Why is skin care important?
If your child is immobilized (unable to move freely) for any reason, pressure sores can occur. Too much pressure on the skin for too long a period of time causes pressure sores. Pressure causes a loss of blood flow to the area, which can cause part of the skin to die. Proper skin care and pressure relief (weight shifts) can help prevent pressure sores.
Where do pressure sores occur?
Pressure sores can occur in any area of the body, but bony areas are more likely than others to have problems.
These include the:
- Skull and ears
- Shoulders and shoulder blades
- Elbows
- Hips
- Lower back and tailbone
- Knees
- Shins, ankles and heels
What are the possible symptoms of a pressure sore?
Your child may have one or more of the following:
- Skin redness that does not go away within 30 minutes after pressure is relieved
- Change in skin color or temperature (warmer or cooler than other areas nearby)
- Skin irritation such as a break in the skin, blisters or sores
Your child’s doctor will talk with you about specific care for your child. Some general guidelines to help reduce the risk of pressure sores include:
• Skin Care
- Check your child’s skin twice each day – morning and night. Check for any signs of irritation such as redness, blisters, rashes, swelling, bruises, dry skin or sores. Look very carefully, especially over bony areas and in creases and folds. If your child is old enough, he may be able to check himself using a long handled mirror.
- Keep your child’s skin clean and dry. Use creams and lotions to help prevent dry skin. Avoid using “antibacterial” type soaps and powders that cause dry skin unless directed by your child’s doctor.
- Have your child avoid tight-fitting clothes and rough fabrics. Wash new jeans before wearing them. Be aware of zippers, buttons and snaps.
- Keep bed linens clean and dry. Watch out for wrinkles, crumbs and small toys that can cause pressure on the skin.
- Protect your child’s feet with socks and shoes. Make sure shoes are not too small or tight.
- Keep toenails clipped short and straight to avoid ingrown toenails.
• Movement
- Move often - have your child move and shift his weight at least every 15 – 30 minutes when sitting. When resting in bed, have him turn and move at least every 2 hours. If he is sleeping, make sure he moves at least every 4 hours or as your child’s doctor directs. If your child is unable to move himself, use the above schedule to move or turn him.
- Do weight shifts - your child should shift his weight in a wheelchair at least every 15 – 30 minutes. He can push his body up with his arms and hold it up for at least 15 seconds or, he can shift his weight from side to side, lean forward or recline in the chair to relieve pressure.
- Use a proper fitting wheelchair and cushion.
- Use pillows or sheepskin in bed to help pad bony areas and maintain a good body position.
- Have your child avoid sitting on a toilet seat more than 15 minutes.
- Teach your child to use good posture when sitting to avoid pressure on the tailbone.
- When you move or transfer your child, avoid friction and bumps to his legs or feet.
- If you use a transfer board, make sure your child is dressed, or powder the board to avoid friction and burns.
- Give your child a healthy diet and plenty of fluids as advised by your child’s doctor. Good nutrition helps keep skin healthy.
- Teens should avoid smoking and alcohol; these can decrease circulation to the skin and cause a greater chance of skin problems.
There is even more risk for skin problems if your child has a loss of feeling in part of his body. If he does, some other general guidelines to follow may include:
- Be careful with hot liquids. Never let your child carry hot liquids in his lap. Test bath water before he gets in.
- Avoid heating pads, electric blankets or other types of heat to parts of the body that have less feeling.
- On hot days, cover hot car seats with blankets or cushions. Cover skin with clothing and use sunscreen when outside.
- On cold days, dress warmly and avoid staying outside too long to prevent frostbite.
When should I call the doctor?
Call your child’s doctor right away if:
- You notice any type of skin redness or discoloration that does not fade within 30 minutes of relieving pressure.
- You notice signs of new skin irritation such as sores, blisters, swelling, bruises, or rashes.
- You have any concerns or questions about your child’s skin.
