Decubitus Ulcer, Bed Sores and Pressure Sores Prevention

Written by Adam Peck Category: Bed Sores January 26th, 2013 1 min read

Ways to Help Prevent Decubitus Ulcers

Positioning in bed

Avoid positioning patient on ulcer
Use positioning device to keep ulcer off surface
Avoid donut-type devices (may cause ulcers)
Written repositioning schedules every 2 hours

Prevention for patients at risk

Avoid positioning immobile patients on trochanters
Use pillows and foam wedges

Relieve heel pressure
Relieve bony prominence pressure (knee and ankle)
Sheepskin does not relieve pressure

Maintain head of bed at lowest appropriate level

Limit time head of bed is elevated
Higher head of bed causes patient to slide down

Sliding leads to shear forces
Sacral ulcers may result

Management: Bed Types

Static Surfaces

Surface types

Mattress
Foam
Static floatation

Indications

Patient in many positions without loading ulcer
No bottoming out of patient
Fully compresses surface to <1" at injury site

Dynamic Surfaces

Surface types

Air-fluid (costs $100 per day)
Low-air (costs $65 per day)
Alternate air

Indications for all dynamic surfaces

Stage 3 or 4 Decubitus Ulcers
Conditions not met for static surface bed
Pressure Ulcer not healing by 2 to 4 weeks

Additional indications for air-fluid or low-air bed

Large Stage 3 to 4 Ulcers
Ulcers on multiple turning surfaces
Ulcer fails to heal on dynamic overlay

Management: Tissue loads while sitting

Avoid pressure on ulcer while sitting
Properly position

Consider patient weight
Consider balance
Consider patient stability

Reposition so pressure points shifted once per hour

Return to bed if this schedule can not be met
Attempt to teach patient to shift weight every 15 min

Appropriate seat cushion (avoid donut-types)

Decubitus ulcer definition:

Ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time; bony prominences of the body are the most frequently affected sites; ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure.

An ulceration caused by prolonged pressure on the SKIN and TISSUES when one stay in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected sites which become ischemic (ISCHEMIA) under sustained and constant pressure.

Common Names for decubitus ulcers:

Bed sore, Bed Sores, Bedsore, Bedsores, Contact ulcer, Decubitus, Decubitus pressure sore, DECUBITUS SKIN ULCER, Decubitus ulcer, Decubitus ulcer any site, Decubitus Ulcers, Pressure Sore, Pressure Sore Or Ulcer, pressure sores, Pressure Sores/Ulcers, Pressure Ulcer, Pressure Ulcers.

– from Steven Peck, Senior Attorney at Peck Law Group

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Written by Adam Peck

Expertise: Personal Injury

Adam J. Peck, ESQ is a principal with Peck Law Group, APC. In 2008, Mr. Adam Peck received his Juris Doctorate from Whittier Law School where he graduated Cum Laude. His practice is primarily dedicated to representing Elders, Dependent Adults, along with their loved ones and family members, who have suffered horrific personal injuries.