Caregivers Should Avoid Sudden Dragging Movements When Adjusting Posture For Bedridden People To Prevent Unnoticed Skin Shear Damage

Most casual careless moves in daily family care can cause invisible damage to fragile skin of long-term bedridden people which takes much longer to heal than common surface scratches

Many new family caregivers even those with years of practical care experience have formed a lazy habit that they grab the bedridden person by the shoulder or hip directly and drag them to the center of the bed when they need to adjust posture, change diapers or tidy the bed sheet. Most of them think the movement is not strong enough to cause harm, and they only move the person for 10 to 20 centimeters each time, there is no need to spend extra time to follow complicated formal operation procedures. This seemingly labor-saving small action has become one of the most easily overlooked risk sources in daily family care, and the harm it causes often does not show obvious symptoms immediately, so it is difficult for people to connect the subsequent skin problems with these trivial daily movements.

The hidden damage behind the dragging movement is called skin shear force injury, which is completely different from the common friction scratch that people are familiar with. When you drag a person lying on the bed, the top layer of skin may stay relatively static with the cotton sheet, but the underlying soft tissue, capillaries and muscle under the skin will be pulled to shift under the action of external force. There is no visible wound or bleeding on the surface of the skin, but the tiny blood vessels have been torn, and the blood supply of the local area will be blocked gradually. For people who have been bedridden for more than three months, or elderly people with skin aging, diabetes or long term use of hormone drugs, the healing speed of this hidden damage is less than one fifth of that of ordinary superficial scratch, and it will develop into deep intractable pressure sore if it is irritated continuously within a week.

The correct operation to avoid shear damage does not require any professional nursing equipment, and it will not take more than 30 seconds of extra time. Before you adjust the posture of the bedridden person, first gently roll the sheet on the side you are about to turn the person towards, and tuck the rolled edge under the side of the person’s body. Then place one hand on the person’s shoulder on the opposite side of the turning direction, and the other hand on the corresponding hip position, push the whole body slowly and evenly toward the target position at the same speed. When you finish the posture adjustment and place soft support pillows at the back and leg gaps, pull the folded sheet out and flatten it gently, you will complete the whole process without any dragging or pulling movement on the skin surface.

Many caregivers often make the wrong judgment that dragging is harmless because the bedridden person they take care of has very light weight, and they do not feel obvious resistance when pulling the body. In fact, the risk of shear injury has nothing to do with the weight of the care recipient, but is closely related to the firmness of the contact between the skin and the bed sheet. Even for a person weighing less than 40 kilograms, if the epidermis is dry and lacks elasticity, a small dragging force can form enough displacement between the skin and deep tissue, and the cumulative damage of 3 to 4 times of dragging a day will form a faint red mark at the sacrum position after 3 days, which is difficult to subside after resting for more than 2 hours.

You can develop a simple 10-second inspection habit after each posture adjustment, lift the edge of the clothing at the sacrum, inner ankle and back of the ear to observe the skin condition, and record all light red marks that cannot fade completely within 30 minutes after the movement. Once this kind of mark appears for more than two consecutive times, it means that your usual posture adjustment movement has caused potential shear stimulation, and you need to correct your pushing and pulling operation mode in time, and you can add a layer of smooth cotton sliding pad under the body to further reduce the friction resistance between the skin and the bed surface.