Module 8 - Pressure Management
Terms and definitions
Pressure ulcers: "A pressure ulcer is a localised injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction." #
Pressure: The force per unit area exerted perpendicular to the plane of interest. * ( Pressure = Force/Area )
Pressure redistribution: The ability of a support surface to redistribute load over the contact areas of the human body. This term replaces prior terminology of pressure reduction and pressure relief surfaces.*
Friction: The resistance to motion in a parallel direction relative to the common boundary of two surfaces.*
Shear/'parallel shear': The force per unit area exerted parallel to the plane of interest.*
Support surface: "A specialised device for pressure redistribution designed for management of tissue loads, micro-climate, and/or other therapeutic functions (i.e. mattress, integrated bed system, mattress replacement, overlay, seat cushion, or seat cushion overlay)". *
Immersion: Depth of penetration (sinking) into a support surface*
Envelopment: The ability of a support surface to conform, so to fit or mould around irregularities of the body.*
# National Pressure Ulcers Advisory Panel: Pressure Ulcer definition and stages, updated February 2007
* National Pressure Ulcers Advisory Panel: "Terms and Definitions Related to Support Surfaces", Ver. 1/29/07 .
Why should we be concerned about PRESSURE Management for SCI clients?
- Clients with SCI have neurologically impaired skin, making it more susceptible to injury below the level of injury. Read more.
- Clients with SCI are at greater risk of developing pressure areas because continuous pressure may not be noticed due to altered or absent sensation, so the client will not automatically weight shift to relieve pressure.
- Muscular atrophy of the lower limbs results in a reduced area available to support body weight, increasing localised pressure around the protruding bony prominences.
- It is better to prevent a pressure problem than to be forced to manage it surgically or with bed rest.
- Once the skin is damaged, the prevention of a pressure ulcer is more difficult (Fries, 2005).
- SCI clients with other co-morbidity such as acquired brain injury can be at a higher risk of pressure development.