Diabetes is only one of the causes that will lead to skin breakdown in a person. Other causes can be anything from smoking, anemia, and a variety of vascular diseases. Other things such as drug use and alcoholism can also do great damage to the cellular level of the skin.
I am Diabetic so for me this is a major concern. Skin is a real concern for us as Diabetics because we have poor circulation and our vascular systems are always compromised with this disease. What we as Diabetics need to be concerned about is what is causing it and how to recognize it then also how to treat it or what to do to prevent it.
The most common areas for skin breakdown (pressure points) in adults
are the sacrum/coccyx (tailbone), heels, elbows, lateral maleollus
(outside of the ankle), greater trocater (hip bone) or the bottom of
the femur (outside and inside of the knee) and the ischial tuberosities
(the bones we sit on). Pressure points for children are different and
based on age and development (7). For infants and children less than
three years of age, the head makes up a greater portion of the total
body weight and surface areas. When they are placed on their backs,
the occipital region (back of the head) becomes the primary pressure
point. When placed on their side, the ears are also very susceptible.
For older children, the sacrum (lower spine) and calcaneous (the heel
of the foot) are most at risk (9).
Source: http://myelitis.org/newsletters/j5/journal-5-04.htm#.UhO31H_pxVI
For those with Obesity problems you should also check under the folds or flaps of skin that may overlap and create no air flow and bacterial breakdown.
Other things that can have a big play on breakdown of skin is if clothing or blankets, pillows are folded under you creating a pressure point. Make sure that you smooth any clothing, blankets or pillows you may be using to keep and insure a better amount of blood and oxygen flow to all parts of your body. Bedding or sheets should be as wrinkle free as possible as well. Make sure not to wear shoes that will rub on toes or feet. Some jewelry also can cause issues of circulation.
Make sure that you keep skin dry and clean it will help you to insure the best possible way to keep your skin from breaking down. At the same time you don't want your skin to not have moisture but make sure it is the right type of moisture. Lotion your skin properly after showers or bathing because you do not want to get cracks in your skin.
Maintain a healthy diet and get proper nutrition. Help your body to stay vascular healthy by eating certain foods such as:
- Omega 3 fatty acids(salmon, mackerel, flaxseed)
-
Vitamin C(citrus fruits, strawberries, broccoli)
-
Vitamin A(Vegetables that are dark green or dark orange in color)
-
Zinc(seafood, meat and eggs)
-
Protein(meat, eggs, cheese, and soy products)
Make sure that you switch positions from sitting to standing to walking and if you are laying on your side in bed switch positions about every 2 to 4 hours. This will help you from keeping pressure off of any one point for too long.
Keep muscle spasms under control
Some muscle spasms can be beneficial as they help you
change position, if you can’t move yourself. Too much muscle
spasticity can cause rubbing and friction, especially when you are in
bed at night. Talk with your care provider about how to best manage
spasticity. Exercise and range of motion are two good ways to reduce
spasticity. Make sure orthotics (braces) are fitting properly, that
they are worn correctly, and that the straps are fastened properly to
prevent friction or pressure. Be sure that your bladder and bowel
programs are working well as increased spasticity can be caused by a
urinary tract infection or constipation. Spasticity can also increase
when you have a burn or skin breakdown.
Source: http://myelitis.org/newsletters/j5/journal-5-04.htm#.UhO31H_pxVI
What does minor skin breakdown look like?
Skin breakdown starts out as a red or purple spot on
fair skin or a shiny, purple, blue or darker spot on dark skin, which
does not fade or go away within 20 minutes. When you press on the spot
with your finger, it does not become lighter (blanch). It may feel
warmer or cooler than the skin around it. The spot may feel hard or
squishy under your fingers and may look swollen. If you have sensation,
it may be itchy or painful. At first, it may not look like much,
especially if the skin is not broken or open, but it can get a lot
worse. If your skin becomes blistered, scabbed or has a small open
area on the surface, this is more serious, as it indicates that the
tissue underneath has begun to die. At this stage, the progression of
skin break down is reversible: the skin will return to normal as soon
as the cause of the irritation is found and eliminated and the skin is
properly cared for. If these steps are not taken, the damage can
rapidly progress to a dangerous level where infection can attack the
underlying tissue and bone, posing a serious risk to your health.
Source: http://myelitis.org/newsletters/j5/journal-5-04.htm#.UhO31H_pxVI
What does serious skin breakdown look like?
Serious skin breakdown occurs when the cause of the
problem is not eliminated and tissue has been deprived of oxygen and
nutrients for so long that the tissue has died and there is now a large
hole or crater. Damage extends at least into the subcutaneous
tissue. In the most serious wounds, tissue death includes muscle and
extends as deep as the bone. Drainage is almost always present. If you
have fever, see green or yellow drainage, and have a warm temperature
around the wound, you may have developed an infection. Wounds such as
this, with or without infection, must be evaluated by a health care
professional. This care may be obtained through your spinal cord
injury provider or you may be referred to a wound center to be evaluated
and treated by a professional that specializes in the treatment of
serious wounds. When an infection forms in a wound, the surrounding
tissue and bone can become infected. If this continues, infection can
enter the blood stream causing sepsis; and if untreated, can be fatal.
Source: http://myelitis.org/newsletters/j5/journal-5-04.htm#.UhO31H_pxVI
Consult your physician with either of these two Serious Skin breakdowns and Minor Skin Breakdowns. Your doctor will be able to give you the proper advice on what you should do for your Skin Breakdown.
I encourage you to read more from this article on
Skin Health: Prevention and Treatment of Skin Breakdown Janet Dean, MS, RN, CRRN, CRNP Link:
http://myelitis.org/newsletters/j5/journal-5-04.htm#.UhO31H_pxVI
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