Once these risks have been defined and mitigated, it is important to follow a structured skin care routine with quality products.
Skin that remains under pressure may develop pressure ulcers in as little as 2 hours. In particular, a bone that pushes against the skin (bony prominence) is more likely to cause injury. Continuous pressure on any soft parts of the body (tissue) may lead to the development of pressure ulcers as well.1
Shear is the result of gravity pulling tissue in one direction while friction keeps the skin still or causes it to go in the opposite direction. 3
Shear often occurs when the head of the bed is in an upright position. Friction may be caused when the skin is dragged across a rough surface such as bed linens.2
Extra moisture on the skin may be the result of incontinence (from urine or feces). It can also come from fluid that comes out of a wound, as well as sweat.2, 4 Although this moisture on the skin does not directly cause pressure ulcers, it softens (macerates) the skin, making it much easier for damage to occur from friction or shear.2
When skin loses its moisture, it becomes dry, flaky, and less flexible. Ulcers are more likely to develop in dry skin.2
Poor nutrition may contribute to the development of pressure ulcers. 2 Making sure patients maintain a proper diet may help prevent them.
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In addition to the factors listed above, there are others that may put a patient at risk for the development of pressure ulcers5 Some of these can be determined by using special scales. The ones used most often by health care professionals are called the Braden and Norton scales. The Braden and Norton scales can also identify risk factors such as a patient's ability to move around (mobility) or feel pain (sensory perception), which may also have an impact on how ulcers develop.6