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Human dignity is an essential part of health care for
all residents, including those who are obese.
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Similar to
residents who are extremely underweight, bariatric patients
are at risk for a host of difficult and costly-to-resolve skin
conditions, making prevention absolutely crucial.
2
Try using the information provided here to arm your staff,
as well as bariatric patients and their families, with the
knowledge, strategies and products to achieve optimal
outcomes.
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Bariatric skin challenges
Bariatric patients face unique challenges that make them
more susceptible to skin issues:
• Reachingcertainareasofthebody–especially
underneath the large belly fold (known as the pannus)
– can be difficult for bariatric residents and their
caregivers.
2
Poor personal hygiene can result,
especially in relation to toileting. Urine or feces left
on the skin, even for a relatively short period of time,
can contribute to skin breakdown.
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• Circulationtendstobecompromisedamongbariatric
residents, primarily because blood does not travel
as efficiently through fatty tissue.
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In addition, obese
residents are at high risk for diabetes, which also
causes poor circulation.
2
Compromised circulation
can impair the skin’s ability to heal.
• Skinrubbingtogether–suchasbetweenthethighs–
is common. This situation often leads to tissue
breakdown.
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• Large,deepskinfoldsmakeitmoredifficultforobese
residents and their caregivers to assess and monitor
changes in the skin.
2
• Physicalimmobilityisattheheartofobesity-related
skin injury, including pressure ulcers.
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This is usually
due to the inability to adequately turn or reposition the
resident.
1
Pressure ulcers often develop as the result
of pressure, friction and shear.
Common skin problems
Three common skin problems for bariatric patients are
friction and shear injuries, conditions related to poor
toileting hygiene and incontinence, and pressure ulcers.
In all these situations, staffing ratios may have to be
increased in order to deliver adequate care.
2
Use the
appropriate number of staff to prevent injury.
1
In addition, be sure to invite equipment specialists or
materials managers onto patient care units to help
increase their understanding of patient care challenges
and to show them how equipment can meet the clinical
needs of patients and caregivers.
1
Friction and shear injuries. Due to their increased weight,
obese patients are at higher risk for friction and shear in-
juries. When skin rubs against and across skin, the friction
generated can injure the epidermis and deeper layers
of the skin. When obese patients are bedbound or chair-
bound and slide along hard surfaces (e.g., sliding down
in bed when the head of the bed is elevated), shear injuries
can occur.
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Friction
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Common Bariatric
Skin Concerns
What is your facility doing to prevent them?
By Alecia Cooper, RN, BS, MBA, CNOR
99156_MKT211390_CAT_Bariatric_tk.indd 24 11/8/11 3:27 PM