What are pressure sores?

Pressure sores are variously described as pressure ulcers, decubitus ulcers, bedsores, pressure necrosis, and ischaemic ulcers. Essentially, they can all be characterized as “any lesion caused by unrelieved pressure resulting in damage of underlying tissue”. In basic terminology they can be called Wounds.

Factors contributing to the development of “Wounds”?

Pressure, Shear, Friction, Moisture, Quality of care, Positioning, Support Surface, Temperature.

What does pressure mapping measure?

In real terms, pressure mapping measures millimeters of mercury (mmHg), which is a measure of pressure. Pressure mapping does not measure shear, stability, maintenance or comfort. It is important to remember that pressure mapping is a clinical tool, much like a tape measure or digital camera, and must be used as an integral part of thorough assessment and clinical reasoning processes.

Average Capillary Pressure.

Any internal or external force applied to bony prominences of greater than 32 mmHg can contribute to capillary closure and cause tissue hypoxia resulting in pressure ulcers.

Using pressure mapping in clinical practice.

Pressure mapping is a clinical tool, and should be integrated with the other skills and tools already used. Pressure mapping can be incorporated in the assessment process, and is used by the authors to verify their hands on assessment. The following is suggested as a way to incorporate the use of this technology into practice:

• Take a baseline recording. This shows the pressure distribution of the client on their existing support surface. Do this before you change anything about the support surface.

• Take a distribution on a firm surface (if evaluating a client’s seating). This allows the clinician to really see what is happening at the interface, in terms of obliquities, rotations and weight bearing surfaces.

• Whilst in the process of trialling different support surfaces, map each one. However it is important to remember the characteristics of each support surface in order to adequately map each one.

• Document clinical decisions and the reasoning behind it. Pressure mapping offers a unique way to present information to funding agencies. And when combined with photographs, pressure mapping helps form a powerful justification.