Minivandals: Pressure Sores

I think that I may have mentioned pressure sores before. They are something that a wheelchair user must constantly be on the look out for. A hint of redness that does not blanch ie whiten when pressed on is something for concern. Pressure sores can lead to holes in the skin and can occur any time there is prolonged pressure by a bony prominence on the skin.

    That is why weight shifts are so important for wheelchair users. When we (ambulatory folks) start to get uncomfortable aka when bones are pressing into our skin, we shift. We do it without thinking. I bet you have shifted a couple of times as you read this. That is what keeps us from getting sores - our unconscious response. For folks in chairs, that response isn't there. It is something one must be conscious of.
    We were told at Moss to shift every 20 minutes for 2 minutes. A shift, at first, consisted of leaning over to one side and then the other. Now, he leans forward. There are other methods - such as pushing up; we are working up to that.
     There is a whole formula for weight shifts and how long to go between shifts and duration etc (click on link above). Jarrad does one every 40 minutes and for 2 minutes. He gets a little nervous if he forgets because he gets sidetracked. So we have a timer on his chair. It helps to keep him on track.
     Why is he so careful? Because he has had a pressure sore. He got it when he fell and it was caused by "shearing" or the skin rubbing one way and the bone another.

Stage four

http://sci.washington.edu/info/pamphlets/pressure_sores.asp

Here is a cool (?) picture of what happens when a pressure sore is untreated - you can get a hole to the bone. Jarrad's pressure sore was just under his shoulder blade. The bad news (wait, that should be "the worst news") is that once you have a pressure sore, you have to be really careful because you can get another in that spot. For us, the good news is that it is highly unlikely that he will get another one in that spot.
So - why am I writing about this? Tell you next blog - I think - it is good; it just requires more than I want to write now.
Now, if you are squeamish, don't look at the following pictures. They are of Jarrad's pressure sore.

This is early November 2012 - You can see new skin growth. This is the first picture I have - be glad because the earlier ones were really bad. Oh, and his surgical scar.

This is late November of 2012. You can see how much healing occurred in 4 weeks. As you look at these picutres, you can really "see" the black and white illustration above.