Individuals with mobility impairments are at a high risk for skin breakdown, especially those individuals who use a wheelchair. Minor skin breakdown can quickly turn into a pressure sore, which can be life threatening. So what are some other risk factors for pressure sores?
- Sitting or lying too long without shifting your weight
- Lying or sitting on hard objects such as catheters or pants buttons
- Friction, for example, from sliding during a transfer
- Loss of muscle mass
- Being either overweight or underweight
- Decreased circulation, or blood flow – from lack of movement
- Secondary conditions – such as diabetes, high blood pressure, chronic urinary tract infections
- Skin that is too wet or too dry
- Aging
- Extreme temperatures
The Pelvis
Two-thirds of pressure sores happen in the pelvic area. Several of the bones in your pelvic area are very close to the surface of your skin (called “bony prominences”), meaning there is not much padding. When you don’t move or shift your weight, these thin areas of your skin wear down. Pressure sores are more likely to happen in moist areas. For women who sit most of the time, the pelvic area can become sweaty and moist, especially in summer months. If you have urinary or fecal incontinence, this area can become even moister.
Prevention
Make daily skin inspection a part of your routine care. You can inspect your skin yourself with the use of mirrors or you can have someone else assist you. Look for changes in both skin color and feel (swelling, hardness, and warmth).
Make sure you are turning (in bed) or repositioning (when you are sitting) frequently to change which area of your body is receiving the pressure from your weight.
Bathe every day using a mild soap and be sure to rinse your skin thoroughly. Be sure your skin is completely dry before dressing. If you have any stool or urine leakage, immediately wash and dry your skin and always change clothing. The same applies if you sweat a lot from being outside, exercising, etc.
Your doctor may recommend a certain pressure-relieving mattress for you to use to prevent breakdown. If you use a wheelchair, you may also need a seating evaluation to be sure you have a cushion that meets your needs.
Resources
The Spinal Cord Injury Model Systems Knowledge Translation Center has an excellent six-part series on pressure sores. Though the focus is on SCI, the information is useful to women with all levels of mobility impairment. View the full series.
