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.