Pressure Sores - tips on prevention and pain relief

Pressure Sores

Prevention and pain relief tips

Pressure ulcers are lesions caused by unrelieved pressure that results in damage to the underlying tissue. Generally, these are the result of soft tissue compression between a bony prominence and an external surface for a prolonged period. Pressure ulcers are among the most common conditions encountered in patients in hospital or requiring long-term institutional care. American studies have shown that pressure ulcers also are common among patients admitted to nursing homes, with reported rates ranging from 10 to 35 percent.

I previously discussed pressure sore in detail in this column including the types of dressings used; if you want more information, check www.whelehans.ie

Pain relief

• Pain is often significant and disabling for those with pressure ulcers.
• Paracetamol may be sufficient, but patients often require stronger analgesia.
• Non-steroidal anti-inflammatory drugs may increase peripheral oedema and are inappropriate for patients with pressure ulcers. (e.g.) Ibuprofen, Diclofenac
• Opioid analgesics may be needed for moderate to severe pain.
• Topical local anesthetics such as lidocaine can provide numbness for a short period of time and can be useful for a specific procedure but should not be used as the only method of pain relief.
• Wound cleansing and dressing techniques may need to be reconsidered if they are causing severe pain. Adequate pain control should be provided for dressing changes and debridement.
• Patients may require a referral to a pain clinic.

General advice to prevent pressure sores

Relieve direct pressure

• Change position regularly and keep moving as much as possible
• Change position at least every two hours
• Stand up regularly to relieve pressure if sufficiently mobile
• Ensure the carer repositions regularly where the patient cannot move independently
• Use pressure relieving mattresses and cushions (speak to an occupational therapist about these)
• Do not drag heels or elbows when moving in your bed or chair

Skincare

• Keep your skin clean and dry
• Keep skin well moisturised especially after washing (as skin loses natural moisture when drying)
• Avoid scented soaps as they can be more drying
• Avoid talcum powder as it dries the skin’s natural oils

General advice

• Ensure bedsheets are smooth and not wrinkled
• Sheets should be cotton or silk like fabric
• Eat a well-balanced diet
• Drink at least two litres of fluid a day (bear in mind caffeine is a diuretic and can exacerbate dehydration)
• Check skin daily for any changes like redness or irritation, especially in areas like the buttocks or heals that are more prone. Use a mirror to check hard to reach areas or ask a loved one or carer to check.
• Inform your doctor or nurse of any skin changes or discomfort as soon as possible, no matter how minor; even slight redness as this is the first sign of an ulcer developing.

Chiropodist

A chiropodist assesses diagnoses and treats diseases and abnormalities of the feet and lower limbs. A chiropodist can significantly improve a person’s quality of life by alleviating painful symptoms and promoting and maintaining mobility including preventing and treating ulcers that can occur in the heal area. Whelehan’s pharmacy Pearse St has a chiropodist weekly. The consultation with our chiropodist takes place in a private consultation room. You can make an appointment, book online on the Whelehans website or in store or by phoning us on 04493 34591.

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore). Email queries to info@whelehans.ie. Find us on Facebook.