Any nurses out there?

I would call them a small area can be very deep and can quickly widen and deepen - best get it looked at.

Yes.

Take a photo and send to the district nurse today

Poor man it sounds dreadful.

I would call the DN. In my experience they do not mind and it may prevent it getting any worse.

I'm not a nurse, but have years of experience of pressure sore care, and I would say that you need to get it seen to.
Sometimes lack of pain can mean that a sore area has gone a bit deeper, away from the sensitive nerve endings.
As I say, I have no medical training, but always, always better to be safe than sorry with these things.

Luckygirl, do you also have the cavillon cream ?

I agree with MissAdventure sometimes lack of pain is a bad sign so he should be looked at asap.

Its the depth of the sore, rather than the area you can see on the surface.
A lot can happen underneath a fairly innocuous looking red mark.

Luckygirl It is important that the DN is made aware of this and should monitor it.

Lying on sheepskin pads is beneficial along with change of position.

I don’t know what is available for pressure points now but we used a bottle of mixture containing meths and olive oil as a preventative which worked well.

I remember using meths and zinc powder on patients whose areas of pressure were red before the skin broke. When anyone got a bed sore we were told off by matron for not turning the patients.

Luckygirl is it possible to turn him on his side for maybe 30 minutes each side with a pillow between his knees and one against his back to keep him there? Even standing for a few minutes relieves the pressure but that would have to be done frequently. Very difficult for you.

I remember those days EllanVannin I think things have changed a lot now.

Luckygirl, do you have a ripple cushion for your DH's chair? You know, the kind that has an air compressor that inflated and deflated the cells. If you don't, it might be worth asking the DN about one. Also, does he have a ripple mattress in his bed? There are also really good foam cushions that redistribute weight.
Barrier cream protects the skin around the sore, and hydrocolloid dressings are good in helping new skin to form and heal the sore.
I once helped nurse a lady with a huge sacral sore. We got it to heal, and her GP was very impressed. I don't know how long ago kalu practised, but sheepskin was outlawed years ago. Sorry kalu.

By special mattress I hope he has a powered hybrid air mattress - this one is what I see most in use. Ignore the prices, they are supplied by the NHS.

Mattress

Now the skin has broken the Community Nurse needs to come and re-evaluate - he may need a dressing along the lines of a Mepilex Border Sacrum to prevent further damage.

Sheepskin has not been outlawed but it tends only to be used as heel and elbow protectors - and it should be real sheepskin not synthetic.

As for meths - that hasn't been used for at least 30 years - or at least I hope it hasn't!

Thank you for all your helpful advice - it is much appreciated.

I have just looked up his Waterlow scale score and it is 17, so not a trivial risk level.

We have been keeping a close eye on it all day - it is no worse, and no significant pain. We have decided to see how it is overnight and talk to DN in the morning.

We do have the cavillon cream and the spray. We have only used the cream up till now, but used he spray today.

I am wondering whether he needs a better mattress and cushion. The cushion looks very hard to me; and he was still in pain last night even on the mattress. The problem is that, although he walks about a bit during the day, he cannot change position by himself during the night - apparently that is typical of PD. He has an NHS profiling bed but that does not help him to turn on his side, which is what he needs to do - I find it very hard to turn him on his side, even though he also has a slide sheet. The bed only changes his head position up and down, which does not deal with the problem.

I will talk to DN tomorrow. Thank you all for your advice - this is all new territory for me.

youtu.be/VZYu0-UjAsA
Maybe watching this kind of video could help you to help him, luckygirl.

Did you see DIY SOS the big build from Mildenhall this week? They provided a profiling bed for the gentleman, which incorporates a tilting function with timer for 30minutes, 60minutes etc. I wonder if they could advise about the mattress/bed?

Do you use a 'draw' sheet underneath him? If so you need not lift him at all. Try pulling the sheet towards you to move him and then place a pillow into his back. No lifting and very little effort. Ask the D/N to show you. It sounds as if a full re-assessment is needed. Do you have a copy of the community nursing pressure sore safeguarding protocol? If not ask for one (just asking tends to get things moving.) Good luck

Cavilon spray/cream is a barrier for use in incontinence to protect the skin - from what you say your husband has a pressure ulcer.

As he's ambulant during the day he shouldn't need turning overnight, if as I said earlier he has an appropriate mattress.

Gosh - lots of interesting advice.

One difficulty is that I can only access one side of the bed as his profiling bed is rammed in next to the double bed. I need to give this some though as the side of the bed I can access would mean I would turn him on his left side (as per the helpful video) and he cannot lie that way as it triggers his AF.

He is ambulant during the day, but in reality spends most of his time asleep in the chair on his cushion. I try to get him with his legs up on the sofa to redistribute his weight but it is difficult - he is mainly in a bent over crumpled position - he finds it hard to lift his head and he is mostly chin-on-chest.

I have always thought the cavillon was a strange thing as he is thankfully not incontinent - I feel he should have a moisturising cream to keep the skin supple.

You have all given me lots of info to use in a discussion with DN:
- does he need a different mattress?
- should he have a better cushion for the day time?
- is the Cavillon the best option for him?
- how to turn him on his side within the confines of the space and his AF? Turning him on his side might not be a good idea and might be unnecessary with the right mattress, as suggested above - it also worries me him being on his side as he has very bony flesh-free hips and I would think they are at risk of getting sore.

I will ask for a re-assessment of the whole situation. I am not the fittest, especially my back and hip and am trying hard not to crock myself up too!

Is there anything else I should be looking at/asking?

We had a Kurtain ( not sure of the spelling ) which meant I could tilt it back when Jim fell asleep and the leg rest could be lifted too . this meant he was not curled up , the OT provided it

The video link of how to turn someone on their side was a huge help and I succeeded in this last night - so his bum is less sore today. I will still ring DN as I would rather be safe than sorry and there are several other things to discuss with her.

Oh I'm so glad it helped.
Yes, please still phone the district nurse, as she will have the most up to date info, plus she does need to have a look at the sore bit.