Preventing Pressure Injuries

Change positions often

Changing positions allows blood to get to your skin and keep the tissue healthy.

In a chair:

• Shift your weight from side to side at least once an hour—every 15 minutes if possible.

• Ask about pads and cushions that can reduce pressure on your skin.

In bed:

• Change positions from side to side at least every 2 hours, more often if possible.

• Use lightweight sheets and blankets to reduce pressure and rubbing (friction).

• Ask about special pads and mattresses that spread pressure over a larger area of your body.

Support your body

Supporting your body spreads pressure over a larger area.

In a chair:

• Lightly cushion your back and buttocks. Don’t use doughnut-type cushions. They can cut off the blood supply to your skin.

• Lightly pad the footrest on your wheelchair.

In bed:

• When lying on your back, put pillows between your ankles and knees to lessen the pressure in that area. Keep your elbows slightly bent.

• When lying on your side, put pillows behind your back so that you are lying at about a 30-degree angle. Also put pillows between your legs, and between your ankles. Keep elbows and knees slightly bent.

Don't rub or slide

Rubbing and sliding cause the skin to break down more easily.

In a chair:

• Keep your feet on a footrest, so your thighs are horizontal. This keeps your buttocks from sliding forward.

• Push up from the arms of the chair to shift your weight or change positions.

• Support your shoulder blades and back with a pillow.

In bed:

• Keep your sheets smooth, dry, and free of small items that could irritate the skin, such as crumbs. Using a sheepskin pad can help prevent rubbing.

• Keep your feet and head slightly raised to avoid sliding. When on bed rest, don’t raise your head more than 30 degrees, except when needed for some medical conditions or for eating.

Keep your skin clean

Keeping your skin clean and dry also helps prevent pressure injuries.

• Keep your skin free of sweat, urine, stool, or wound drainage. Change bed linens if they become damp, wet, or soiled.

• Use a mild soap when cleaning the skin. Pat the skin dry. Don't rub it.

• Apply protective creams and use absorbent pads if you don't have bladder or bowel control. Gently clean and dry the soiled skin right after each occurrence.

• Check your skin for signs of breakdown. You may need a caregiver to look at some common areas of pressure injury, such as the lower backside.

Eat healthy and move around

If you are in a bed or a wheelchair most or all of the time, you need to:

• Eat enough calories to stay at a stable weight.

• Get plenty of protein, vitamins, and iron, and drink lots of fluids each day.

• Get help getting out of your bed or chair so you can change positions as much as possible.

Check your skin

Do skin checks as part of your daily routine. Skin breakdown starts with slight changes but can progress very quickly. Have a caregiver help with looking at the areas you can't see, including the lower back area. This is one of the most common areas for breakdown because it's a pressure point.

• Look for redness, bruises, cuts, and other irritations, especially over bony areas.

• Look for scabbing, blistering, or open areas on the surface of your skin. These are more serious and must be treated right away.