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Preventing and Treating Pressure Ulcers in People with Amyotrophic Lateral Sclerosis (ALS)

People with amyotrophic lateral sclerosis (ALS) are at high risk of suffering from pressure sores or ulcers. Pressure Ulcers can result from pressure to an area of the body from a bed or chair. Any surface that presses against the skin and underlying tissues decreases circulation to the area, as the pressure collapses capillaries, interrupting the tissue's supply of oxygen and nutrients. When a person remains in one position for too long, the pressure obstructs the blood flow, causing tissue to break down. 

The first sign of this is redness. Unrelieved pressure, however, can lead to ulcer development, beginning with a red mark that won't blanch and then ends with deep tissue destruction. Thus, a red mark that won't go away is the first sign a pressure sore is developing. Many pressure sores go unnoticed for long periods because they begin at the bone or muscle and progress upward. This means underlying tissue can be severely damaged before the skin turns red. Although pressure sores can develop over any bony prominence pressing against the mattress or chair, the areas that are the most prone to tissue breakdown are the bony prominence of the vertebrae in the lower spine, tailbone and hipbones.

Appropriate repositioning helps prevent continuous pressure on any body part. People who are immobile should be turned or moved regularly and properly supported by pillows or foam to provide maximum comfort and to prevent pressure sores and deformities.

A mattress overlay, such as an alternating pressure pad or mattress, protects against pressure sores. However, a two-inch foam overlay provides only comfort. Variable-pressure mattresses composed of air pockets and spongy material are also available for optimal protection against pressure points, particularly the bony prominences. When sitting, use air, gel or foam seat cushions. Proper limb positioning helps prevent joint stiffness and contractures.

Alternating pressure mattress / low air loss mattress for prevention / treatment of pressure sores.

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Comments on The Topic
tammy (Jun 09, 2014 03:09:39 PM) [reply]
discussionI am a professional caregiver. I have a female patient with ALS for about 5 years. She is bedridden 24 / 7 and has poor health condition. I have taken care of her very carefully but she still developed bed sores on her back and hip. One of the spots is between stages II to III probably. I am trying to find a good and less expensive alternating pressure mattress since her financial condition is not so good. Considered the alternating pressure pad but I heard that it will not work well due to the thin layer. Any thoughts?
jan smith (May 27, 2006 01:23:09 AM) [reply]
discussionThis is a great piece of information. My mom is 95 and has been bed bond since early last year after she had strok. She started to have redness on her back recently. It might be the beginning of bed ulcer. May need to see doctor.

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