1.  Definition – areas of the skin that become broken and painful caused by continuous pressure.  Also called:  Pressure Sores  Bed Sores

2. 1. Pressure 2. Friction 3. Lack of Cleanliness – sweat, urine, feces, wound discharge, soap left on skin

3. Pressure results from: 4. Obesity 5. Casts / Splints 6. Bandages 7. Wrinkles in sheets 8. Staying in one position too long 9. Shearing force – skin rubbing on sheets

4. Pressure causes: Decrease in circulation Increase in heat & moisture  Heat  Redness (Erythema)  Tenderness  Discomfort / Burning  Broken skin

6. w.pele.com.tw/image/stage.jpghttp

8. 1. Shoulders 2. Elbows 3. Hips 4. Sacrum 5. Heels 6. Ankles 7. Toes 8. Ears 9. Breasts

9. http://www.univie.ac.at/cga/courses/be528/pressure/24820034.jpg

11. Below is the image at: meded.ucsd.edu/.../skin_decubitus_ulcer.htmmeded.ucsd.edu/.../skin_decubitus_ulcer.htm

12. http://www.epuap.org/aberdeen/images/horch2.jpg

13. http://www.skinsight.com/images/dx/webAdult/pressureUlcerDecubitusUlcer_45753_lg.jpg

14. 1. Assure clean, wrinkle-free linen 2. Encourage activity 3. Turn bed-bound patients every 2 hours 4. Massage around reddened areas 5. Provide back rubs 6. Keep skin clean and dry 7. Assess skin – report changes promptly 8. Limit time on bedpan

16. Egg-crate foam Sheepskin Alternating pressure air bed Flotation mattress Turning bed

17. www.rehabmart.com/bedroom2.asp

19. http://www.universalmedicalinc.com/patient-positioning/gel- positioners?gclid=CKSyv5OvsZ8CFRBGagodCWYBlA

20. http://www.ilcaustralia.org/images/ACT/2114008.jpg

22. 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

23. Relieve pressure on reddened area Gentle massage around area – not directly on it Special dressings: (Opsite / Transderm) Lights to wound Surgery if extensive ulcer