Where do pressure ulcers occur? 
Head, the shoulder, Lower spine, Sacrum, Heel, Toes.

What are risk factors?

• Low mobility
• Lying in bed or sitting in a chair for a long time
• Constant sliding on the bed from top to bottom
• Stretching on the bed when changing position
• skin dryness
• Skin exposed to urine, feces or sweat
• Decreased mental awareness
• Decreased sensation
• Improper nutrition
• Blood flow problems

How can patients minimize their risk? 
Patients should follow some basic steps below to help prevent pressure ulcers.
Step 1: Protect the skin:
1. Check your skin every day, including skin folds. Look for any red, irritated areas. Use a mirror to view hard-to-see areas, such as the bottom of the legs.
2. Use a suitable moisturizer (Zitan cream) to prevent skin dryness.
3. Do not massage bony areas. This may damage the skin.
4. Translation is too long to be saved.
5. If the skin is wet or dirty from urine or feces: clean your skin immediately with a pH-normal skin cleanser that does not need to be rinsed (zitan foam). Dry the skin gently (like stroking) if needed. Use an ointment, cream or moisture barrier to protect the skin.
6. If you use an absorbent pad or brief for incontinence, change it when it gets dirty or wet. Avoid using products with plastic coating.

Step 2: Prevent pressure: 
For people who are bedridden:
1. Use a special mattress that is made to reduce pressure.
2. Rotate or reposition frequently.
3. Do not lie on reddened skin or on medical devices such as tubes or drainage systems.  
4. Elevate the head of the bed as little as possible, as a steeper angle can put more pressure on the coccyx. Avoid bent over positions.
5. When changing position on the surface, lift the patient, do not drag. Sliding or pulling can damage the skin.
6. Avoid placing the patient directly on bony areas.
7. Keep clothes and bed sheets dry, smooth and without wrinkles.
8. Protect your elbows and heels. Use a pillow under the leg to keep the heels off the mat.

For patients in chairs or wheelchairs: 
1. Use a special cushion to reduce pressure. 
 2. Shift your weight often with small movements, bending forward and shifting your weight from side to side.

Have good nutrition: 
Nutrition is important. 
1. Calories, protein, and fluids all help keep you healthy and protect your skin from damage.
2 .Tell your doctor or nurse if you have trouble eating or notice weight loss. They may recommend liquid nutritional supplements.  

Pressure ulcer care: 
To heal a pressure ulcer, the wound must be clean, free of dead tissue and covered with a special dressing. Dead tissue is yellow, black, or brown in color and can lead to infection.
Step 1: Clean the wound
Regular cleaning of the wound is important to help it heal.
1. Gently clean the wound with a saline solution or wound cleanser with each dressing change.
2. Wash the wound thoroughly to remove any debris or dead tissue.  

Step 2: Cover the wound.
Special wound care dressings are used to cover and protect the wound. Wound care dressings either keep the wound moist, absorb secretions, or both.
1. Put a bandage on the wound.
2. The type of dressing can be different: some dressings cover the wound and some are used to fill deep wounds.  

How to tell if a pressure ulcer is healing? 
The wound will start to get smaller as it heals. You should start to see new texture that is shiny red or pink in color. If your wound is oozing, it will be less oozing after it heals. 

What are the symptoms of infection? 

• Redness or inflammation around the wound.
• Swelling and tenderness around the wound.
• Excessive discharge, yellow or green.
• Pungent smell of the wound.
• Fever.
• Chills.
• Weakness.
• Lethargy.

Unit 4. No. 6. 3rd Golzar Alley. Poonak Sq. Tehran - Iran
Tel: +98 21 44335451 
info@zimateb.com