DENVER, CO  Well over two million people in hospitals and nursing homes suffer from pressure sores. Individuals who are most susceptible to pressure sores are those persons who are immobile.

     Although the cause of pressure ulcers is unknown, unrelieved pressure on the skin is the primary cause. Ulcers occur because of compression of tissue between external sources of pressure and bony prominences beneath the skin. Individuals who are most succeptible to pressure sores are those who are confined to a bed or chair for a long or short period of time. Pressure sores can develop within 24 hours of the time of the incident or they may take up to five days or more. Caregivers must constantly examine the skin for redness or other signs of pressure, shear or friction.
     According to research, sixty-three percent of individuals in nursing homes are immobilized or nonambulatory. These persons are confronted regularly by forces
of pressure, shear and friction which they can not avoid.
     In addition to these external forces, individuals who are malnoursihed are more susceptible to pressure wounds. They often lack sufficient calories and protein. The more malnourished an individual, the more severe a pressure ulcer, if one develops.
     Skin that is too dry from lack of appropriate moisturization or too moist from urinary or fecal incontinence, perspiration, or extreme humidity is also susceptible to pressure sores.
     The fourth major factor that contributes to pressure sores is impaired mental status. Individuals whose mental status is compromised are 25% more likely to suffer a pressure ulcer.
     To prevent pressure ulcers, caregivers should inspect the skin daily for areas of redness or open wounds, especially in bony areas. Individuals should use a moisturizing cream or lotion for dry skin, and a skin sealant or ointment for over moist skin.
     Individuals who are bed bound should be moved every two hours and those who are chair bound should be repositioned every hour. Individuals should lift themselves to move, rather than dragging when changing positions.
     A mattress overlay or special cushions are recommended for individuals who are bed bound. Pillows or wedges can be placed between the knees and ankles to keep them from touching each other and rubbing together. Heels should be suspended above the surface of the bed.
     Individuals should eat a balanced diet that is high in calories and protein. Nutritional supplements may be needed.
     Individuals who are incontinent of bowel and bladder should have the skin cleaned as soon as it is soiled. Absosrbent pads or undergarments with a quick drying surface should be used. Cream or ointment should also be used.
     The role of the caregiver is often identified as the most critical component in preventing pressure sores. If you or a loved one are immobile, special care must be exercised to maintain healthy skin.
For information on ways to prevent or treat pressure ulcers, you may contact the Denver Wound Care Center at 303.839.6130. Many home health agencies also specialize in treating wound care.

Eileen Doherty is the Executive Director of Senior Answers and Services and the Colorado Gerontological Society. She has 25 years of experience in clinical practice, education and training, and public policy with seniors. She can be reached at 303-333-3482.