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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
Careflex
Heritage Homecare
pressure relief seating
Huntleigh Healthcare
Inclusion - OT consultancy
Nexus DMS
Otto Bock
Sidhil
Squirrel Medical
SupaSupport cushions & supports
Wilcare Wales
Win Health Dermasavers, cushions & supports
The new Squirrel Diamond airflow mattress has been designed to provide effective pressure care, while at the same time offering a stable surface to facilitate safe independent transfers and self positioning. Just 12.5 cm thick, it can be used safely even with standard height bed rails.
Click to view on-line movie on safe transfers from pressure care mattress
The
new Optima dynamic pressure relief system from Nexus DMS offers pain
relief and pressure management for users weighing from 7kg to 300kg.
It prevents the feelings of nausea some people experience when lying
on a classic alternating mattress, and the high pressure pump is quiet
and operates only on demand, so that it doen't disturb the user's sleep.
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.
In addition to pressure beds, you can also obtain a separate mattress or mattress overlay, which may be more cost-effective.
Foam
mattress overlays (right) 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.
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.
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.
DermaSavers are protectors for fragile skin, helping to protect from damage caused by friction, rubbing, abrasion and pressure, which can lead to skin breakdowns, tears and splits. They can also help to heal existing skin tears and lacerations without the restriction of bandages and dressings.
Click to view on-line DermaSaver movie
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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