The Recommended Pressure Ulcer Prevention Hygiene Protocol


8 simple rules to avoid bedsores

Pressure ulcers are a common problem for incontinent people who are immobilized or domiciled, however, they can be avoided.

They develop as a result of a combination of different actors, internal (physical and psychological) and external (care, equipment and climate) and do not just develop from continuous pressure on the body (although this is a triggering factor) . Good prevention involves several combined elements, which is precisely the subject of our blog.

Dear Caregivers, we strongly invite you to participate in these preventive actions, which are crucial for the well-being of the persons you assist and care for.

All the official organizations (Société Française de l’Escarre, NICE, EPUAP, NPUAP) say it: The priority is to make a formal assessment of the skin condition and the risk of pressure ulcer development that results from it (specific assessment scales are the Braden, Waterloo and Norton scales), crucial in determining the preventive care protocol for a patient. Don’t forget, all these instances are primarily aimed at medical professionals.

When it comes to domiciled people, either the caregiver does not have the time to do this assessment or is not competent to do it (which is totally comprehensible since she is not a registered nurse), or the domiciled person himself/herself does not know where to start (unless he/she is following a post-hospitalization protocol). So whether or not you have the possibility to evaluation your skin condition, begin with the following steps:

1.Check the skin –

You may not have a made a formal evaluation of your skin condition but you may check your skin yourself from head to toe (and with the help of your Caregiver for the less reachable areas) at least once a day. In fact, it only takes a few seconds to look at yourself. As a matter of fact, don’t we do that kind of thing naturally, without even thinking about it, when it is not a job to be done?

Redness is the first visible sign that the skin is under unusual pressure, and it means the pressure ulcer has already started. In particular, check the areas most at risk which are the back of the head, the buttocks, sacrum, ischium, elbows, and heels.

If you see redness, seek medical advice immediately to avoid any risk of skin degradation.

2.Change position –

At least every 2 hours and make sure you are no longer putting pressure on the area at risk. These changes can be made with the help of cushions and pillows that will lift certain areas of the body and offload the weight.

The change of position is the number 1 prevention rule! Even if is the only thing you do.

3.Avoid water and soap –

Use a gentle cleanser instead, specially designed for the sensitive skin of incontinent, elderly or diabetic people because good old soap dries out the skin. Look for a rinse-free solution, as skin chafing can occur when you wash, rub, and wipe down to clean and dry an area. Note that cleansers don’t wash as well as soap and water but that very regular cleansing will compensate for the lack of soap.

4.Reduce hot bats

We recommend that you customize (not program, for example once or twice a day) the frequency of bathing to avoid excessive friction and hot water as much as possible. Of course, the skin should be cleansed regularly to kill bacteria, but water that is too hot is more likely to dry out, crack and tear the skin.

5.Clean yourself with every change –

Don’t wait for fecal incontinence to cleanse yourself. Do it at your own pace, but do it each time you have an incontinence episode, even a urinary one. Your skin can be exposed to moisture for a long time (incontinence or sweating) if you are immobile. But remember, your skin should stay as clean as possible!

6.Protect areas at risk for pressure ulcers –

Although it creates a natural barrier against moisture and irritation, as the skin ages it produces less and less sebum. In high-risk areas, whether to prevent pressure sores or inflammation of the skin (irritative contact dermatitis), it is EXTREMELY important to protect your skin with a polyvalent ointment or a protective barrier. Ask your chemist shop or doctor for advice.

7.Keep skin supple and hydrated –

Again, the body may not be able to protect itself anymore and the skin becomes dry. Hydrate your body properly. Daily application of a moisturizer will help reduce the likelihood of red areas while promoting healthy and healing skin. If you are the domiciled person and find it tiring, then choose to hydrate one or two different areas depending on the day of the week, and gently to avoid breaking the skin.

8.Be careful of the bony parts –

On the other hand, avoid massaging areas with bony prominences to limit friction and deterioration of the epidermis. Instead, try to keep pressure ulcer-prone areas well cushioned and protected, and again, skin dry, clean, and healthy.


THE THERMOCONTOUR TEAM, advocating positive care