2 Foot Productions

Basic Foot Care for Nurses and Carers across Australia

Pressure Area Care What are pressure areas? What causes pressure areas? Where will you find pressure areas? What happens if you don’t attend to a pressure area? What can you do to help?

What are pressure areas?

Pressure areas are areas of skin break down. You can see them in many stages – from a slightly reddened area right through to a major ulceration that exposes bone. As for pain, pressure areas will usually range from being a bit tender to very painful.

What causes pressure areas?

Obviously pressure is the key factor here. More specifically, pressure over a boney prominence. Other factors that put people at risk of developing a pressure ulcer include: general illness, loss of weight, poor nutrition, dehydration, vitamin deficiency, immobility, poor circulation, loss of feeling in the affected area and poor hygiene.

Where will you find pressure areas?

On the foot, the heel is the most common site for a pressure ulcer.

followed by the ankle bones,

and then the boney prominence on the outside of the foot.

What happens if you don’t attend to pressure area care?

A pressure area will very quickly degenerate into a full-blown ulceration if left unattended. Pressure ulcers are generally very difficult to manage. Prevention is the much better option. Once an ulcer is established, other complications such as infection of surrounding skin, bone or joints becomes an issue, as well as the general negative impact on health. Increasing pain as the pressure area develops is also a major consideration.

What can you do to help?

Your goal is to maintain skin integrity. Consider the following ideas.

Reduce friction and irritation to the skin by making sure the patient is comfortable and stable in the bed or chair. Move them carefully. Try and distribute pressure evenly over the whole body using appropriate mattresses, cushions, pillows and supports.

Keep skin moisture at an appropriate level. Very dry skin is more likely to split but very moist skin can break down as well.

Special socks and booties can also be useful for cushioning, reducing friction, preventing trauma from bed rails or toenails and possibly maintaining skin integrity.

Other factors such as nutrition and hydration, general health and hygiene need to be attended to also. Constant and careful observation is the key to prevention of serious pressure area complication. Any area that you are concerned about should be reported to the registered nurse.