With Worldwide Stop Pressure Ulcer Day taking place later this month, we thought we’d take a look at how some of the most common causes of pressure injuries might be avoided.
Remember, it’s always far better to avoid pressure injuries than to treat them. So don’t worry about being over-careful with your patients – you’re doing them a favour even if it feels like you’re fussing!
A pressure injury is defined as a distortion of the soft tissue (usually the skin). They are most commonly caused by one of the following:
1. Direct, Concentrated Pressure
One of the most common causes of pressure injury, this occurs when a patient’s weight has not been distributed evenly enough. For seated patients, the most common areas on the body where this occurs are the buttocks, the lumbar and the back of the thighs. However, it’s important to remember that pressure injuries can happen anywhere on the body. Bony areas such as the ankles or wrists are also particularly susceptible to pressure injury due to the thin layer of protective tissue.
Wherever this type of concentrated pressure occurs, tissue damage can develop relatively quickly.
To avoid this happening, it’s important to make sure a patient’s weight is evenly distributed. Correct use of a footrest can ease pressure on the buttocks and the calves. Extra cushions can provide support for the lumbar region and help spread the weight through the back and shoulders. Place the cushions to minimise the area of the back not touching the chair, as these are causing extra pressure on contact points.
Shear occurs when pressure is being applied from different directions onto an area of soft tissue. For example, if a patient is sliding in their chair, gravity may be causing the spine to apply downward pressure while the chair is resisting and applying upward pressure.
Areas of the body that are particularly susceptible to this are those used as support when in a seated position, such as the shoulder blades, the elbows or the backs of the ankles.
Because shearing cuts off blood flow quicker than direct pressure, injuries caused in this way can often become more serious, more quickly.
To avoid shearing, it’s essential to make sure that a patient is not slipping in their chair. Ways this can be achieved include:
- Ensuring that backrests are set to the correct angle.
- Adjusting the seat depth to accommodate body shape, For example, with tall patients it may be necessary to adjust so that the backs of the thighs are entirely supported with no overhang.
- Setting the leg rest to a negative angle beneath the chair. Particularly appropriate for patients with tight hamstrings as it allows them to be completely supported by their chair.
- Placing lateral support cushions at appropriate points. These stop the patient from slipping sideways.
When a patient is sitting for a long time, sweat and moisture can build up in contact areas. This can soften the skin, which in turn heightens the risk of pressure injury. Moisture lesions can also be caused by incontinence issues.
Ways to avoid these types of injuries include:
- Ensuring good air circulation by distributing the pressure as much as possible throughout the body and regularly moving the patient.
- Choosing a chair with material that promotes air flow. Some materials are more effective than others at reducing moisture lesions. Look for material that is both absorbent but also promotes air flow.
- Where incontinence is an issue, sourcing appropriate products such as pads to minimise the amount of moisture contact with skin.
- Nutrition is also important, as maintaining a good diet can reduce the amount of excretion and promote healing.
- Temperature. Maintaining a comfortable but cool temperature will reduce the likelihood of moisture developing in contact points.
All Recliners Chairs have been designed to make it as easy as possible for caregivers to help reduce pressure injuries within their patients. Within our extensive range you will find chairs with adjustable seat depth and leg angles, a complete range of cushions for extra support, with all materials chosen to promote enhanced comfort.