Pressure Ulcers
A pressure ulcer is generally found in patients who have diminished or absent sensation, or who are debilitated, emaciated, paralyzed, or chronically bedridden. The shearing force contributes to the destruction of deep tissue through the angulation and obstruction of blood vessels and excessive stretching of tissue. Avoid an improper environment that may exacerbate the ulcer such as infrequent shifting of the patient’s position or by friction, irritation, and pulling of the skin from ill-adjusted supports or wrinkled bedding or clothing.

• Regularly reposition immobile patients to reduce pressure and shearing forces
   
• Keep bed linens clean and free of wrinkle
   
• Prevent moisture accumulation in casts and supports to allow adequate air circulation
   
• Perform circulation-inducing massage
   

Diabetic Ulcers
The decreased circulatory capabilities of diabetic patients can result in ulcers that do not heal as quickly as ulcers in those without diabetes. Poor circulation and subsequent slower healing time increase the opportunity for infections to occur. Diabetic patients may experience additional complications as a result of their tendency to develop neuropathy, which can cause a lack of the pain sensation that would normally be associated with a sore and may cause patients to trivialize what could become a serious medical problem.
 

• Avoid wearing shoes that are too small
   
• Regularly check for protruding objects that the patient may see but not feel