PRESSURE INJURY PREVENTION AT HOME: MATTRESS, MOVEMENT, AND MORE

Pressure injuries, also known as bedsores or pressure ulcers, are a serious concern for anyone with limited mobility. These skin and tissue injuries happen when there is prolonged pressure on a body part, especially over bony areas like the hips, heels, tailbone, and elbows. They can range from mild redness to deep wounds that expose muscle or bone. If not treated early, these injuries can become infected and even life-threatening.

The good news is that most pressure injuries can be prevented, especially when we take action at home. Whether you’re caring for a loved one who spends a lot of time in bed or in a wheelchair, or you are recovering from surgery or illness, there are simple yet important steps you can take to protect the skin and maintain overall health.

Let’s break down the essentials of prevention into three key areas: mattress, movement, and more.

1. The Right Mattress Matters

The surface we sleep on greatly affects our skin health. A traditional mattress may be too firm or uneven, leading to pressure points that cut off blood flow to the skin.

Here’s what to consider:

Pressure-Relieving Mattresses and Overlays

Some support surfaces are made to lower pressure, distribute weight, and reduce friction:

• Foam mattresses with high-density or memory foam cushion the body more evenly.
• Alternating pressure mattresses use air cells that inflate and deflate in cycles, relieving pressure from different areas regularly.
• Gel or air overlays can be placed on an existing mattress for added protection.

These tools do not replace the need for regular movement, but they significantly reduce risk, especially for patients who are bedridden or have very limited mobility.

Keep It Clean and Dry

Moisture can damage skin quickly, especially when there is pressure. Use absorbent, breathable bedding and replace soiled linens right away. Think about using a waterproof mattress cover that lets air circulate.

2. Movement Is Medicine

Lack of movement is the leading cause of pressure injuries. Even the best mattress cannot make up for staying in one position too long.

Repositioning Schedule

If a person is in bed most of the time:

• Change position at least every 2 hours. This includes turning from side to side, elevating the legs, or using a wedge to shift weight off bony areas.
• For those in wheelchairs, shift weight every 15 to 30 minutes. This can mean leaning forward, to the side, or using a tilt-in-space wheelchair if possible.

Set alarms or use caregiver checklists to help maintain a regular turning schedule. If your loved one is in a facility, ask to see their repositioning chart as it is that important.

Encourage Safe Movement

Even small movements matter. If the person is able, encourage leg lifts, toe wiggles, and arm stretches to promote circulation. Physical or occupational therapists can provide safe exercises suited to the individual’s ability level.

3. More Than Just Skin Deep: Additional Prevention Tips

While mattress and movement are important, preventing pressure injuries also requires attention to nutrition, hygiene, and skin monitoring.

Nutrition and Hydration

Healthy skin needs fuel. Protein, vitamins (especially A, C, and zinc), and hydration all support skin repair and resistance to injury.

• Aim for balanced meals with enough calories and protein. This can be tough for those with reduced appetites or swallowing difficulties. Consider nutritional supplements if needed.
• Dehydration makes skin dry and fragile. Encourage regular sips of water unless medical reasons restrict fluid intake.

Daily Skin Checks

Early detection is crucial. Examine the skin once a day, especially over bony areas—for:

• Redness that doesn’t fade when pressed
• Swelling, warmth, or hardness
• Blisters, open areas, or dark purple discoloration (especially in darker skin tones)

Catching changes early allows for quicker intervention, often preventing a small issue from becoming a serious wound.

Protective Devices

Consider using:

• Heel protectors or cushions to offload pressure
• Foam wedges to support safe positioning
• Barrier creams for patients with incontinence to protect skin from moisture and irritation

Know When to Get Help

Despite your best efforts, wounds can still occur. If you see signs of a pressure injury or if the skin seems to deteriorate from one day to the next, it’s important to involve a healthcare professional. Early treatment is easier and more effective than trying to heal an advanced wound.

Also, consider seeing a wound care specialist if:

• There are repeated skin breakdowns
• Healing is slow or has stopped
• There’s more pain, odor, or drainage from the skin

Final Thoughts

Pressure injuries go beyond skin damage; they impact comfort, quality of life, and can cause severe complications. However, with awareness, consistency, and the right tools at home, most can be prevented.

Begin with a supportive surface. Incorporate regular movement, and focus on the small details that keep skin healthy. These steps may seem straightforward, but they are effective when done daily.

Whether you’re caring for someone you love or managing your own recovery, you don’t have to handle pressure injury prevention by yourself. Reach out to your healthcare team, ask questions, and take proactive steps, and it’ll be worth your while vs dealing with pressure sores. 

Author

Jenna Wishnew Dr. Jenna Wishnew is a board-certified general surgeon with over a decade of experience serving the North Dallas community. Known for her compassionate, patient-centered care, she specializes in wound care and hyperbaric oxygen therapy (HBOT), currently serving as Medical Director at the Wound Care and Hyperbaric Center at Methodist Richardson Medical Center. Dr. Wishnew is a recognized leader in her field, earning two international awards for excellence in wound care. She also has extensive experience managing gastroparesis and Enterra Gastric Stimulators.