392 Unit 4 Healthcare Skills Copyright Goodheart-Willcox Co., Inc. 3. to prevent deformities—muscles can atrophy (waste away) and cause contractures (shortening) and ankylosis (stiffening) when they are not actively moving If the patient has foot drop due to illness or injury, she will be unable to lift the front part of one or both feet due to muscle weakness or paralysis. This can cause the toes to drag on the ground while walking. When in bed, proper positioning and support will be especially important for this condition. 4. to relieve pressure and strain on the skin and to prevent the formation of a decubitus ulcer Preventing Decubitus Ulcers Many patients require assistance when moving and turning due to immobility. Certain conditions may also make it impossible for a patient to turn on his own, such as when he has serious fractures that require traction appli- ances (Figure 13.26). These appliances may be a supporting brace or suspended weights used to help injuries heal. It is especially important that immobile patients are turned regularly to prevent skin breakdown and the formation of a decubitus ulcer (also known as a bedsore or pressure sore). A decubitus ulcer is caused by pressure that restricts blood circulation to the skin. This pressure can be the result of immobility, but also the rubbing of a cover or clothing on the skin, wrinkled or wadded up sheets, irritation from tubing on or around the body, or even food crumbs among the bed- ding. Fragile skin is particularly susceptible to decubitus ulcers. Stages of Decubitus Ulcers The appearance of a decubitus ulcer can range from very mild, pink col- oration of the skin to a severe wound that extends to the bone and sometimes into internal organs. The severity of decubitus ulcers is identifi ed using four stages (Figure 13.27): • Stage 1: the skin is not open but is discolored, turning red on people with light complexions and blue or purple on those who have a darker complexion. If the skin does not turn to white when pressed, this is a sign that a decubitus ulcer has already started to form. • Stage 2: the decubitus ulcer is still considered superfi cial (or shallow) but the skin is now open. A blister fi lled with fl uid, an abrasion, or a shallow sore that looks like a crater can be seen, and the surrounding area may be irritated and red in color. ankylosis the stiffening or immobility of a joint resulting from disease, trauma, surgery, or bone fusion foot drop a condition characterized by the inability to lift the front part of one or both feet due to weakness or paralysis of the muscles in the foot causes the toes to drag on the ground while walking immobility a condition characterized by a limited, or complete lack of, ability to move traction the use of a pulling force to treat muscle and skeletal disorders decubitus ulcer a skin sore that is a result of lying in one position too long caused by pressure that interferes with blood circulation to the skin Richard Lyons/Shutterstock.com Figure 13.26 Traction appliances help support injured limbs such as a broken leg.