Chronic wounds develop over time and may take a long time to heal; a
pressure ulcer is one example. Also known as bedsore, it is an area
of skin that breaks down when something keeps rubbing or pressing
against the skin. The pressure on the skin reduces blood flow to the
area. Without enough blood, the skin can die and an ulcer may form.
When it comes to pressure ulcers, an ounce of prevention is worth a
pound of cure. Change your position at least every 2 hours to
relieve pressure (at least every half hour in a wheelchair). Keep
sheets tight, clean and free of food crumbs. Raise the head of your
bed only as much as necessary and for a limited time to keep your body
from sliding down and rubbing against the sheets. Ask your
health care provider about devices that can help reduce pressure such
as special mattresses, cushions and pads. Do not use donut-shaped or
ring-shaped cushions; they interfere with blood flow to that area and
cause complications. And do not massage the skin near or on the ulcer
as it can cause more skin damage.
Always remember that a wound heals best when it has a moist and clean
environment. The watery fluid that naturally occurs in a wound contains
substances that help heal the wound. Avoid hot water or rubbing alcohol
which can dry skin. Your health care provider can recommend creams or
moisturizers to help protect the skin. After you urinate or have a bowel
movement, clean the area and dry it well. The skin around the wound must
be kept clean, free of dead cells, pus, and foreign matter. Generally,
pressure ulcers (open sores) are rinsed with a salt-water rinse to
remove loose, dead tissue. A dressing promotes healing by keeping a
wound moist, creating a barrier against infection and keeping the
surrounding skin dry. The sore should be covered with special gauze
dressing made for pressure ulcers.
A healing body needs extra fluids (8 to 10 cups of water everyday),
proteins, vitamins and minerals. Make sure that you eat
right to keep your skin healthy and prevent infection. You may consult
with a dietitian to determine the best diet to support healing.
Nutritional supplements may help but consult with your health care
provider who can also prescribe medicines that promote skin healing.
Exercise daily and to the extent that you can to help promote good
circulation. Performing range of motion exercises, appropriately matched
to your abilities, is an important step in maintaining healthy skin.
Inspection of the skin should be a part of your routine home care. A
pressure ulcer can spread deep into the body, even down to the bone
which makes it easy for infection to set in. Get immediate medical care
if you notice signs of infection which include: increased pain; increased
swelling; pus; and a foul odor from the ulcer. Other signs of infection
include fever, weakness, and confusion.
You play a very important role in your recovery and well-being; be an advocate
for proper preventive care. And try to have patience–healing takes time.
