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DECUBITUS ULCER Definition – areas of the skin that become broken and painful caused by continuous pressure. Also called: Pressure Sores Bed Sores
DECUBITUS ULCER
Definition – areas of the skin that become broken and painful caused by continuous pressure.
Also called:Pressure SoresBed Sores
CAUSES OF DECUBITUS ULCERS:
1. Pressure2. Friction3. Lack of Cleanliness – sweat, urine,
feces, wound discharge, soap left on skin
CAUSES OF DECUBITUS ULCERS:Pressure results from:4. Obesity5. Casts / Splints6. Bandages7. Wrinkles in sheets8. Staying in one position too long9. Shearing force – skin rubbing on
sheets
SYMPTOMS:Pressure causes: Decrease in circulation
Increase in heat & moisture Heat
Redness (Erythema)
Tenderness
Discomfort / Burning
Broken skin
SERIOUS & DIFFICULT TO CURE!
STAGES OF DECUBITUS ULCERS
w.pele.com.tw/image/stage.jpghttp
DECUBITUS ULCERS FREQUENTLY OCCUR OVER BONY PROMINENCES:1. Shoulders2. Elbows3. Hips4. Sacrum5. Heels6. Ankles7. Toes8. Ears9. Breasts
DECUBITUS OF FOOT
http://www.univie.ac.at/cga/courses/be528/pressure/24820034.jpg
DECUBITUS ON BUTTOCKS
SACRAL DECUBITUS ULCER
Below is the image at: meded.ucsd.edu/.../skin_decubitus_ulcer.htm
http://www.epuap.org/aberdeen/images/horch2.jpg
DECUBITUS OF THE FOOT
http://www.skinsight.com/images/dx/webAdult/pressureUlcerDecubitusUlcer_45753_lg.jpg
PREVENTION IS THE KEY!!1. Assure clean, wrinkle-free linen2. Encourage activity3. Turn bed-bound patients every 2 hours4. Massage around reddened areas5. Provide back rubs6. Keep skin clean and dry7. Assess skin – report changes promptly8. Limit time on bedpan
WHAT NEEDS TO BE DONE HERE?
PREVENTION DEVICES THAT REDUCE PRESSURE:
Egg-crate foam
Sheepskin
Alternating pressure air bed
Flotation mattress
Turning bed
SHEEPSKIN MATTRESS PAD
http://www.universalmedicalinc.com/patient-positioning/gel-positioners?gclid=CKSyv5OvsZ8CFRBGagodCWYBlA
AIR – PRESSURE MATTRESS
http://www.ilcaustralia.org/images/ACT/2114008.jpg
HTTP://WWW.LINET.COM/DATA2/DEP_5/IMAGE003(3).JPG
TURNING BED
SPECIAL SKIN CARE NEEDS OF THE ELDERLY
1. Dryness, less elastic skin (decreased oil gland function/soap left on
skin)2. Skin less nourished - thin (decreased circulation) 3. Bed Bound – Immobility - Skin pressure
- Rubbing on sheets- Sheets soiled / wrinkled
TREATMENT:
Relieve pressure on reddened area
Gentle massage around area – not directly on it
Special dressings: (Opsite / Transderm)
Lights to wound
Surgery if extensive ulcer
