New Zealanders suffer a staggering 55,000 pressure injuries every year. Figures from ACC show that 4% to 8% of New Zealanders who receive healthcare experience a pressure area. While many pressure injuries are preventable, they’re currently costing our health system $694 million every year.
What causes pressure injuries?
As a therapist, you’ll know it’s important to first understand the etiology of the skin and the causes of pressure injuries.
In older adults, the skin becomes noticeably thinner and loses its ability to stretch and absorb pressure. When people are confined to a bed or sit for long periods of time, this reduces the blood flow to the skin and creates wounds on certain areas of the body such as the heels and buttocks. In younger people, pressure injuries can develop due to multiple intrinsic and extrinsic factors such as loss of sensation, reduced mobility, continence issues, lifestyle and poor transfer techniques.
Pressure injuries can develop in as little as two hours and occur when there’s loss of blood flow to the skin causing hypoxia and tissue death. The most common area for a pressure area to develop is over a bony prominence.
Shear can also result in skin damage and the development of a pressure area. Shear occurs when there is pull and stretch on the blood vessels and tissue and this results in the tissue becoming hypoxic. One example of a shear force is when a person slides down the bed surface when the head of the bed is raised (the skin stays still but the skeleton moves).
It’s also important to create good airflow around the body (microclimate). When the skin temperature rises, the metabolic needs of the skin also increase and if the skin is under pressure, the nutrients and oxygen required cannot be delivered, resulting in pressure areas.
Changes to the look and feel of the skin are common signs that a pressure injury may be developing. The first stage is often a red, non-blanching area. Restricted blood flow and a lack of nerve activity may mean there’s no immediate pain – but that can change if the person has intact sensation.
Tools to help relieve the pressure
Having the right support surface for an individual’s needs can make a huge difference. There are a range of different foam mattresses with different density, pressure redistribution and immersion. There are also a range of alternating air mattresses which can be used for prevention and for those with existing pressure areas. Cushions, shower commode chairs and positioning products like heel wedges and special pillows are also great tools to help prevent pressure injuries from occurring.
Cubro has more than 30 years’ experience developing products to help tackle problems such as this and make life more comfortable for older adults and individuals with disabilities. If you’d like some advice on what solutions would work best for your clients, we would love to help. Email us at [email protected]