Prevention is important with pressure ulcers. Steps to prevent pressure ulcers and further complications include:

• Daily skin inspection. Routinely check for any sign of breakdown in the skin barrier like cuts, blisters (raised areas on the skin surface that contain fluid), sores, or cracks. It is especially important to examine bony areas of the body (e.g., elbow, heels, hips, ankles, shoulders, back, back of the head). A mirror can help. Patients should immediately notify their physician if a problem is present.
  
  
• Daily hygiene. The skin should be gently but thoroughly washed and patted dry. A physician can recommend whether to use balms, lotions or powders to protect the skin. Generally, creams and oils should not be used in certain areas (e.g., between the toes) because the moisture can result in infection and skin breakdown. Nails should be trimmed along the contour of the finger or toe and any sharp edges filed. When bathing, warm (not hot) water and mild soaps are generally recommended.
  
  
• Properly fitting clothing. Correct fit of clothing is an important factor in pressure ulcer prevention. Thick seams or buckles and other fixtures may increase friction on the skin. Buying shoes late in the day can ensure a better fit because the feet tend to be less swollen in the morning. Having at least two pairs of shoes and alternating them every other day reduces the risk of pressure in the same location on the foot.
  
  
• Prevention or cessation of smoking. Smoking increases the risk of pressure ulcers because it impedes circulation.
  
  
• Control of high cholesterol (a fatty substance found in foods and produced by the body). High levels of cholesterol and other fats in the blood increase the risk of atherosclerosis, the hardening of the arteries that is a risk factor for pressure ulcers.
  
  
• Diabetes control. Close control of blood sugar results in better skin condition and a reduced risk of medical complications.
  
  
• Proper nutrition. Healthy skin is less likely to be damaged. It is important to eat a balanced diet with plenty of protein and calories.

Prevention of pressure ulcers also includes:

• Teaching patients how to shift weight in a wheelchair or bed
  
  
• Repositioning frequently, generally every two hours, by lifting rather than sliding the patient
  
  
• Avoiding donut-shape (ring) cushions, which may block circulation
  
  
• Using special mattresses or wheelchair cushions
  
  
• Protection of prominent bony areas with padding
  
  
• Avoiding massage over bony parts of the body