legal resources necessary to hold negligent facilities accountable.
Bed Sore Treatment
Bed sores are skin and soft tissue injuries caused by prolonged pressure, often occurring on the skin covering bony areas of the body. People at risk of pressure sores include those with limited mobility or completely immobile, such as the elderly, disabled, and extremely ill individuals.
Once a pressure sore forms, immediate treatment is crucial to prevent it from progressing. Otherwise, the dead tissue can spread, penetrate deeper into the skin, and become prone to infection.
Did you or a loved one develop pressure sores in a nursing home? Or perhaps receive poor treatment for them? If so, the nursing home abuse attorneys at Nursing Home Law Center, LLC, can help you hold the negligent parties accountable for their actions.
Contact our bedsore lawyers at (800) 926-7565 (toll-free phone number) for a free consultation to determine your legal rights.
What Are Pressure Ulcers?
"Pressure ulcers" is a term used in the USA and other countries and has been accepted as a Europe-wide term by the European Pressure Ulcer Advisory Panel (EPUAP). They are also called bedsores and decubitus ulcers.
A pressure ulcer is an injury to the skin and soft tissue caused by excessive pressure on the skin and underlying tissue. It is usually caused by sitting or laying in one position for too long, cutting off blood flow to the skin. After two to three hours of lack of circulation, the skin starts to die, and a pressure sore forms.
People at risk of these injuries have limited movement and cannot reposition themselves without assistance. At-risk groups include:
- Paralyzed patients (e.g., spinal cord injury victims)
- Wheelchair users
- Extremely ill patients
- Patients recovering from major surgery or injury
- Frail and elderly individuals
- Obese people
Pressure Sore Risk Factors
The following risk factors can make a person more prone to developing bedsores:
- Urine or stool incontinence
- Malnutrition and dehydration
- Medical conditions that affect blood flow or blood vessels (e.g., diabetes and vascular disease)
- Lack of sensory perception (e.g., inability to feel pain)
Where Do Pressure Sores Form?
People develop pressure sores in different locations, depending on their position, for most of the day. Wheelchair users tend to develop sores on the:
- Shoulder blades
- Tailbone or buttocks
- Backs of arms and legs where they rest on the wheelchair
On the other hand, people confined to their beds often develop sores on the:
- Back or sides of the head
- Lower back or tailbone
- Heels, ankles, skin behind the knees
Pressure Ulcer Stages
The signs and symptoms of a pressure sore depend on its stage. Pressure sores are divided into four stages:
The affected skin appears red and feels warm to the touch. The skin may have a blue or purple tint on dark skin. The patient may complain of slight pain, itching, or burning in the area, and the site may feel different from the surrounding skin (e.g., warmer or cooler).
If the skin color does not return to normal after removing pressure, a pressure sore has formed, and there is restricted blood flow in the area.
Once a Stage I pressure sore penetrates deeper into the skin, a Stage II sore will form. The skin is broken and has an open wound, blood-filled blister, or scratch. The area is swollen, red, and warm, indicating that the body is trying to heal itself. The sore may also leak clear fluid or pus.
The patient will complain of significant pain on the site. At this stage, keeping the wound clean is crucial to prevent the sore from worsening or contracting an infection.
A Stage III pressure ulcer has gone through the second layer of skin into the adipose (fat) tissue. The sore is crater-like and may show signs of infection, such as redness, odor, pus, heat, and drainage. If the skin has died, black dead tissue is visible in or around the sore.
Stage III bedsores have a moderate risk of contracting a life-threatening infection.
A Stage IV bedsore is a deep tissue injury and is the most severe. They are deep, large, and show signs of infection. There is also dead tissue in or around the sore, and tendons, muscles, and bones may be visible.
Stage IV injuries have the highest risk of contracting a life-threatening infection, especially for frail and immunocompromised patients.
Suspected Deep Tissue Injury (SDTI)
An STDI occurs when the skin's surface looks like a Stage I or II sore, but it is Stage III or IV underneath.
A decubitus ulcer can be unstageable if the doctor cannot see the bottom due to full-thickness tissue loss and slough or eschar on the wound bed. The doctor may flush the wound bed to determine the sore's depth.
Complications of Pressure Sores
Pressure sores are open wounds that are prone to bacterial infection. Without proper and immediate treatment, the following complications may occur:
- Cellulitis (skin and soft tissue infection)
- Bone infections (osteomyelitis) and joint infections (septic arthritis)
- Cancer (squamous cell carcinoma)
- Gangrene (death of body tissue; potentially life-threatening)
- Sepsis (potentially fatal blood infection)
Common Causes of Pressure Sores in Nursing Homes
Nursing home residents can develop pressure injuries due to:
- Infrequent Repositioning: Wheelchair users must change positions every 15 minutes and bedridden patients every two hours or less. If nursing home employees don't reposition these patients accordingly, the prolonged pressure on patients' bodies can cut off circulation and cause the skin to die.
- Lack of Risk Assessment: Nursing homes must conduct a structured risk assessment to identify residents at risk for pressure sores. Otherwise, at-risk residents may not receive the care and attention they need to avoid these injuries. Nursing staff must also carefully assess people with dark skin, as pressure sores on darker complexions are harder to see.
- Poor Hygiene Care: Extended exposure to sweat, urine, and stool increases the risk of pressure sores, as moisture makes the skin more prone to injuries.
- Inadequate Bedsore Monitoring: Nursing home staff must watch for developing pressure sores in at-risk patients and use preventative measures immediately, such as relieving pressure from the affected skin. Otherwise, sores can grow rapidly and progress into worse stages.
- Malnutrition and Dehydration: A diet lacking essential nutrients to maintain healthy skin increase the risk of bedsores. Similarly, dehydration dries the skin and makes it more susceptible to injury.
Treating Pressure Sores
Early diagnosis and treatment of pressure ulcers are crucial in preventing wound progression and infection. Treatment options for bedsores include:
Repositioning and Mobilization
According to the National Pressure Ulcer Advisory, healthcare providers must turn and reposition at-risk individuals unless contraindicated by an illness or injury.
The general clinical practice guideline for frequency of repositioning is every 15 minutes for wheelchair users and two hours or less for bedridden patients. However, the frequency can depend on other factors, such as the support surface in use, the skin's tolerance, and the patient's preferences.
Nursing staff can also relieve pressure by putting foam pads, special pillows, or mattress pads on residents' beds and wheelchairs.
Keeping the skin clean and dry can reduce its sensitivity and the risk of injury. Nursing staff can use barrier creams, incontinence pads, and fecal management systems to reduce the skin's contact with waste materials, which can cause or worsen bedsores.
Proper diapering is also crucial. Nursing staff must change patients' diapers frequently and ensure that the genitals are as clean and dry as possible.
Once a Stage II decubitus ulcer forms, an open wound on the skin's surface is susceptible to bacterial invasion. Proper wound care is essential to prevent bacteria from entering the wound and multiplying.
For Stage I pressure sores, staff must clean the affected areas with mild soap and water. A moisture barrier (cream or ointment) may also be necessary to protect the skin from bodily fluids.
A Stage II open sore should be flushed with saline solution to remove loose and dead tissue, then covered with a special dressing or gauze to protect it against infection. Using hydrogen peroxide, iodine cleansers, and even mild soap is not advisable as they can cause tissue damage.
If the patient has a pus or blood-filled blister, the general clinical practice guideline is to keep the sore covered with a dry, sterile dressing to promote healing.
In addition to cleaning the affected skin, nursing staff can apply antibacterial creams on Stage I ulcers to prevent infection on vulnerable skin.
Healthcare providers should not use topical creams on an open sore as they can aggravate the wound and cause further skin damage.
Stage III and IV bedsores involve tissue death. Hence, these sores often require debridement--the surgical removal of dead tissue--to help sores heal. The surgeon may use a high-pressure water jet or surgical appliance to remove the damaged tissue.
In some cases, surgery may also involve taking tissue from healthy skin with surgical instruments to repair an open sore (flap surgery).
Antibiotics and Pain Medications
The doctor may prescribe antibiotics to treat infections. The type and length of antibiotic use will depend on the infection's severity and the patient's overall health.
Nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen sodium) may also be necessary to help reduce pain.
Proper Nutrition and Hydration
Good nutrition and hydration are crucial for skin health, wound healing, and immunity. Vital nutrients for skin health and healing include Vitamins A, C, E, zinc, omega-3, and biotin.
Nursing homes can reduce residents' risk of skin damage by providing patients with a healthy diet and enough water daily. Furthermore, residents will be more able to recover from bedsores faster and avoid infection.
Nursing homes must also address patients that are obese or overweight, as excess weight exerts more pressure on beds and wheelchairs. Calorie-controlled diets can help these patients lose excess weight and avoid bedsores, among many other injuries.
Some mattresses are designed to help relieve pressure, such as those made with static foam or have a pump that provides a constant flow of air throughout the bed.
Hyperbaric Oxygen Therapy
Patients with severe bedsores may benefit from hyperbaric oxygen therapy, which increases oxygen in the body to promote healing. The process brings oxygen to oxygen-starved tissue, reducing swelling in the damaged blood vessels and stopping tissue death.
Friction can cause further injury and delay wound healing, especially for patients with fragile skin. Thus, nursing staff should prevent residents from rubbing against the bedding. Possible solutions may include sprinkling powder on beds and wheelchairs, installing heel and elbow cradles, and using draw sheets when repositioning patients.
Taking Legal Action For Pressure Ulcers Caused by Nursing Home Abuse
Pressure ulcers don't develop instantaneously. In most cases, a nursing home resident would have to spend hours unattended before developing a pressure sore. Furthermore, pressure ulcers are relatively easy to spot if the affected patient receives proper care and attention from staff.
Nursing homes are responsible for preventing, diagnosing, and treating pressure sores. Failure to do so can lead to complications, such as infections, cancer, and even death.
Hence, pressure ulcers are often indicators of nursing home abuse and neglect. If you or a loved one developed a pressure sore due to lack of care, you have the right to seek legal compensation for your injury.
Who is At Fault?
The liable party can be anyone from your loved one's health care team, such as doctors, nurses, or nursing aides. If the individual has failed to recognize, diagnose, or treat a pressure sore according to medical standards, they could be held responsible for a personal injury claim.
By filing a claim against responsible parties, you could recover financial compensation for:
- Medical Bills: Pressure sore treatment expenses, including hospitalization, medication, surgery, etc.
- Disability: Related damages if the pressure sore causes a disability, e.g., mobility aids, loss of quality of life, physical therapy.
- Pain and Suffering: Physical and emotional harm, including physical pain, emotional trauma, mental distress, etc.
- Loss of Quality of Life: Quality of life lost due to the injury and related complications, manifesting through reduced independence, social withdrawal, dependence on medications, etc.
- Lost Wages: Income, wages, and benefits lost while caring for an injured loved one.
- Wrongful Death: Funeral and burial costs, grief therapy, loss of consortium, and other death-related damages if your loved one dies due to pressure sore complications.
Filing a Claim or Lawsuit
Your nursing home abuse attorney will help you file a claim with the negligent facility's insurance company. The insurer may offer you a settlement, which you can accept immediately or negotiate with your lawyer's help.
If the insurance company refuses to make a fair offer or negotiations have stalled, your lawyer can help you bring your case to civil court, where a judge or jury will hear evidence from both sides. Lawsuits generally take longer than insurance settlements but may be necessary to recover fair compensation.
Schedule a Free Consultation With a Nursing Home Abuse Lawyer Today
Did you or a loved one suffer a pressure sore due to a nursing home's negligence? Or did the nursing home provide poor treatment of pressure ulcers? Whatever the case may be, you deserve financial compensation for your troubles.
The personal injury attorneys at Nursing Home Law Center attorneys, LLC, can help you seek justice for such negligence. Our experienced team defends the legal rights of abused or neglected nursing home residents, especially victims of preventable harm, such as bedsores.
Contact our lawyers at (800) 926-7565 or use the contact form for a free consultation. All confidential or sensitive information you share with our legal team will remain private under an attorney-client relationship.
Our lawyers handle all accepted cases on a contingency fee basis. You don't have to pay for our legal services unless we win your case.