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I have to tell you that it doesn't take long for
the skin to become compromised after a
person has been in one position for too long.
The skin could look perfectly fine from the
outside, but then once it breaks you could
possibly have deterioration down to the
muscle, opening the person up for infection.
They could even become septic (infection in
the blood stream.) I have seen patients come
into the hospital with non stageable pressure
ulcers, and it only took a week for their skin to
get in that condition.
Make sure the skin stays clean. Be prompt
after soiling in cleaning the area and always
moisturize the skin, especially dry skin.
Moisturizers rich in vitamin E and aloe are
recommended. Your older population can have
extremely fragile skin to the point of being
paper thin, so during skin care be very careful.
Most people don't realize that diet can play a
very important role in tissue regeneration. In
the hospital setting patients with impaired skin
integrity are immediately put on a high protein
diet ( Important for the growth and repair of
The following supplements should also be
added to the diet:
- Vitamin C : This helps to prevent free radical production which could inhibit healing.
- Arginine : Promotes collagen synthesis for new skin. It also increases the blood flow
to the wound and may help to fight off infection.
- Vitamin B12 : Aids in wound healing and tissue repair.
- Zinc : Required for tissue regeneration and repair (BUT could also suppress the
function of the immune System.)
Look for foods rich in these supplements and add them to the diet. If I was going to put emphasis on
one thing it would be the protein. Finally, inspect the skin daily. This could be done during the time that
you do your turns and also during soil changes. Document the condition of the skin on a skin log.
Anything different that you notice should be documented on the log. Look for any signs of possible
breakdown, which may include a redness that doesn't go away once position is changed and pressure
is removed from the area. Also be suspicious of open or blistered skin. Should you notice these or any
sign suggestive of skin breakdown, immediately take pressure off of the area and keep it clean of
urine and feces. If the skin is broken seek medical advice to obtain the best possible treatment to heal
the ulcer. If there is redness do not massage the area. If you notice a progression seek medical advice
for prompt treatment.