Skin is the body’s defence against external elements. There are two main tissue layers – the epidermis (outer layer) and the dermis (the layer that provides nutrients to the epidermis from the blood supply). The epidermis on a child is on average 30% thinner than in adults, and the epidermis is 20% thinner. As a result, PU prevalence rates can be as high as 27% in paediatric intensive care units and as high as 23% in neonatal intensive care units.
Pressure ulcers in children can cause scars which can be distressing in both physical and social terms, especially those that develop on the head preventing hair growth.
Detrimental changes in body image can make children withdrawn and have a negative effect on socialisation and education (Kozierowski, 1996).
Around 50% of the pressure sores that affect children are caused by friction from the device that is helping their treatment, which makes them difficult to avoid. However, by checking the skin regularly and using equipment to redistribute the pressure, such as a dermal gel pad or evacuated bead supports, something that is manufactured by Karomed onsite, this risk can be decreased. It is also important to use breathable silicone adhesives that are easily removed, and that water based solvents are used to help the tape removal.
A number of risk assessment tools for paediatric PU prevention are now available which have been adapted from the corresponding adult scales.