking the water, use sterile saline, sterile water, or a wound cleanser for the wound care (AHCPR, 1994).
 
  • Do not use well water or sea water if making saline at home (AHCPR, 1994).
  • Watch carefully for signs and symptoms of wound infection: redness, increased pain, warmth, fever, swelling, increased odor, drainage or pus. Report any of these immediately to your healthcare professional.
  • Wound infection is the most common complication of having a wound and can slow wound healing. Infection can spread to surrounding tissue (called cellulitis), bone (called osteomyelitis) or throughout the body (called sepsis). These are serious complications - so, do everything you can to follow these tips for infection control and prevent infection.
Treating pressure sores. Consumer Version Clinical Practice Guideline Number 15. Agency for Health Care Policy and Research (AHCPR), U.S. Department of Health and Human Services, December 1994.