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Common Areas for Bed Sores

Common Areas for Bedsores to Develop

where-bed-sore-form-nursing-home-patientsBedsores are a serious problem for the elderly and can lead to life-threatening complications. If you or someone you love is at risk of developing bedsores, it's crucial to know what causes them and how they can be prevented.

Nursing Home Law Center, LLC, our personal injury attorneys are legal advocates for nursing home residents victimized by the negligent actions of caregivers, family members, and other patients.

Call our bedsore injury lawyers at (800) 926-7565 (toll-free phone number) or use the contact form to schedule a free consultation.

We want to help educate people about this issue to all work together on preventing these dangerous skin ulcers from occurring in our loved ones.

What are Bedsores?

Bedsores are damaged areas of tissue and skin that can cause life-threatening problems for the weakened, informed, and elderly. The sore occurs on different body parts when there is sustained pressure, shearing conditions, or friction.

Individuals who are bed-bound or paralyzed have an increased potential of developing bed sores on the buttocks, heel, head, back, hips, or other body areas.

Repositioning the body every fifteen minutes can significantly decrease the potential of developing pressure sores. In addition, adjusting the body reduces the risk of skin damage, tissue destruction, and increased possibilities for infection.

The most common pressure ulcer occurs when prolonged external pressure is on the skin's surface—for example, laying in one position for too long or being placed on a firm surface without proper cushioning.

Shearing is caused by the movement of the skin over the bone and causes tissue tearing, loss of skin cells, and increased risk for infection. The most common areas that develop shearing sores are on the buttocks or heels.

Friction occurs when skin-to-skin contact occurs between two surfaces with extensive pressure on the skin applied. Friction can also occur on muscle and bony tissue due to constant rubbing. Arms, elbows, and heels are the most common areas for friction sores.

What a Bed Sore Looks Like in The Beginning

Initially, an early developing pressure ulcer typically appears as a red, sore area on the skin that is often painful to the touch. In the early stages of bedsore, there will be a little swelling and bleeding, but it can easily turn into a more severe problem if left untreated.

In some cases, pressure ulcers may not be noticeable until it breaks through the skin. When this occurs, it's important to seek medical treatment immediately since bacterial infections are a serious concern for preventing further complications.

Comparatively, a Pressure wound in the later stage of development is typically deep with extensive damage of underlying tissue and muscles.

In addition, layers of skin can peel away from one another, increasing the risk of developing more pressure ulcers and further infection due to bacteria or fluid leakage. At this stage, the formation of pressure injuries can be difficult to manage and requires immediate medical attention.

Are Bedsores the Same as Pressure Ulcers?

Although bedsores and pressure ulcers are often used interchangeably, doctors sometimes use different terms to mean.

For example, the wound is at an advancing stage. However, bedsores are often recognized as pressure sores, ulcers, wounds, and decubitus ulcers.

Clinically, a pressure ulcer might involve a sore that occurs when excess pressure causes local damage to the dermis and epidermis over some time. In the beginning stages, this will cause minor cuts or blood circulation problems in the affected area but can quickly develop into a larger problem if untreated.

Pressure ulcer commonly develops over bony areas such as hips or heels but can also occur on soft tissue areas if left unchecked for extended periods.

In contrast, bedsore refers to any sore caused by shearing, friction, or prolonged external pressure to the skin. This bedsore can happen in all body areas and is usually more intense than pressure ulcers since it damages the soft dermis and epidermis layers and bones.

Signs You May Have a Pressure Ulcer or Bedsore

Individuals at risk for developing bedsores often display multiple symptoms before extensive damage to tissues, muscle, bones, and other structures in the affected area.

These common signs of infection include:

  • Difficulty moving around normally
  • Unexplained changes in skin color or texture
  • Redness or discoloration of skin near the site of a pressure ulcer
  • Severe pain while laying down or trying to change positions

Caregivers need to be aware of these signs so that they may act quickly when necessary.

Assistive Devices Can Minimize Skin Damage

With so many pressure sores, preventing them from forming in the early stages can be challenging. However, various products help reduce further damage and improve the quality of life for patients with bedsores. Some examples include:

As part of an overall care plan, these products can help prevent sores in the future by reducing risk factors associated with developing bedsores.

How Bedsores are Diagnosed

Doctors, diagnosticians, wound care specialists, nurses, nursing aides are trained to identify the initial stages of developing bedsores. Typically, the skin around an area of suspected pressure ulcer is assessed.

A breakdown of the epidermis or dermis, also known as skin necrosis, is the most common indication that a pressure ulcer has developed. However, should there be no signs of damage to the dermis and epidermis layers yet, clinicians can use either a visual approach or non-invasive measures to determine whether the patient will develop an area of compromised tissue.

Through visual examination, physicians look for one or more of these visible stages in determining if it's likely that the patient will develop an area of severe skin damage:

  • Reddened skin
  • Dry, leathery texture present on both sides of the wound
  • Significant loss of the dermis and epidermis layers surrounding the wound
  • Significant cutaneous inflammation

When examining a patient, clinicians typically check for redness, swelling, and warmth in the at-risk area. This examination requires touching the skin with a gloved hand or a cotton swab to determine if an infection has already formed.

Non-invasive measures can be used to assess how likely it is that a nonexistent lesion will develop into a full-blown bedsore. The most common of these diagnostic tests are:

  • Percutaneous Electrical Bioimpedance (PEB): PEB uses electrodes placed on the skin's surface to measure electrical impedance in the body tissues. This method takes readings from different depths to calculate fluid levels beneath the skin's surface.
  • Computerized Tomography (CT): This diagnostic test creates images, or pictures, using x-rays and computers. The patient is placed on a table that slides into the CT machine, scanned completely by emitting radiation waves through their body. Then, the technician takes images from different angles to create a three-dimensional view of the area of concern.
  • Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields and radio waves to take images of the internal structures in the body. Since this procedure is non-invasive, there are no worries about damage to the dermis and epidermis layers due to friction or pressure applied during an examination. Usually, patients sit inside an open cylinder similar to what is seen in an x-ray machine.

After the clinician has gathered enough information, they will create a treatment plan that involves detailed skincare around the area of concern. Findings are then communicated to any other health care providers involved with the patient's care.

Symptoms of Bedsores

Pressure ulcers may develop as a noticeable red area on the skin's surface or an open wound without discoloration.

Many elderly individuals that have developed bedsores report feeling a constant itch or burn at the site. In addition, there may be pain, warmth, or mild numbness in the tissue surrounding the lesion.

In some cases, it is difficult to identify if bedsores are developing because there are no visual signs present until an open wound has occurred.

There are three different classifications of pressure ulcers:

  • Stage I: The epidermis shows visible damage and could lead to ulceration.
  • Stage II: An open sore with damage down to the subcutaneous epidermis (the layer between skin and muscle) and possibly involving tendons and bone structures.
  • Stage III: This is the most severe pressure sore that penetrates all layers of skin, causing damage to muscle and bone tissue.
  • Stage IV: This Life-threatening stage involves severe open wounds exposing muscles, ligaments, tendons, and bone tissue to outside environments, leading to the risk of bone infections (osteomyelitis) or blood infections (sepsis).
  • Unstageable: In some incidents, there is too much debris, necrotic (dead) tissue, or other particles filling the open wound that makes it nearly impossible for the doctor to accurately identify its stage.
  • Deep Tissue Injury: The tissue damage has reached down to skeletal muscles, tendons, or bone. If the infection spreads, it could lead to osteomyelitis or septic arthritis.
How are Bedsores Treated?

Most bedsores are treated by a physician with topical antibiotics and wound cleansing medications. Burn dressings may also be used in some cases if there is extensive damage.

More serious stages of pressure ulcers will require surgical debridement (removal of dead epidermis function). The opening can then be closed using skin grafts taken from different areas of the individual's body.

Surgery is necessary when the patient shows a beginning sign of possible sepsis, osteomyelitis, or other complications involving formation spread to major organs in the body.

Patients must be placed on bedrest with enough pillows or foam wedges supporting their back while lying in a prone position (on the stomach). They must also be repositioned at least every two hours to prevent further sores from developing.

Without this, it will only continue to get worse and damage muscles and epidermis underneath the skin. In addition, physical therapy may be needed to improve mobility and range of motion (ROM) for individuals experiencing pain when moving around freely.

Other Treatment Options to Maximize the Healing Process

Many different treatment options depend on the severity of the lesion(s) found. However, some other examples include:

  • Performing electrical stimulation
  • Dressing wounds with artificial dermis (Integra)
  • Healing by secondary intention - skin grafts are performed to close the wound

It is strongly encouraged that individuals involved in elderly care assistance with daily activities. This car includes personal hygiene, grooming, and feeding. In addition, it is important to make sure that mobility aids are used if there are any severe balance issues. Transportation devices should also be adjusted appropriately to allow for height adjustment of footrests to prevent pressure ulcers from occurring.

Keeping the knees tucked under instead of holding them up with pillows is advised when positioning the person on their side.

The only exception is when using a wheelchair or being transferred into/out of bed after repositioning. Keep all bedding smooth and tight around bony prominences (knees, hips, elbows, heels) to avoid bedsores.

Thorough hands-on skin assessments should be performed to determine any signs of pressure ulcers or other skin conditions. If pain or temperature changes are found in the feet, this could indicate possible blood clots, which could easily allow bedsores to develop.

It is crucial always to assess the stage of pressure sores since they can worsen quickly if not treated properly. Making sure that there is no redness present can also be helpful when determining whether it is healing or getting worse.

If the person is bedridden or in a wheelchair, occupational therapists may provide therapeutic exercises to improve range of motion and muscle strength without straining the sore area(s).

What Precautions Should Be Taken?
  • Make sure patient positioning equipment has been appropriately fitted before use
  • Inspect the skin for any signs of redness or open sores that may be increasing in size or depth
  • Use a CT scanner to identify the depth if it is too difficult for a doctor to determine this visually
  • Report any stage 2 and 3 pressure ulcers immediately to avoid further complications from occurring
What is Deep Tissue Injury?

Deep tissue injury refers to damage that has occurred down at the skeletal muscles, tendons, or even bones. If an infection spreads, osteomyelitis or septic arthritis may occur.

How are Deep Tissue Injuries Treated?

Most deep tissue injuries are treated by a physician with topical antibiotics and wound cleansing medications. Burn dressings may also be used in addition to compression bandages if needed.

If an infection has occurred, it will be treated with intravenous antibiotics depending on the severity of the case. Pain medications may also be given to lessen any discomfort or agitation after deep tissue injuries are sustained.

Simple Measures for Prevention

Since ulcers can be caused by poor positioning and lack of skin hygiene, no single preventative measure works for everyone.

However, if a caregiver or doctor suspects that a patient is at risk for developing pressure ulcers during their hospital stay, preventative measures must be taken immediately. Some ways to reduce this risk include:

  • Ensuring proper positioning of the patient
  • Providing proper nutrition and hydration to prevent dehydration
  • Making sure that all wet or soiled linens are changed immediately
  • Applying moist wound dressings if necessary

There are many things you can do at home to prevent bedsores from developing. The following are some helpful tips:

  • Keep your loved one clean and dry by frequently changing their position in bed or on a reclining chair. Keeping the skin dry is key because moisture increases your chances of developing ulceration.
  • Make sure they have soft clothing made of cotton against the skin. Never use wool as it creates friction on the surface, which leads to lesions. Also, be careful not to bunch up clothes around bony areas such as the tailbone, hips, and heels.
  • Be aware of skin conditions, color changes, rashes, or sores that have recently appeared. These could be signs of infections that will need medical attention. Do not apply oils or ointment without consulting a medical professional.

Consult with your loved one's medical care provider about using special beds or cushions to reduce pressure on specific areas such as your loved one's hips and feet. If you are caring for a loved one that is bed-bound or paralyzed, consult with their medical professional about skin conditions and the use of pressure relief mattresses.

Covid-19 and Bedsores

The spread of Covid-19 throughout nursing homes is created a serious problem in the healthcare industry when residents are exposed to life-threatening contagion. However, medical scientists have yet to identify the extent of diminishing mobility creating the perfect environment for developing pressure sores.

Prevention is better than cure! Being aware of how to prevent these sores from developing will save you time, money, stress, and it will greatly improve your loved one's quality of life. Contact our law office today for additional health information on preventing a developing pressure ulcer and diminishing the health of those confined to a bed or wheelchair.

Were you or a loved one injured by a facility-acquired bedsore?
Pressure Ulcer on the Buttocks

The hipbones, buttocks, and tailbone have an increased potential of developing a pressure ulcer for paralyzed individuals or wheelchair users. In addition, paralyzed individuals will often develop pressure ulcers through a loss of sensation from the waist down.

Individuals who use a wheelchair might not change positions to alleviate the pressure on the sacrum, back of the legs, and buttocks.

Pressure Sore on the Heel

Developing a pressure sore on the heel is usually the result of confinement in a bed or wheelchair. Tight bedsheets can constrict the foot and ankle while increasing the potential of a pressure sore on the heel when the person cannot move their lower extremities.

Pressure Injuries on the Shoulder Blades and Head

A pressure ulcer on the head is often undetected because it can be hidden by the patient's hair, even though it is one of the common areas for bed sores. A back-head pressure ulcer is often the result of immobility when paralyzed or in a coma.

The head must be repositioned every fifteen minutes to minimize the potential of developing bedsore.

Decubitus Ulcer on the Back

Developing a decubitus ulcer is common on individuals' back, shoulders, and arms confined to the bed or wheelchair. This ulcer is common because hard objects from the wheelchair, including the armrests, mattress, and linens on the bed, produce constant pressure on the skin.

The shoulder blades and spine can easily rub against the back of the chair or mattress springs, causing pressure ulcers. Additionally, wheelchairs can produce extensive decubitus ulcers through friction when the chair is rolling.

The Best Bed Sore Treatment is to Prevent Them from Initially Developing

The Best Bed Sore Treatment is to Prevent Them from Initially DevelopingNearly every type of bedsore (Also known as Pressure Ulcers, Pressure Sores, Decubitus Ulcers) can be prevented, especially in a clinical setting. Individuals that have the greatest potential for pressure ulcers include those with degrading skin integrity at common sites who:

  • Are recently experiencing a hip fracture, which can often continue to develop long after leaving the nursing home or hospital
  • Are confined to a wheelchair or bed, especially if suffering from a spinal injury
  • Are unable to reposition the body without assistance, including those in a coma paralyzed, injured, or recovering from surgery
  • Are unable to control the bowels or bladder, where the body might come in
  • contact with excess moisture, which can soften or irritate the skin
  • Are malnourished and not eating a proper healthy diet containing adequate protein, which can slow the healing process
  • Are getting older, when the skin often becomes significantly more fragile, thinner, and less elastic
  • Are smokers, where blood flow cannot provide adequate nourishment and oxygen to the skin
  • Are experiencing a fever, with a higher body temperature, placing excess stress on skin already at risk for developing pressure ulcers
  • Are already suffering significant health issues, compromising the healing process, including diabetics and those with heart disease

The best way to treat pressure ulcers is through prevention or taking steps to reduce any further damage. The best treatments relieve pressure on the skin by often repositioning the body, allowing the body weight to spread evenly across the mattress, wheelchair, or other support.

Caregivers should keep the pressure ulcer clean and covered, and slightly moist. In addition, the person must be fed a healthy diet.

Do You Know Someone Who is at Risk for Pressure Ulcers?
Do You Know Someone Who is at Risk for Pressure Ulcers?

The risk of developing pressure ulcers is a common problem when people spend long periods in one position.

They usually form on skin that's under pressure, such as where your body weight presses against the bed or chair. This ulcer can happen to anyone who spends a lot of time sitting or lying down, especially if they have poor blood flow from conditions like diabetes and obesity.

But even healthy people can get them after surgery, injury, or illness. If not treated properly, pressure sores can lead to serious infections and other complications – including death. That's why it's so crucial to keep an eye out for early signs of damage and act right away!

You don't want to wait until there's already permanent damage before you act - because once there's irreversible epidermis loss, it may be too late! So, don't let this happen to your loved ones - make sure they're getting the care they need by calling us today!

We'll help ensure their safety with our professional services, which include:

  • Repositioning patients every two hours while awake (or more frequently)
  • Using proper positioning equipment (such as wedges)
  • Turning patients regularly throughout the day (at least every 2 hours)
  • Applying moisture-retaining dressings on wounds daily

These simple actions will go a long way towards preventing pressure sores from starting in the first place! So, call us now at (888) 424-5757 (toll-free phone number), or use the contact form to schedule a free consultation.

Legal Responsibility of Facilities to Prevent & Treat Bed Sore

The medical staff and administrators at a hospital, nursing home, or assisted living facility are responsible for providing every elder or injured patient with proper care.

They have to provide treatment to avoid decubitus ulcers, promptly identify pressure sores surfacing, and treat existing sores to ensure they do not worsen, become infected, or lead to serious health issues.

Nursing Home Law Center LLC at (800) 926-7565 hold the medical staff accountable for negligence leading to pressure ulcers, including:

  • Failing to reposition patients
  • Failing to monitor and treat pressure ulcers properly
  • Failing to provide proper nutrition to promote bedsore healing
  • Failing to provide necessary assistance with the patient's hygiene

Our seasoned pressure sore attorneys are experienced in established elder law and pursue justice and security for every client. We hold responsible parties accountable to protect the rights of the injured when seeking financial recovery.

Call our legal team today for legal advice. Let us discuss receiving financial compensation related to your damages.

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