Constant vigilance in monitoring the rotation of body pressure among people who are confined to beds and chairs is the most important factor in treating pressure ulcers. For the bedridden immobile, positions must be changed at least once every two hours. Keep the head of the bed low as low as possible in order to prevent sliding, which pulls at the skin. Never lie directly on the hipbone. Finally, keep pillows between the patient’s knees and ankles to prevent them from rubbing against each other, and place a pillow under the calves, to keep the heels elevated. Never place a pillow behind the knees.
For the immobile confined to chairs, positions must be changed every hour, and for those who can move themselves, sitting positions must be rotated every 15 minutes. Lift, rather than drag the patient, as dragging can damage the surface of the skin by bending or stretching the underlying blood vessels. Finally, avoid using donut-ring cushions as they increase pressure on parts of the buttocks.
Inspect the skin often, and pay special attention to the bony pressure points. Notice reddened areas that remain after changing position and removing pressure. Make sure the skin stays clean and dry, and always clean the skin immediately after soiling. Use warm water, mild soap, and a gentle washcloth for bathing the skin, and apply creams or oils to over dried skin. When possible, treat incontinence, and if it cannot be prevented, use pads or briefs that absorb urine and wick moisture away from the skin.
