PREVENTION OF PRESSURE SORES
PRESSURE SORES 197
It is important that both the child and family learn about
the risk of pressure sores and how to prevent them.
• Avoid staying in the same position for very long. When lying down, turn from
side to side or front to back at least every 2 hours (or up to 4 hours if padding and
cushioning are excellent). When sitting, lift body up and change position every 10 or
15 minutes.
• Use thick, soft padding, pillows, or other forms of cushion arranged so as to
protect bony areas of the body. (For cushion designs, see p. 199 and 200.)
• Use soft, clean, dry bed sheets. Try to avoid wrinkles. Change bedding or clothing
every day and each time the bedding gets wet or dirtied. A person who stays wet gets
pressure sores—especially if it is from urine.
• Bathe the child daily. Dry the skin well by patting, not rubbing. It is probably
best not to use body creams or oils, or talc, except on the hands and feet to prevent
cracking, as these soften the skin and make it weaker. Never use heat-producing oils,
lotions, or alcohol.
• Examine the whole body carefully every day, checking especially those areas
where sores are most likely to occur. If any redness or darkness is present, take added
care to prevent all pressure over this area until the skin returns to normal.
• Good nutrition is important for preventing pressure sores. Be sure the child gets
enough to eat (but do not let her get fat). Give her plenty of fruits, vegetables, and foods
with protein (beans, lentils, eggs, meat, fish, and milk products). If the child looks pale,
check for signs of anemia (see p. 320) and be sure she gets iron-rich foods (meat, eggs,
and dark green leafy vegetables) or takes iron pills (ferrous sulphate) and vitamin C
(oranges, lemons, tomatoes, etc.).
• As much as is possible, the child should learn to examine her own body for
pressure sores every day and take responsibility for all the necessary preventive
measures herself.
Other precautions
• To avoid pressure sores or other injuries on feet that do not feel, use well-fitted,
well-padded sandals or shoes. These and other precautions are discussed under “Spina
Bifida” (p. 173) and “Leprosy” (p. 224).
• To avoid pressure sores when straightening
limbs with casts, put extra padding over bony
spots before casting and do not press on these
spots as the cast hardens. Listen to the child
when he says it hurts, and check where it hurts.
If it hurts in these spots,
it is probably the tight cord
(tendon). A little pain is
normal with stretching, but
if it hurts a lot, examine it.
If it hurts in one of the spots marked
with an X, it may be a pressure sore.
Remove the cast and see.
disabled village children