If unsure, ask...
Prevention is the best strategy for dealing with pressure sores, as many occurrences of pressure sores can be avoided. In the early stages, pressure sores usually heal by themselves once pressure is removed. Above all it is important to seek professional advice as soon as you notice signs of pressure. 
For further information about pressure sores talk to your Doctor or Nurse. Tissue Viability Nurses are specially trained in pressure ulcer care. Advice on seating aids and equipment may be available from your local physiotherapist or occupational therapist. 

Checking the skin condition

It is important to check the skin for signs of pressure damage routinely throughout the day. Visual inspections are especially important if sensation is affected through paralysis or diabetes. Close daily inspection of a bedridden or chairbound person's skin can detect early redness or discoloration. Any sign of redness or discoloration is a signal that the person needs to be repositioned and kept from lying or sitting on the discoloured area until it returns to normal. Manual handling techniques and equipment must be used that minimise the risk of shear and friction. Keeping the skin clean and dry is important. Skin should not be too moist from sweating or too dry from vigorous washing and drying. A balanced diet is important to keep skin healthy and contributes to healing as well as avoiding severe nutritional and weight loss. The signs to look for are: 
  • Purplish/bluish patches on dark-skinned people
  • Red patches on light-skinned people
  • Swelling
  • Blisters
  • Shiny areas
  • Dry patches
  • Cracks, calluses, wrinkles
The signs to feel for are: 
  • Hard areas
  • Warm areas
  • Swollen skin over bony points

Shift position

Because shifting position is necessary to keep the blood flowing to the skin, oversedation should be avoided. People who cannot move themselves should be repositioned at least every 2 hours. This may need to be more frequent if sitting. Lying directly on the hip bone should be avoided (a 30° position is best). When lying on your back, keep lower legs up by placing a thin pillow under the lower legs, but do not place the pad directly under the knees as this will reduce the blood flow to the lower legs. Do not use donut shaped support cushions or synthetic or genuine sheepskins as pressure relieving aids as they reduce the blood flow. 

Protect bony projections

Bony projections (such as heels and elbows) can be protected with soft materials, such as cotton or fluffy wool. Lying on thick seams from clothing or bedding and zips, studs and buttons should be avoided. There should be no seams or wrinkles in the bedding and two-way stretch materials should be used to reduce the risk of shear forces. Adjusting clothing and bedding should take place during the turning or repositioning. 

Use specialised equipment

Special mattresses, such as air-filled alternating-pressure mattresses, and cushions that redistribute pressure help reduce pressure on sensitive areas in people who are wheelchair-bound or bedridden. These products can reduce pressure and offer extra relief. A doctor or nurse can recommend the most appropriate mattress surface or seat cushion. It is important to remember that none of these devices eliminate pressure completely or are a substitute for frequent repositioning. It is important that pressure care is considered in all applications, for example wheelchair, bed, bath, toilet. SupaSupport have developed a range of products to suit your needs. 

Recommendations on Correct Seating

Recommendations on Correct Seating – Nursing Standard (Collins 1999) 
  • Seat width should allow 1” either side of thighs otherwise damage to trochanters may occur. 
  • Depth of the seat should extend to 1” behind the back of the knee, ensuring the thigh is fully supported. 
  • Height of the seat from the floor must be the same as the patients lower leg, measured from the back of the knee to the floor. 
  • Hips, knees and ankles flexed at 90°. 

SupaSupport pressure relief systems minimise cross infection and hygiene problems which have recently become major issues facing Health Service providers across Europe. Systems are available in a range of materials and support levels to provide maximum comfort.