UCLH has a dedicated nurse led inpatient tissue viability team covering all hospital sites.

The tissue viability team is committed to providing support, training and education to clinical staff, patients and carers about maintaining, promoting skin integrity and preventing pressure sores. If during your hospital stay you have a wound that is failing to heal, or that is of concern to the staff looking after you, you may be referred to the tissue viability team for specialist advice.

The nurses in the tissue viability team can provide specialist advice on all types of wounds, including:

  • pressure ulcers
  • leg ulcers
  • surgical wounds
  • traumatic wounds.

The work of this team is important because the skin is an organ like the heart or lungs. If it is damaged, then the protection the skin provides from the outside is lessened and we may be more likely to suffer from infection, long-term open wounds or scarring. Wound care helps to make sure that the skin recovers from such damage.

Our aim is to work in partnership with patients and carers, helping them to look after their wounds and prevent the risk of future skin damage.

A pressure ulcer is damage that occurs on the skin and underlying tissue. Pressure ulcers are caused by three main things:

  • Pressure: the weight of the body pressing
    down on the skin.
  • Shearing: the layers of the skin are forced to slide over one another or over deeper tissues,e.g. when you slide down, a bed or chair.
  • Friction: rubbing the skin.


Early signs of a pressure ulcer are:

  • Change in skin colour - skin may redden
  • Change in skin temperature - hotter or colder
  • Discomfort or pain


The most common places for pressure ulcers are over bones, close to the skin such as:

  • Bottom
  • Heel
  • Back

Anyone can get a pressure ulcer, but some people are more likely to develop one than others. People who may be at increased risk include patients:

  • That have or have had a pressure ulcer
  • That have problems moving and need assistance to change position
  • That cannot feel pain over part or all of their body, for example, a damaged spinal cord
  • That are incontinent
  • That are seriously ill
  • Have a poor diet and don’t drink enough water
  • That are very old or very young
  • Having suffered an injury, for example a broken hip.

Your named nurse will assess your risk. This will involve a head-to-toe skin assessment and a discussion of the risk factors such as diabetes, a stroke, smoking or surgery.

Pressure ulcers can develop quickly and may cause pain, or mean a longer stay in hospital. They can damage deeper layers of tissue beneath the skin so they can take a long time to heal. Therefore, at UCLH to help prevent pressure ulcers we use the SSKIN care bundle that identifies five key aspects of pressure area care. Working  together we will agree what your care will be.

SSKIN stands for:

Skin Assessment
Surface
Keep moving
Incontinence
Nutrition

Skin Assessment

Your skin will be assessed regularly to check for signs of pressure ulcer development. How often your skin is checked depends on your level of risk.

Surface

We use two types of mattress. We will discuss with you which one best suits your  needs.

Keep moving

One of the best ways of preventing a pressure ulcer is to change your position regularly.

If you have reduced movement because you are in pain, the nursing team will offer you painkillers and help you to change your position. We will advise you on how  pressure is best reduced or relieved including advice on:

  • Correct sitting and lying positions
  • How to adjust your position
  • How often you need to move or be moved
  • Supporting your feet

Incontinence

It is important your skin is kept clean and dry.
Skin that is damp is at risk of damage. This
may be due to:

  • Incontinence
  • Sweating
  • A weeping wound

Nutrition

Eating well and drinking enough water is very important. We will discuss your diet with you and offer extra snacks, supplements and refer you to a dietician if needed

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