Learn about pressure ulcers, who is at risk and how to prevent them.
Key points
Pressure ulcers can damage many layers of skin.
Be gentle when giving your child a bath.
Change your child's position often, unless your child's doctor has told you not to.
Make sure your child is resting on a comfortable surface (for example wheelchair seat pad or mattress).
Introduction
What are pressure ulcers?
Pressure ulcers are sores that are a result of constant pressure on your child's skin. Pressure can cause damage many layers of skin. Pressure ulcers are also known as bedsores or pressure sores.
Causes, risk factors and prevalence
Cause of pressure ulcers
Pressure ulcers occur when there is ongoing compression of the soft tissue between bony parts of the body and an external surface. They usually occur on the skin that overlies the heels, the back of the head and the tail bone. They can also occur on the ears, elbows, spine and shoulder blades.
Pressure ulcer causeConstant pressure compresses skin layers, which can cut off blood flow. This can damage the skin layers causing a pressure ulcer.
Pressure ulcers can vary in severity. In the more mild form, the skin is still intact and there is redness of the area. In the more severe forms, the ulcer penetrates through the skin and you are able to see exposed fat, bone, tendon or muscle underneath.
Who is at risk?
The risk factors for developing pressure ulcers include:
decreased mobility (often patients who are restricted to a bed or wheelchair)
moisture left on the skin from sweating or unclean diapers
continuous pressure from an external device such as a splint or oxygen mask, or a piece of tubing or equipment your child may be lying on such as an oxygen tube or IV (intravenous) tube
poor nutrition does not cause pressure ulcers but lack of nutrition can put someone at higher risk of developing pressure ulcers
Pressure ulcer caused by external deviceConstant pressure from lying on an external device like tubing can also compress skin layers causing a pressure ulcer.
Prevention
Preventing pressure ulcers
The following tips will help prevent pressure ulcers from developing:
Protect skin and promote good skin care
Change your child's position often throughout the day and night, unless your child's doctor tells you not to. While in the hospital, the nurse will frequently change your child's position.
Make sure your child is not lying on a tube or piece of equipment for long periods of time.
Check your child's skin for redness or sores at bath time, when changing their position, or when moving them from one surface to another (for example from the bed to the wheelchair).
Make sure your child is resting on a comfortable surface such as a wheelchair seat pad or mattress.
Be gentle when giving your child a bath.
Protect skin from excessive moisture
Keep your child's skin dry. Quickly clean up moisture from body fluids such as sweat and urine.
Be gentle when cleaning your child's skin. Use a soft cloth and a soft touch.
Complications
Complications from pressure ulcers
If pressure ulcers are left unnoticed or untreated, then they can result in complications such as:
pain
infection
When to seek medical attention
Questions to ask your child's doctor or medical team
If you are concerned about your child's skin, consider asking the following questions:
Is my child's illness affecting their skin?
Are there protective barrier creams that might help?
Is there anything that can be used to prevent moisture from damaging the skin?
Is my child on the best possible surface to prevent skin breakdown (for example wheelchair seat pad or mattress)?
Could advice from a dietitian on how to eat well help my child's skin condition?
If you are not in the hospital, consider taking a photograph of the area so that you can show your doctor or nurse.
