Moisture Contributes to the Development of Pressure Sores?

Moisture lesions and pressure ulcers are common concerns for caregivers of bedridden elderly individuals. These conditions, while related, are distinct and require different approaches in prevention and treatment.

Moisture lesions, a form of dermatitis, are caused by prolonged exposure to bodily fluids such as urine, feces, or sweat. They weaken the skin's integrity, making it more susceptible to damage. The lesions often appear near skin folds, such as close to the buttocks, breasts, or the back of the knee. They can be identified by their slightly painful nature when touched with a fingertip, and their circular shape.

On the other hand, pressure ulcers are more visible and can resemble a blister or a purple patch. They are more likely to develop on bony areas of the body, such as the shoulder, thigh, elbow, hips, ears, knee, heel, etc. In some cases, a swelling over a bony region that is constantly under pressure may indicate a pressure ulcer.

The development of pressure ulcers is facilitated by moisture, which compromises the skin’s resistance to mechanical forces such as pressure and friction. By softening the outer skin layers, moisture creates an environment where microscopic skin injuries are more likely to occur and spread, accelerating the progression from intact skin to pressure ulcers.

Prolonged exposure to moisture can cause skin maceration, softening and breakdown, increasing the risk of skin damage and ulcer formation. This is particularly concerning for elderly individuals, who often have thinner, more fragile skin and limited mobility, making them more susceptible to pressure ulcers.

Preventive care emphasizes keeping the skin clean and dry to maintain barrier function, alongside regular repositioning and the use of specialized support surfaces to reduce prolonged pressure and shear forces. Caregivers should also be aware of the risk of pressure ulcers during patient transportation, as the wetness during repositioning or transportation can increase the skin-support coefficient of friction, potentially facilitating the growth of pressure ulcers.

An Israeli study has concluded that pressure ulcers can occur in bedridden people during transport, not necessarily during a rested state. It is important to note that moisture alone does not cause pressure ulcers, but it does significantly increase the likelihood of their development.

Diagnosing moisture lesions can be challenging, and it is crucial for caregivers to be vigilant in monitoring the skin condition of their patients. By understanding the risk factors and taking preventive measures, caregivers can help protect their patients from these potentially harmful conditions.

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