Pressure Ulcer Prevention and Mitigation: Products and Strategies from Skil-Care
By Steve Warhaftig, Founder

Decubitus ulcers, or pressure ulcers, are a major concern in healthcare settings, particularly in nursing homes and hospitals. Skil-Care focuses extensively on preventing and mitigating these ulcers. Pressure ulcers develop due to several factors:

  1. Interface Pressure: Long-term pressure on the skin, especially over bony prominences, leads to ulcers. Common sites include the heels, coccyx, elbows, knees, ankles, back of shoulders, back of the head, ears, hips, and sacrum.
  2. Friction: When the skin rubs against another surface, such as a sheet or seating surface, it can damage blood vessels under the skin. Shear, a subcategory of friction, involves parallel or tangential force between the skin and support surface.
  3. Moisture: Sweat, urine, feces, or excessive wound drainage can weaken the skin, making it more susceptible to pressure, friction, and shear.

Vulnerability
Aging skin is more prone to pressure sores due to thinning, reduced circulation, and slower healing times. Conditions such as diabetes also increase the risk; over 30% of people with diabetes will develop a foot ulcer in their lifetime. Pressure injury rates in hospitals are approximately 7%, and while prevention is possible, it remains challenging in critically ill patients.

Pressure Ulcer Prevention
To reduce the occurrence of pressure ulcers, various methods are employed, including specialized mattresses, seat cushions, and repositioning products. It is recommended to reposition patients every 2 to 4 hours. Exercises to improve circulation and skin integrity are also beneficial. Keeping the skin clean and dry, as well as regular exfoliation, helps maintain skin health and reduce vulnerability to tears.

Skil-Care Products for Pressure Ulcer Prevention and Treatment
Skil-Care has developed a wide range of products over 40 years to prevent and treat pressure ulcers. Here are some key products and their features:

Interface Pressure
Wheelchair Seat Cushions: Skil-Care offers over 70 variations of wheelchair seat cushions designed to reduce pressure. Gel cushions provide cooling and movement to minimize pressure over bony prominences. The gel redistributes pressure, reducing the risk of ulcers. Stretch covers on these cushions reduce shear forces and improve posture.
Mattresses: Specialized mattresses help redistribute weight over a larger area. Skil-Care’s mattresses have separate foam cells that move with the patient and three zones (heel, torso, and head) to further reduce pressure. They also feature roll-off prevention and can be enhanced with gel or air overlays to prevent sliding and lateral leaning.

Shear Forces
Super Slings and Glide Systems: To address shear forces caused by dragging patients over high-friction surfaces, Skil-Care offers super slings for lifting and transferring patients, as well as glide systems for chairs and beds.

Moisture Management
TLC Pads: These pads have three layers, two of which absorb moisture and drain away urine, helping to prevent skin breakdown. They are launderable and feature “Cozy Cloth,” a moisture-absorbing fabric that also reduces shear forces.

Heel Ulcers
Heel Protection Products: Skil-Care provides over 15 products for heel protection, including gel overlays, open-heel designs (zero heel pressure), and specialized materials and fabrics.

Redistribution of Pressure
Gel Cushions and Positioning Aids: Gel cushions redistribute pressure by moving the gel, reducing the time pressure is applied to any one point. Skil-Care offers over 10 products for redistributing body weight in bed, including wedges and positioning sheets.

Exercise and Skin Exfoliation
X-Box Exercise System: This system strengthens the upper and lower body using multiple bands and stretchable materials. It is designed for both ambulatory and non-ambulatory patients.
Bath Net for Exfoliation: The mesh surface of the bath net is intended for skin exfoliation, removing dead skin cells and unclogging pores.

Conclusion
Skil-Care has been a significant contributor to pressure ulcer prevention and treatment for over four decades, offering effective products and solutions. These products, ranging from cushions and mattresses to slings and moisture management aids, are designed to reduce the risk and impact of pressure ulcers, enhancing patient care in nursing homes and hospitals.

References:
• Sweitzer SM, Fann SA, Borgtk, Baynes JN, Yost MJ (2006). “What is the future of diabetic wound care?”
• Mensah GA, Roth GA, Sampson UK, Moran AE, Feigin VL, Forazanfar MH, et al. (GBD 2013 Mortality Causes of Death Collaborators) January 2015