The Skin You’re In: Preventing Pressure Ulcers

Good skin health is important to living a full and active lifestyle

By Corrie Dinwiddie, RN
Oxford HealthCare Wound Coordinator

The skin is the largest organ of the human body. According to the online journal LiveScience.com, the average person’s skin counts for 16 percent of their total weight, and spans a surface area of 22 square feet. It is also one of the most important organs for our general health, helping to:

  • Maintain your body temperature
  • Protect you from germs
  • Gather information for your nervous system
  • Assess and react to your surroundings (e.g. heat, cold, pain, sensory touch)

To function properly, your skin needs adequate attention and proper care. A break-down in your overall skin health can put you at risk for injury and disease.

Possible Skin Problems

Even if you have healthy skin, problems may occur if you are immobile for long periods of time, especially in a lying or sitting position. When this happens, pressure from your body weight on the bed or chair surface cuts off the blood supply to skin. As a result, those skin cells don’t get the oxygen and nutrients they need to survive, and a pressure ulcer may result.

Pressure ulcers occur from prolonged sitting or laying

The condition mainly occurs on skin areas that cover a bone or bulge, such as heels, shoulders, hips, and upper buttocks. Pressure ulcers have many names, including:

  • Bedsore Decubitus (de-KU-bi-tus) ulcers
  • Dermal wounds
  • Pressure sores

Risk Factors for a Pressure Ulcer

You may be at risk for a pressure ulcer if you are experiencing:

  • Limited activity or confined to bed
  • Reduced tactile sensation (sense of touch)
  • Chronic, complicated medical problems such as diabetes, obesity, smoking, poor circulation, and spinal cord injury
  • Increased skin moisture from bladder or bowel control issues
  • Poor diet or nutrition Low protein intake, especially if nutrition is already poor

Older adults are more at risk for a pressure ulcer, as are patients who slide down in the bed. Sliding down can cause friction that may tear delicate or already damaged skin.

Symptoms of a Pressure Ulcer

If you have a pressure ulcer, you may have burning, aching, or itching at the site. The injured skin may be red or bruised, or have a purplish discoloration that continues even after you shift position. People with darker skin tones may not show redness or discoloration, and some may need to compare the injured area with uninjured skin tissue.

A pressure ulcer may feel firm or mushy, and may be warm to the touch. Swelling and tenderness are common, and a blister or shallow sore may develop. Sometimes a clear or blood-tinged fluid may drain from the ulcer area. If un-noticed or un-treated, the wound may deepen and extend into the fat layer or adipose (ADD-ih-pose) tissue, or even down to the bone. Pressure ulcers are sometimes categorized in stages (Stage I, Stage II, etc.), based on how deeply the tissue is injured.

Stages of bedsores and pressure ulcers

What Can You Do to Help Prevent a Pressure Ulcer?

You and your family members are important to the prevention and care of a pressure ulcer. Your skin health can be improved when general steps are taken, including:

  • Not smoking
  • Daily exercise (even bedridden patients need activity)
  • Good nutrition
  • Maintaining a healthy weight
  • Adequate hygiene
  • Moving and turning
  • Asking your family or caregiver to help you move and turn if you are confined to a bed or chair

How Do Hospitals and Nursing Homes Prevent Pressure Ulcers?

Your nurses and doctors will begin a plan of care to help keep your skin healthy. If you are not able to move yourself, the hospital or nursing home staff will help you move and turn. They may use special skin care products to protect your skin, and connect you with a dietitian to help you improve your diet. If your nurse or doctor suspects an ulcer, he or she will work to relieve pressure on the area. In some cases, a special mattress or bed may be used to help redistribute pressure.

Even though your skin is one of the most complex and important organs in your body, caring for it is not complicated. Follow these simple steps, and ask your doctor if you have further concerns about potential pressure ulcers.

February is American Heart Month!

by Pam Gennings, Executive Director Special Projects

Heart disease prevention is important year-round.

Knowing the causes, symptoms and preventions of Heart Disease is important year-round.

February brings Valentine’s Day and heart-shaped boxes of candy, but it’s also American Heart Month. First declared by President Lyndon Johnson in 1964, it was designed to bring awareness to the symptoms, causes and preventions of Heart Disease, which at that time was responsible for more than half of all deaths in this country.

Awareness and prevention have greatly increased in the half-century since the first Heart Month. As a result, heart disease has steadily declined since 1968, with fewer than 400,000 actual deaths in 2010, according to the National Heart, Lung and Blood Institute (NHLBI). The institute estimates that if 20th-century heart disease trends had continued unchecked, it would have been the cause of nearly five times as many deaths – more than 1.8 million – in 2010.

However, heart disease is still the current leading cause of death in both women and men in this country, responsible for one in four deaths in the United States. Though a heart attack is the most-often associated health risk, other serious types of heart disease include coronary artery disease (the most common), heart arrhythmias (irregular heartbeat), cardiomyopathy (diseased heart muscle), atrial fibrillation (a type of arrhythmia), and congenital heart defects.

Risk Factors for Heart Disease

According to the Centers for Disease Control (CDC), there are numerous hereditary and environmental factors that determine an individual’s risk for heart disease. They include;

  • High Blood Pressure
  • High Cholesterol
  • Diabetes
  • Age/Family History/Race or ethnicity
  • Lifestyle choices such as:

->  Unhealthy Diet
->  Physical Inactivity
->  Obesity
->  Too Much Alcohol
->  Tobacco Use

Symptoms of a Heart Attack

The National Heart Attack Alert Program notes these major signs of a heart attack:

  • Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes, or that goes away and returns. It may feel like uncomfortable pressure, squeezing, fullness, or pain.
  • Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath. This can often accompany chest discomfort, but can also occur before any other signs are noticeable.
  • Other symptoms. This includes breaking out in a cold sweat, nausea, or light-headedness.

If you think that you or someone you know is having a heart attack, you should call 911 immediately.

Preventing Heart Disease

While the effects of heart disease are serious, the good news is there are many common-sense steps that you can take to limit your risk factors, according to the CDC. Some of them include;

1.     Live a healthy lifestyle – Healthy behaviors can lower your risk for heart disease, which include;

  • Eat a healthy diet
  • Maintain a healthy weight
  • Get enough physical activity
  • Limit alcohol use
  • Don’t smoke or use other forms of tobacco

2.     Check your cholesterol – Your health care provider should check your cholesterol at least once every five years. If you have already been diagnosed or have a family history of heart disease, your cholesterol should be checked more frequently. If you have high cholesterol, lifestyle changes or prescribed medication may help reduce your risk of heart disease.

3.     Control your blood pressure – High blood pressure usually has no symptoms, and is important to have yours checked on a regular basis.  If you are diagnosed with high blood pressure, your health care provider might recommend that you lower the sodium in your diet, prescribe medication to lower your blood pressure, and make some lifestyle changes.

4.     Manage diabetes – If your health care provider identifies symptoms of diabetes, they may recommend that you get tested. If diagnosed, it’s important for you to monitor and control your blood sugar levels. Lifestyle changes can help keep your blood sugar under control, and reduce your risk for heart disease or other diabetic complications.

5.     Take your medicine – If you take medication to treat high cholesterol, high blood pressure or diabetes, follow your doctor’s instructions. NEVER stop taking your medication without talking to your doctor, nurse or pharmacist.

6.     Talk with your healthcare provider – Work with your medical team to prevent or treat medical conditions that can potentially lead to heart disease.

How We Can Help

If you or a loved one is diagnosed with heart disease, Oxford Healthcare has numerous Home Care programs that can help. Contact us to find out about our cardiovascular, telemonitoring, and specialty services designed to help more people with heart disease stay healthy, and stay home.


About the Author
Pam Gennings has a Bachelor of Arts and has worked in the field of Geriatric Social Work and Care Coordination for more than 30 years. She started working for Oxford HealthCare in 1993. During the course of her career she has helped thousands of people find resources to remain in their homes, as well as providing guidance to families that were facing difficulties with their aging loved ones.