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Relief and Wound Care
Pressure Relief and Wound Care
It is commonsense that prevention is better than cure - this applies particularly to pressure sores, which are painful and slow to heal, and most of which are definitely preventable if good clinical practice is followed. The Royal College of Nursing has published guidelines in 'Pressure ulcer risk assessment and prevention'. It is important to identify those who are at risk and to intervene early with strategies for prevention, in the bed, wheelchair or chair, in the bath and on the commode - indeed, it is a requirement within the National Standards for Care Homes to do so:
"Standard 8.3 Service users are assessed, by a person trained to
do so, to identify those service users who have developed, or are at risk
of developing, pressure sores and appropriate intervention is recorded
in the plan of care.
8.4 The incidence of pressure sores, their treatment and outcome, are
recorded in the service user’s individual plan of care and reviewed
on a continuing basis.
8.5 Equipment necessary for the promotion of tissue viability and prevention
or treatment of pressure sores is provided."
Suppliers of pressure relief products. Click the name to open their storyboard page in a new window:
BaKare Beds
Between the Sheets
satin sheets to prevent friction
C & S Seating
Careflex
Genie Care lateral turning
system
Gerald Simonds
Heritage Homecare
pressure relief seating
Huntleigh Healthcare
Otto Bock
SupaSupport
Wilcare Wales
Win Health
For
people who also have difficulty maintaining good posture, positioning
rolls are a useful means of providing support and helping to
prevent pressure damage. These 'T' shaped rolls from can be used to keep
the legs comfortably aligned when the person is lying on their back.
Left,
an alternating and lateral rotating pressure relief system combines turning
of the occupant, thus ensuring that this task is carried out regularly
without burdening the carer, with continual inflation and deflation of
the air cells so that pressure is not exerted on one place for any period
of time.
A
cost-effective alternative, Genie Care's TOTO (right) is a lateral turning
system that is compatible with any single bed, including profiling beds.
It can be programmed to move the occupant at intervals, by gently tilting
over a ten minute cycle. With its fast inflate unit, which lifts at a
greater angle, it also provides a complete turning facility, enabling
care staff to move their patient with less risk than by using traditional
manual handling techniques.
In addition to pressure beds, you can also obtain a separate mattress or mattress overlay, which may be more cost-effective.
Foam
mattress overlays (left) may have a cross cut or textured upper surface
to allow greater conformity.
They can also reduce friction and shear by allowing the surface to move with the user.
Foam can act as an insulator, raising the skin temperature, so a cross cut surface helps to counteract this by improving ventilation.
Foam overlays need turning on a weekly basis and should be replaced regularly (every 6 - 9 months) as their performance deteriorates.
Gel-filled supports address some of the problems inherent in foam; for example, they support the patient evenly across the horizontal plain without breaking down over time, and as the gel is designed to simulate the composition of human fatty tissue, it helps to reduce the sheer and friction that contribute to pressure sores. Gel doesn't have the insulating properties of foam.
There is more information about care beds in our specialist bed section.
An
effective combination of air-filled cells and high tech foam makes adjustable
cushions suitable for clients who spend a great deal of time seated. The
air cells (shown left) are inflated using a hand pump, until they provide
the desired degree of support. The air in the cells is moved about in
response to the body's natural movements, efficiently redistributing pressure.
The soft foam outer layer is designed for maximum air circulation and effective moisture dissipation, with a hygienic, impermeable cover.
This sort of cushion can be used in an armchair, wheelchair, car or office seat: wherever pressure relief is required.
Specialist
seating, such as the unit shown on the left, offers built-in pressure
relief in the seat and backrest.
These systems can make it easier to ensure consistent posture and pressure management for the individual.
There is more about specialist seating in our care seating section.
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