The View from Where I Sit

Tag: PURSUN

  • A Day in my shoes!

    Nowadays, that I’ve finished university, a day in my shoes could consist of weekly Podiatry appointments, bi-weekly Jobcentre appointments and quarterly visits to the Shipley Library for arts and crafts, which is a social group, with the Shine Charity. I’m also a member of the PURSUN group, with the University of Leeds, that provides pressure ulcer prevention and relief.

    I’m living in Ilkley which is a posh retirement area around Yorkshire. This area has many charities, retirement homes, gift shops and coffee shops.

    Blogging is another favourite pastime of mine to keep myself busy. I also have a children’s book that I’m trying to get off my chest. I never realised writing a book would be so deep. I could self publish and sell, but I also have to fund the production of the book. In other words the problem is income versus revenue.

    Income is the total earnings of a business or individual, while profit is the amount remaining after all expenses are deducted from revenue.


    Income refers to the total money earned by a business or individual from various sources. For businesses, this includes revenue from sales of goods or services, as well as non-operating sources like interest, dividends, or gains from asset sales. Income can be categorized as earned income (from active business operations) and unearned income (from investments or passive sources).


    Profit, on the other hand, is the residual amount left after subtracting all costs, expenses, and taxes from revenue. It represents the financial reward for taking business risks and is a key indicator of a company’s financial performance. Profit can be further divided into gross profit (revenue minus cost of goods sold) and net profit (gross profit minus operating expenses, taxes, and other costs).

    Key Differences
    Calculation    : Income is the total earnings, while profit is calculated by deducting expenses from income or revenue.


    Purpose: Income shows the total resources available for reinvestment or distribution, whereas profit indicates how much money exceeds total costs during a period.


    Timing: Income is often reported periodically (monthly, quarterly, annually), while profit is typically assessed after all expenses are accounted for.


    Scope: Income can include non-operating sources like interest or dividends, while profit focuses on the net gain from business operations.


    In essence, income measures total earnings, while profit measures the efficiency and success of operations after costs. Understanding both is crucial for financial planning, tax calculations, and evaluating business performance.

    Alternatively, Access Consultancy is a new interest I have found, while Journalism and Politics are still my passion.

    Pressure Ulcer Prevention at Home | You’re not alone | PUP

    ‘What it takes to be ME’

  • Pressure Ulcer Prevention Poem

    That pressure injury or sore was 7cm deep, it resulted in me being in bed rest for seven months to heal, that was quite a traumatic experience in its own way and I can talk more about that

    I think I spend a large proportionate of my time either managing my care situation, or managing the medical situation that I’m in so dealing with appointments, dealing with scheduling appointments, dealing with getting hold of doctors, chasing things up when things don’t happen, all that sort of thing.  That I think I consider these days to be my full time job. 

    I do try to keep it as consistent as I can only because with the number of carers that come through, we do struggle to find continuity of care, we do struggle to find people who are consistent that come back and I think that is again, back to the pressure side of things, that can be a challenge too when you’ve got new people coming in.

    The quality of the care varies just depending, I’ve had some very good carers and some of them will have done very minimal care, they will have just come from domiciliary and then gone to a training course in an office and then shipped out there. So I do end up doing a lot of the training if you will myself because everybody’s routines are slightly different. 

    Interviewer: It sounds like you’re carrying a huge amount on your shoulders, that you’re managing your care package, you’re managing your own health, you’re having to train carers who are coming into you where the knowledge isn’t the standard that you require, on top of running your life like everyone has to do which isn’t straightforward.  That’s a huge amount for one person to carry.

    It is and I can do that now, if you ask me that in 10 years’ time, I don’t know if that answer would be the same.  I don’t know how I’m going to be doing this in 20 years from now, you know? 

    There’s only so much you can physically you can do yourself, there’s only so much bandwidth that you’re bringing and if you’re in pain, which I am sometimes, that becomes even more difficult because the pain is your focus, it’s not really necessarily the carers, again that’s when mistakes get made because you’re just trying to deal the acute rather than you need to be able to see something, say something, whatever. 

    So yeah, mental health wise, I think fortunately, I do speak to a therapist, a speaking therapist weekly, that helps me sort of destress in a way or at least get out all the frustrations and whatever that are going on.  What I’ve found since I’ve been talking to her and I’ve known her for a while now, is that I would say if we have four monthly conversations, out of those, at least two of those would be spent talking about care and that’s not really where I want it to be.  I would like be talking about other things rather than, “this is what’s going on this week because of my care ..”, blah blah blah. 

    That’s how much of an impact and an influence if you will the care situation has in my particular life. It’s difficult, it is difficult.

  • ‘Pressure Ulcer Prevention in a Pandemic’


    “Pressure ulcer prevention and management is an art as well as a science.

    Different people with similar conditions need different care and that care should be holistic and tailored to the individual.”

    Linda Nazarko OBE Consultant Nurse West London NHS Trust

    Before the pandemic, I never got home visits, because I’m not bed-ridden. Previously, only people who are bed-ridden got home visits. Nowadays, I’ve been getting home visits from carers and district nurses, since the pandemic. I even received my Covid-19 vaccination, Astra Zeneca, by way of home visits.

    “Pressure ulcers remain a concerning and mainly avoidable harm associated with healthcare delivery.”

    National Pressure Ulcer Prevalence and Quality of Care Audit, November 2020

    I became a PURSUN researcher during the pandemic in 2020. I used to attend annual Spina Bifida Clinics before the pandemic from 2013. However, since the pandemic, I’ve had no success in booking Spina Bifida Clinics, due to the surge and resurge of Covid-19 cases. In addition to the PURSUN research, the Spina Bifida Clinics also help me to improve the way that I take care of myself.

    “The overall prevalence of PUs recorded, in terms or proportion of patients with 1 or more PUs, was 9.04%…The audit sought to understand not just the number of pressure ulcers that were present, but the care that was being delivered to the patients to prevent pressure ulcers occurring….Findings regarding implementation of preventative actions vary considerably between organisations and even between sites within organisations. Identification of these areas is important to the individual organisations as it allows them to focus quality improvement efforts into the areas that may make a difference.”

    Stop the Pressure: National Pressure Ulcer Prevalence and Quality of Care Audit 2020

    By December 2020, concerns about foot amputation were being raised by District Nurses, Tissue Viability Nurse and Podiatry. Since then, I’ve been wearing splints and callipers to protect my feet from any further damage. My feet have been x-rayed and scanned. I’ve also been prescribed antibiotics for my infected heel bone. Before the pandemic, I used to order and pick up my prescriptions from the Lloyds Pharmacy but ever since the pandemic they’ve been delivered to my house.

    I received assistance from my sister with groceries because online shopping was fully booked during the first three months of the pandemic.

    She stayed with me for three months but then had to leave after that because I was at risk of losing my Housing Benefit under assisted living, if she stayed any longer. Carers have been restricted on admission. There is more chance of emergency admission to the hospital.

    “A phased approach will be used to develop Pressure Ulcer surveillance in the NHS.. Clinicians with responsibility for Pressure Ulcer reporting (most likely tissue viability nurses) will need to ensure their organisations are aware of and prepared for the new surveillance system. As part of this, systems will need to understand the difference between surveillance reporting and clinical incident reporting. The purpose of surveillance reporting is to capture the full incidence and prevalence of Pressure Ulcers across a system to drive quality improvement at organisational level. The purpose of clinical incident reporting is to support learning from mistakes so action can be taken to keep patients safe.”

    A new national Pressure Ulcer Surveillance system using The Model Hospital System, November 2021

    Pressure ulcer prevention in a pandemic taught me how to:

    • network with colleagues who are working to improve the measurement, reporting and prevention of pressure ulcers and harm
    • Reflect on national developments and learning including learning from Stop the Pressure: National Pressure Ulcer Prevalence and Quality of Care Audit
    • Learn from outstanding practice in pressure ulcer reporting
    • Implementing the new national Pressure Ulcer Surveillance system and learning from pilot sites
    • Change the way you view pressure ulcers – eliminating the focus on a voidability
    • Developing effective training and education of frontline staff that will empower frontline teams to take ownership for improving care processes and preventing pressure ulcers
    • Understand how you can reduce pressure ulcers and harm from pressure ulcers
    • Improve sustainability in the reduction of pressure ulcers during Covid-19
    • Understand plans for a new national pressure ulcer data system to support quality improvement
    • Understand the factors that increase the risk of pressure ulcer development, and explore effective risk assessment tools
    • Develop a better understanding of pressure ulcer prevention at the end of life
    • Reflect on a case study in reducing pressure ulcers in Covid-19 patients
    • Improve Nutrition and Hydration
    • Learn from Clinical Negligence claims related to pressure ulcers
    • Ensure you are up to date with the latest evidence and definitions
    • Self assess and reflect on your own practice
    • Supports CPD professional development and acts as revalidation evidence.
    • group approval for revalidation purposes

    “We continue to have a challenge with patients developing pressure ulcers, and also a challenge with having some standardisation and consistency of care. There is considerable variation of about what happens in practice, in particular, underuse of evidence based care and overuse of ineffective interventions.”

    Jacqui Fletcher OBE Clinical Lead, The National Wound Care Strategy Programme, November 2021
    http://www.healthcareconferencesuk.co.uk
  • NORTH AND WEST YORKSHIRE ASBAH COMMUNITY CONFERENCE

    NORTH AND WEST YORKSHIRE ASBAH COMMUNITY CONFERENCE

    After 50 years of service, The North and West Yorkshire ASBAH had their first ever Community Conference. It was held on the 16th of October, at Hollins Hall Hotel, Golf and Country Club in Bradford. This was a day planned especially for people in the Spina Bifida and Hydrocephalus communities to come together and celebrate. There was lots of information on continence care, PIP and DLA form advice, education, and pressure ulcer prevention and cure.

    During the first workshop, I joined the PURSUN Group from Leeds, to do a presentation on Pressure Ulcer Prevention and Cure. It was very good to meet Delia Muir and share my experiences on the subject.

    Heather Chapman was at the ASBAH Charity conference, talking to wheelchair users about nutritional therapy by Wheely Therapy. Nutritional therapy is the application of nutrition science in the promotion of health, peak performance and individual care.

    Nutritional therapy practitioners use a wide range of tools to assess and identify potential nutritional imbalances and understand how these may contribute to an individual’s symptoms and health concerns. This approach allows them to work with individuals to address nutritional balance and help support the body towards maintaining health.

    Nutritional therapy is recognised as a complementary medicine. It is relevant both for individuals looking to enhance their health and wellbeing and for those with chronic conditions wishing to work with or ‘consult’ a nutritional therapist in collaboration with other suitably qualified healthcare professionals.

    I also learned about SEND. This presentation workshop was about guidance on the special educational needs and disability system for children and young people aged 0 to 25, which started on 1 September 2014. The questionnaire that the presenter gave out, was a very good teaching tool.

    Additionally, there were stalls and activities for the children. There were free prizes and charity merchandise on display as well. One of our sponsors, Irwin Mitchell, provided bags with freebies inside too. They also support the SHINE Charity.

    Dr. Kate Wildig was the guest speaker who ended the whole conference. North and West Yorkshire ASBAH has a good support group. Use It!

    https://fb.watch/fgJu3S12UL/

    https://form.jotform.com/katyravenasbah/conference-registration-form

    https://www.linkedin.com/company/north-and-west-yorkshire-asbah/

    https://www.nwyasbah.org/nwyasbah

    https://www.carefreesmarthomes.co.uk/group/disability-diary/discussion/b86d1cfe-90c2-42e7-9229-e3043c3b46cc

    http://www.wheelyhealthy.co.uk

    https://www.gov.uk/government/publications/send-code-of-practice-0-to-25

    https://www.hollister.co.uk/en-gb/products/ostomy-care-products

    https://www.irwinmitchell.com/?ref=google&infinity=ict2~net~gaw~ar~353754706478~kw~irwin%20mitchell~mt~e~cmp~MEC+Brand+HV+Irwin+Mitchell+Exact~ag~Brand+-+HV+Core&&ds_lpt_start&ds_lpt_end&gclid=CjwKCAjw-rOaBhA9EiwAUkLV4hbptkb2WjS1oL5NWyP1zEv8oaEMV66IqQXjPXb8DbSqSlgIv38NDxoCl8IQAvD_BwE&gclsrc=aw.ds

    https://www.bbuk.org.uk/adults/adults-resources/
    https://theelitevenueselection.co.uk/?fbclid=IwAR0ZkWVptOo3R3Op17iYaqol5fZ5lsQ8b-9Nc8cqAgOD8A1lVR1P088UJdI

  • THREE SOFT TISSUE THERAPIES FOR SCAR TISSUE

    Active Release Technique Therapy

    A.R.T is somewhat similar to massage therapy in that a therapist will use their hands to manipulate soft tissues. During A.R.T, however, the patient or the therapist will actively flex and extend different muscle groups during manual therapy. This active motion improves circulation and helps to break down scar tissue. A.R.T can help people with:

    • Plantar fasciitis
    • Tennis elbow
    • Shin splints
    • Carpal tunnel
    • Neck pain
    • Back pain

    One study found that A.R.T was helpful for people with neck pain as it improved range of motion and the pressure pain threshold score.

    Graston and Astym Therapy

    In Traditional Chinese Medicine, there is a therapy called Gua sha, which is where a therapist uses a tool, such as a smooth stone, to scrape the skin. Gua sha improves circulation and helps to break down scar tissue. Many therapists have taken the gua sha concept and applied it to different physical therapy techniques, such as the Graston technique and the Astym technique.

    Therapists that follow Graston and Astym protocols use plastic and/or metal tools to rub down soft tissues instead of their hands. If you have deeper areas of scar tissue that can’t be resolved by manual therapy, then these types of tools can be beneficial since the therapist can apply deeper pressure. These tools also come in a variety of shapes, which can help therapists pinpoint difficult-to-reach muscle groups, like the iliopsoas. Lastly, these tools help stimulate new cell growth in soft tissues and help the body resorb scar tissue.

    Dry Needling

    Dry needling is a therapy where practitioners use thin needles to break up scar tissue and reduce inflammation in trigger points. Trigger points are tight muscle fibers that can form from soft tissue trauma, muscle imbalances, and repetitive motions.

    Some people may confuse dry needling with acupuncture treatments. While dry needling looks like acupuncture, Healthline points out some distinct differences.

    For example, acupuncture is rooted in T.C.M and is meant to improve energy flow in the body; dry needling’s main focus is on correcting overly tight muscles with scar tissue. If your soft tissue injury has caused muscle spasms, then dry needling may be a good option. Some people’s soft tissue injuries may cause extreme sensitivity to touch, so dry needling may be a better option for these patients instead of A.R.T or Graston/Astym therapy. 

    I’m glad to know this because I only have a Tissue Viability Nurse and none of these techniques were suggested to me. I intend on trying out these new techniques soon.

    http://theresumexpert.com/2022/07/27/3-soft-tissue-therapies-for-scar-tissue/

  • Hygiene and Amputation

    With foot deformities and insensate feet, Spina Bifida patients are at risk of foot skin breakdown, pressure ulcers, and osteomyelitis. Rarely, pressure ulcers progress to squamous cell carcinoma. Spina Bifida patients may require limb amputation for osteomyelitis, foot ulcers, and squamous cell carcinoma. There is concern that transtibial amputations would have poor functional outcomes in Spina Bifida patients because of lower-extremity weakness.

    However, there is no available literature on transtibial amputation outcomes in this population. More distal calcanectomy and Symes amputations have been successful in restoring ambulation in lower-level Spina Bifida patients. https://journals.lww.com/ajpmr/Fulltext/2015/11000/From_Wheelchair_to_Cane__Elective_Transtibial.10.aspx

    Foot Care for Amputees

    LOOK
    Check your feet every day for any changes and use a hand mirror to see underneath your feet.


    PROTECT
    Wear correct fitting shoes and never go barefoot


    PREVENT
    Don’t allow problems to occur – wash and dry your feet properly every day.


    SEEK
    If you notice any changes immediately seek medical advice from a foot care professional


    DO
    Have an annual foot check from a podiatrist.

    For more information, you can search http://www.limbs4life.org.

  • Leg Elevation Rules

    Elevating legs occasionally

    Rest– Immediately rest the affected area as much as possible. Experts recommend 24 to 48 hours of no weight-bearing activities. Continued use of a moderate or severely sprained ankle can delay healing, increase pain, or even worsen the injury. With a mild sprain, activity is generally tolerated after 24 to 48 hours of rest.
    Ice– To help reduce pain and swelling during the first 48 hours after injury, ice the area 20 minutes at a time every 4 hours, using an ice pack covered in a towel. If you don’t have an ice pack handy, an alternative would be to use a bag of frozen peas, corn, or other veggies. Try not to ice the injury for more than 20 minutes at a time, as it may actually cause further tissue damage.

    In the majority of studies, researchers found icing was effective in numbing muscle soreness, but observed — for up to 15 minutes after ice treatment — significantly reduced:

    • Muscle strength
    • Power
    • Fine motor coordination


    Compression– Using an elastic medical bandage, wrap the area to help decrease swelling and internal bleeding (if present). The wrap should be snug, but make sure you have proper circulation. Some signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling. If you think you need to use the wrap for more than 48 to 72 hours, you may have a more serious issue that requires prompt medical attention.


    Elevating your limbs and Exercise! Raise the injured body part above heart level so that gravity can move fluids away from the injured area.

  • The frequency of lymphoedema in an adult Spina Bifida population

    The Fight Against Pressure Ulcers

    Lymphoedema


    Lymphoedema is a swelling often of your legs which is due to fluid collecting in the tissues under the skin. This can leave you prone to cellulitis and skin breakdown, and can interfere with independence as your legs get heavy and difficult to move. Ask your GP to arrange treatment with pressure stockings or appliances, which are very effective.

    The National Lymphedema Network (lymphnet.org) defines lymphedema as “an accumulation of lymphatic fluid in the interstitial tissue that causes swelling, most often in the arms and/or legs, and occasionally in other parts of the body. Lymphedema can develop when lymphatic vessels are missing or impaired or when lymph vessels are damaged or lymph nodes removed.

    Feet
    It is suggested that you see a podiatrist/chiropodist regularly to have your toenails cut and hard skin removed if you have loss of feeling or poor circulation in your feet. Use a foot-softening cream on your feet and moisturiser on your legs to prevent cracking as bacteria can enter this way. If your skin is very dry, use aqueous cream instead of soap when bathing. Dry carefully between your toes and treat athlete’s foot straight away. Creams and sprays are available from pharmacies and larger supermarkets.

    There have been very few studies to date documenting the occurrence of lymphedema in the Spina Bifida population, despite a case series in 2001 that suggested that the occurrence may be higher than in the general population. A total of 240 electronic medical records from the Adult Spina Bifida Clinic from January 2005 to August 2008 were retrospectively reviewed.

    This is why incontinence/ moisture management, movement, and sensation are important for Spina Bifida patients.

    10 Methods to tackle swollen feet

    1. Drink 8 to 10 glasses of water per day
      Though it might seem counterintuitive, getting enough fluids actually helps reduce swelling. When your body isn’t hydrated enough, it holds onto the fluid it does have. This contributes to swelling.
    2. Buy compression socks
      Compression socks can be found at a drug or grocery store or even bought online. Start with compression socks that are between 12 to 15 mm or 15 to 20 mm of mercury.

    They come in a variety of weights and compressions, so it might be best to start off with lighter-weight socks and then find the kind that provides the most relief.

    1. Soak in a cool Epsom salt bath for about 15 to 20 minutes
      Epsom salt (magnesium sulfate) may not only help with muscle pain. It may also reduce swelling and inflammation. The theory is that Epsom salt draws out toxins and increases relaxation.

    Just make sure to get Epsom salts marked with the USP designation. This means that it meets standards set forth by the U.S. Food and Drug Administration and is safe to use.

    1. Elevate your feet, preferably above your heart
      Prop your feet on cushions, pillows, or even things like phone books, when you sleep. If you’re looking to reduce foot swelling while pregnant, try elevating your feet several times a day as well. Aim for about 20 minutes at a time, even on an ottoman or a chair.

    Try to avoid standing for long periods of time and stay off your feet when you can.

    1. Get moving!
      If you sit or stand in one area for a long period of time (like at work), this can lead to swollen feet. Try to move a little bit each hour, even if it’s a walk to the break room, a walk around the block at lunch, flexing your knees and ankles, or a lap around the office.
    2. Magnesium supplements can be helpful for some people
      If you retain water, you might have a magnesium deficiency. Eating foods high in magnesium can help. Magnesium-rich foods. Trusted Source to add to your diet include:
    • almonds
    • tofu
    • cashews
    • spinach
    • dark chocolate
    • broccoli
    • avocados
    • Taking 200 to 400 milligrams of magnesium daily might help with the swelling. But before you take any kind of supplement, ask your doctor. Magnesium supplements aren’t right for everyone, especially if you have a kidney or heart condition.
    1. Make some dietary changes
      Reducing your sodium intake can help decrease swelling in your body, including in your feet. Opt for low-sodium versions of your favourite foods, and try to refrain from adding salt to meals.
    2. Lose weight if you’re overweight
      Being overweight can cause reduced blood circulation, leading to swelling of the lower extremities. It can also lead to extra strain on the feet, causing pain when walking. This can result in being more sedentary — which can also cause fluid buildup in the feet.

    Losing weight can help ease the strain on your feet and possibly reduce foot swelling as well. Talk with your doctor about whether you need to lose weight and healthy ways to go about doing so.

    1. Massage your feet
      Massage can be great for swollen feet and can also promote relaxation. Massage (or have someone massage them for you!) your feet toward your heart with firm strokes and some pressure. This can help move the fluid out of the area and reduce swelling.
    2. Increase your intake of potassium-rich foods
      A potassium deficiency can contribute to high blood pressure and water retention. If you have no dietary restrictions, consider eating foods containing potassium. Some potassium-rich foods. Trusted Source include:
    • sweet potatoes
    • white beans
    • bananas
    • salmon
    • pistachios
    • chicken
    • Try drinking orange juice or low-fat milk instead of soda, too. If you have any medical conditions, especially kidney issues, talk with your doctor before adding lots of potassium to your diet.

    How long should I elevate my feet to reduce swelling?


    The more the swelling and the longer there has been swelling, the longer and more frequently your need to elevate your legs. Start with 20 minutes twice a day. This might do the trick. If not, go to 30 minutes or even an hour.

    LET’S WORK TOGETHER TO STOP THE PRESSURE!!!

    https://www.shinecharity.org.uk/self-care/skin-and-tissue

    https://mobilitymgmt.com/Articles/2011/06/01/Lymphedema.aspx

  • The Fight Against Pressure Ulcers!!!

    MORE TIPS

    Skin Checks
    Surfaces- Beware of pressure on pelvic bones depending on how you sit.
    Keep Moving
    Increased Moisture Management because increased moisture could imply or result in heart failure.
    Nutrition

    STOP THE PRESSURE!!!

    http://www.legsmatter.org.

  • Dietary Impact of Food on Pressure Ulcers

    Pressure ulcers (also known as pressure sores) occur when the skin and surrounding tissue is damaged by medical devices or the weight of the body pressing down. This restricts blood flow and the delivery of oxygen and nutrients to the area. They often develop where bones are close to the skin such as on the lower back/spine, hips, heels and elbows. Having a poor nutrient and fluid intake can increase the risk of pressure ulcers.

    The risk increases in those who are underweight or overweight. Maintaining a healthy weight and eating a balanced diet can reduce the risk of developing pressure ulcers. You should try to adopt a meal plan like this:

    Breakfast
    Mid-morning snack
    Lunch
    Mid-afternoon snack
    Dinner
    dessert

    This is because being overweight can reduce mobility and increase the weight bearing load through pressure areas such as the bottom.
    Being underweight can mean there is less natural padding on bony areas such as the bottom and hips.
    The skin needs a good supply of fluid and nutrients to maintain its circulation and keep it supple.


    Nutrition and pressure damage
    Once a pressure ulcer has developed, nutrition plays a vital role in the healing process. This is because the body needs protein, energy (calories), vitamins and minerals (such as vitamin C, iron and zinc), and plenty of fluids to support the wound healing process.

    Protein
    Your body may need more protein if you have a pressure ulcer. Foods that are high in protein include meat, fish, eggs, dairy products, nuts, beans and pulses. Try to have at least one of these foods at each meal. Aim to have one pint of milk per day or a variety of milk and dairy foods such as milk puddings, cheese or yoghurts.

    If you are overweight choose low fat versions. They contain the same amount of protein as full fat versions but are lower in calories. There are also some yoghurts, ice cream and milks available that contain higher amounts of protein.

    If you use milk substitutes, soya milk contains a similar amount of protein as cow’s milk. Oat, rice, hemp and nut based milks contain significantly less protein.

    Iron
    Iron is important for the healing process by helping to maintain adequate blood haemoglobin levels. Foods that are good sources of iron include meat, fish and eggs. Iron is also found in other food such as beans, pulses, green vegetables and dried fruit, but these are less easily absorbed.

    Vitamin C
    Vitamin C helps with the absorption of iron from your food and also directly with the healing process. Vitamin C is found in a wide variety of fruit and vegetables. It is not stored in the body so a daily supply is needed. Vitamin C is destroyed during the cooking process, so it is important not to overcook your vegetables, or if possible, steam them. Drinking a small glass of fruit juice (150ml) with your meal is a good way to improve your intake. If your vitamin C intake remains low you may need to take a supplement.

    Zinc
    Zinc is important for the formation of new skin tissue and to help pressure ulcers to heal. Good sources are lean red meat, shell fish, milk, cheese, bread, lentils, beans and cereal products such as wheatgerm.

    Vitamin and mineral supplements
    If you cannot eat enough foods containing key vitamins and minerals then you may need to take a supplement. If you are unable to manage a varied diet, or have a poor appetite, an “A to Z” type vitamin and mineral supplement may be necessary and these are available from many high street chemists. If you are managing to eat a full and varied diet then there is no benefit in taking high levels of vitamins and mineral supplements – in fact, this can be harmful.

    Fluid
    Dehydrated skin can become dry and fragile. It is important that your skin is kept moist from the inside. You should aim for 1.5 to two litres per day (six to ten mugs). This could include any liquid (tea, coffee, milk, water, juice) but not alcohol. If you are overweight avoid drinks that contain sugar, choosing sugar free alternatives or using low-calorie sweeteners in hot drinks.

    Body weight
    If you are overweight, losing weight could help to reduce the risk of pressure ulcers and protect a newly healed pressure ulcer. However, if you restrict your intake too much whilst a pressure ulcer is healing it could delay the healing process.

    It is important that you maintain a balance to your diet so that your body continues to get all the nutrients it needs. Simple changes that you could make to your diet if you are overweight are:

    • Cutting out sugar from hot drinks or using a sweetener.
    • Using low fat cooking methods such as grilling, baking, microwaving or steaming rather than frying.
    • Opting for snacks that are lower in energy and fat such as low fat yoghurts and fruit.
    • Remember to have meals that are balanced. Try not to miss meals.
    • Aim to lose an average of no more than 0.5 to 1kg a week.


    If you are underweight, pressure ulcers need a lot of nutrients to help them heal. If you are underweight you may not have enough nutrient stores in your body so you will need extra nutrition from your diet. Without nutrients the healing process may take longer. Some changes that could help to increase your intake are:

    Ensure that you have regular meals. If you find it difficult to prepare and cook meals then there are a wide variety of tinned, chilled or frozen ‘ready meals’ available. Frozen or tinned vegetables can also be useful.
    Try to have three small meals and two to three nourishing snacks throughout the day (such as yoghurts, cheese, nuts and biscuits).
    If your appetite is poor, try to also include two nourishing drinks each day such as: milk, malted milk drinks, fruit juice or powdered supplement drinks which are available from your local chemist or supermarket.
    Oral Nutritional Supplements (sip feeds)
    If your food intake remains low, it may not be enough to help heal the pressure ulcer. If this is the case, it may be necessary for you to have some prescribed oral nutritional supplements. These types of drinks provide a rich source of energy, protein and other nutrients. A dietitian may be available to discuss with you the most appropriate one and how many you will need. You should not take additional vitamins and mineral supplements if you are taking three or more oral nutritional supplements per day.

    If you have diabetes, poorly controlled diabetes can delay healing. Diet and medication may need to be adjusted to achieve good diabetic control. Speak to your GP, nurse or dietitian if you require help with this.

    Eating a balanced diet and having a healthy body weight will help to reduce the risk of developing a pressure ulcer. If you have a pressure ulcer, eating and drinking well will help it to heal. If you are overweight then it would be beneficial to try to lose weight gradually. If you are underweight then weight gain will help improve the padding over the bones. This can be best achieved by eating small and frequent meals and snacks.

    For more information, you can follow: https://www.bda.uk.com/resource/pressure-ulcers-pressure-sores-diet.html.