The first step is to work with your nurses and doctor to develop a plan that you and any caregivers can follow. The cornerstones of such a plan include position changes along with supportive devices, daily skin inspections and a maximally nutritious diet.
- Avoid lying directly on your hipbones. On your side, lie at a 30-degree angle
- Support your legs correctly. When lying on your back, place a foam pad or pillow — not a doughnut-shaped cushion — under your legs from the middle of your calf to your ankle. Avoid placing a support directly behind your knee — it can severely restrict blood flow.
- Keep your knees and ankles from touching. Use small pillows or pads.
- Avoid raising the head of the bed more than 30 degrees. A higher incline makes it more likely that you'll slide down, putting you at risk of friction and shearing injuries. If the bed needs to be higher when you eat, place pillows or foam wedges at your hips and shoulders to help maintain alignment.
- Use a pressure-reducing mattress or bed. You have many options, including foam, air, gel or water mattresses. Because these can vary widely in price and effectiveness, talk to your doctor about the best choice for you. For some people, a low-air-loss mattress may provide enough support. But more expensive and technologically sophisticated beds may be needed for people who have recurring pressure sores or who are at very high risk
Pressure-release wheelchairs, which tilt to redistribute pressure, may make sitting for long periods easier and more comfortable. If you don't have a pressure-release chair, you or your caregiver will need to manually change your position every 15 minutes or so. If you have movement and enough strength in your upper body, you can do wheelchair push-ups — raising your body off the seat by pushing on the arms of the chair.
All wheelchairs need cushions that reduce pressure and provide maximum support and comfort. Various cushions are available, including foam, gel, and water- or air-filled cushions. Although they may help relieve pressure, cushions and other devices don't prevent pressure sores from forming or replace the need to change your position often.
For products to help with pressure reduction click here.
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