Preventing bedsores: a family guide to caring for a bed-bound patient

Bedsores (pressure ulcers) form when body weight presses the skin against a bony prominence for too long and cuts off the blood flow. The most exposed spots are the tailbone, the heels, the hips, the shoulder blades and the back of the head.

The first sign you must not ignore

Redness that does not fade when you press it with a finger and let go. At this stage the skin can be saved completely if the pressure is removed at once. A blister or broken skin means the ulcer has already started and needs a medical assessment.

Five steps of prevention

1. Reposition every two hours, day and night, alternating between the back and each side at a 30-degree tilt, with a pillow between the knees and one behind the back.
2. An alternating-pressure air mattress for every patient who cannot turn alone, checking daily that the pump works.
3. Clean, dry skin: change wet pads immediately, wash with warm water and a mild soap, then apply a barrier cream on exposed areas.
4. Enough nutrition: protein (eggs, milk, meat, legumes) and water are the building blocks of skin. Rapid weight loss is an early warning.
5. Inspect the skin daily during washing or dressing, especially the heels and tailbone, and write down any redness.

Common mistakes

• Rubbing a red area firmly: it adds damage and does not improve circulation.
• Ring (donut) cushions: they shift the pressure to the ring of skin around them.
• Raising the head of the bed above 30 degrees for long periods: the body slides down and friction on the tailbone increases.

When to get medical help immediately

An open wound, discharge, odour, a fever, or surrounding skin turning purple or black. Stage 3 and 4 ulcers need specialised dressing and sometimes surgery.

Scrub Men nurses are trained in this prevention protocol, in staging ulcers and in specialised dressing, and we supply the air mattress and hospital bed as part of the service. Request a free assessment of your patient.