ABSTRACT
This chapter revises pressure sore development, identifies some assessment systems available, and describes some ways of preventing pressure sores. Most hospitals employ tissue viability nurses, who are a valuable source for advice and resources, but it is also valuable for intensive care units to have a tissue viability link nurse to: disseminate information and provide an immediate resource for staff, and audit skincare. When external pressure exceeds capillary pressure, perfusion fails, leading to necrosis. Capillary occlusion pressure, the amount of pressure required to occlude capillaries, is often cited at 30–32 mmHg. Falls are more common when patients have neurological conditions or are admitted with trauma, and surprisingly are most common among patients aged 35–64. Pressure areas should be regularly assessed, and assessment tools can provide useful cues, but become counterproductive if they are viewed as just another paper exercise. Prompt hygiene and "comfort" washes reduce risks, and lubricating dry skin can prevent breakdown.
