Bed Sore Articles

Bedsores, also called pressure sores or decubitus ulcers, develop on points of the body subject to continuous pressure. The pressure restricts blood flow which necrotizes or kills the skin and tissue. Healthy individuals move around and even when they are asleep turn and roll over. This prevents a pressure point from wearing down until the skin dies.

What Factors Put You at Risk of Getting Bedsores?

There are a number of factors that contribute to getting a bedsore. Some of them are direct causes while others tend to exacerbate the problem.

• Paralysis. Trained caregivers must turn and "off-load" patients who cannot move themselves to relieve pressure and prevent tissue death.
• Coma. A patient in a coma is not like a sleeping patient. They do not roll over and must have someone frequently turn them. Pressure relieving surfaces may also assist in preventing bed sores.
• Weakness. Some elderly or sick patients lack the energy to move themselves and require assistance from caregivers.
• Smoking. Smokers have reduced healing capacity, which can exacerbate bedsores.
• Diabetes. Diabetics also suffer from reduced ability to heal.
• Atheroma. The buildup of plaque in the arteries restricts blood flow and can make it easier to develop a pressure sore.
• Dehydration. Dehydrated skin is more vulnerable to developing a bedsore.
• Incontinence. Wet skin is more susceptible to bedsores, and fecal matter is an infection threat.

Where Do Bedsores Tend to Show Up?

Bedsores form on parts of the body that bear weight when one is lying in bed or sitting in a chair. Parts of the body that protrude or have little fat to act as a cushion are especially susceptible. They include:

• Back of head
• Ankles
• Heels
• Hips
• Lower back
• Knees
• Spine

How Serious Can Bedsores Get?

Bedsores go through stages of severity. When they first appear, they are little more than swollen red spots on the skin. In later stages they are gaping craters that go down to the bone. Pressure sores fit into four categories:

• Stage I. The skin appears red and may be swollen. Later, the red may turn into purple. The skin is likely hard and warm to the touch.
• Stage II. The skin has broken open into abrasions. These do not go deeper than the surface level. There may also be blisters. Stage II presents an increased infection risk.
• Stage III. A shallow crater-like wound has formed as the skin has worn away, revealing the tissue underneath. The risk of infection is significant and the wound may emit a foul odor.
• Stage IV. The skin and tissue are entirely gone and the muscle and bone underneath are showing. The patient's life is in danger and the infection risk is a virtual certainty.

What's the Treatment?

Treatment can vary depending on circumstances, especially the severity of the bedsore. Treatment options include:

• Debridement. The chemical or surgical removal of dead skin and tissue. Not necessary for Stage I but may be for Stage II.
• Wound vacs. A device that drains liquid from a wound and fills the crater with a foam-like substance to prevent infection. Often used after debridement.
• Flap reconstruction surgery. For severe cases of bedsores, surgery to replace the missing skin with healthy skin from another site on the body may be necessary.
• Colostomy. A colostomy bag will prevent feces from getting into the wound and infecting it.
• Amputation. In the most severe of cases, a patient may lose a limb to necrosis. The surgeon removes part of the limb to save the rest of it.

Bedsores are a potentially serious - but completely preventable - problem. Nursing home and hospital staff need to be on the lookout for decubitus ulcers. Preventative measures include pressure relieving devices and frequent turns while in bed. Daily inspection of the body will catch incipient bedsores before they can break open into wounds.