Medical Perspective

A Medical Practitioner's Perspective

Pressure Ulcers on the Increase

One of my dear, elderly patients was recently discharged from a teaching hospital after undergoing surgery to repair a hernia. The discharge summary claims the operation was a complete success but notes that "the patient developed heel ulcers during convalescence" which will be "looked after by the community nurses".

During my 30 years in general practice, I have witnessed the increasing technical sophistication of hospital care, but I still despair when I see my patients develop stage 4 pressure ulcers on their heels.

Sadly, my patients are developing pressure ulcers far more frequently. Prevalence studies have shown about one in 10 hospital patients has a pressure ulcer. Is this just a reflection of our ageing and increasingly frail population? Definitely not!

Pressure ulcers are mostly preventable, and usually represent substandard care.

I was first introduced to effective pressure area management while a resident doctor at Royal Prince Alfred Hospital. Even though I reminisce through the rose colored glasses of memory, regular repositioning and an abundant supply of medical sheepskins prevented even the sickest patient from developing a pressure ulcer.

Lucy, my patient with the bilateral pressure ulcers on her heels, was an active septuagenarian looking forward to getting back to her lawn bowls.

Now she is confined to a chair with her exquisitely tender, painful heels that must be dressed every couple of days for the next three to six months.

Had a medical sheepskin been placed under Lucy's heels while she was on the operating table and in the recovery ward, her months of agony could have been avoided.

By providing a friction free surface and a dense wool pile to redistribute the weight of her feet, the medical sheepskin would have enabled Lucy's vulnerable heels to be protected while she was anaesthetized and as she was transferred from table to trolley to bed.

Prevention Rather Than Cure

The Australian Medical Sheepskin with the unique properties of its dense wool pile offers health professionals a most versatile product for preventing pressure ulcers.

It provides local pressure relief when placed under the common sites of pressure neurosis such as the sacrum, trochanters and heels. It offers protection to patients where other pressure relieving devices may be unsuitable such as those with deformities and contractures.

Waterproofing is mandatory in health care facilities but the use of impermeable plastic covers causes moisture to accumulate at the skin interface.

This moisture may simply be from normal insensible perspiration or from the profuse sweating of spinal cord damaged patients or from the incontinent elderly. But when a medical sheepskin is placed between the patient and the plastic cover, wool's unique moisture absorption characteristics keep the skin dry.

Patients with dry skin can be moved without causing excessive shearing and frictional force. There is less risk of capillary rupture with concomitant deep ulceration and less risk of superficial skin tears.

Easily transportable, the Australian Medical Sheepskin stays beneath the patient as they move from bed to trolley to chair to x-ray table and so on.

Now that medical sheepskins can be laundered to meet the most rigorous infection control standards, they will be able to be used in the operating theatre which is a common site of pressure ulcer development.

Nursing Support

Many nurses have been reluctant to believe in the efficacy of the Australian Medical Sheepskin despite using the product successfully for decades. They have fallen victim to the overseas medical literature that has condemned "sheepskin", a word that refers to at best, a sheepskin without any Merino content or at worst, a synthetic polyester pile, machine knitted onto a synthetic fabric.

Genuine Australian Medical Sheepskins with their dense wool pile courtesy of their Merino content, have rarely been seen outside Australia let alone described in medical literature.

Australians are lucky to have such a product readily available for patients at risk of pressure ulceration. The judicious use of medical sheepskins in hospitals, nursing homes and the community would certainly reduce the incidence of pressure ulcers.

The above report was submitted by:

Dr. Robert Carter

Medical Practitioner

Sydney