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

EGG – CRATE FOAM

www.rehabmart.com/bedroom2.asp

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