People confined to bed, especially when they are emaciated, elderly, or neurologically impaired, are particularly susceptible to skin damage and ulceration. Pressure sores result from sustained compression that obliterates arteriolar and capillary blood flow to the skin, and from shear forces created by body movements. When a person slides down in bed from a partially sitting position, for example, or is dragged rather than lifted up after being supine, rough movement can distort the soft tissues of the buttocks and close off the arteries and arterioles. Friction and moisture further increase the risk of abrasions and sores.
Assess every susceptible patient by carefully inspecting the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels. Roll the patient onto one side to see the low back and gluteal area best.
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