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How Much is Spent Treating Bed Sores on an Annual Basis?
By Nursing Home Law Center
The last extended study of bedsores occurred in 1999 by the Agency for Healthcare Research and Quality. The study estimated that annual expenditures for bedsore treatment were between $5 billion and $8.5 billion. More recent estimates put the total cost of wound care in the United States at around $1.3 billion.
In the interim, the government stopped reimbursing hospitals for wound care costs if they considered the wound or bedsore preventable. This inducement to avoid bedsores in hospitals may be partially responsible for the reduction in bedsore costs.
What is a Bedsore?
Bedsores are wounds that form on a body part that has been subjected to continuous pressure, friction or traction. The resultant loss of blood flow to the area deprives the body of necessary oxygen and the tissue starts to die. Over time, it grows more severe if steps are not taken to treat the wound.
There are four categories of bedsores, each having to do with the severity of the sore.
- Stage I. There is no broken skin but there is red discoloration. Later, the red may darken into a purple color. The skin may be swollen, hot and hard.
- Stage II. Infection becomes a problem as the outer layers of skin are breached. Abrasions and blisters characterize this stage.
- Stage III. The skin has been worn away, revealing damaged tissue underneath. Infection is now a serious risk and immediate steps must be taken to treat the problem.
- Stage IV. A bedsore that is not treated will eventually reach stage four, where the underlying tissue has died and revealed muscle and bone underneath. This is a life-threatening condition and may require reconstructive surgery as part of treatment. The infection risk is extremely high.
What Treatment is There for Bedsores?
Treatments vary depending on the severity of the bedsore and other factors. Doctors have several options, including:
- Debridement. This involves the removal of dead tissue so that normal, still living tissue can regrow and the wound can heal. There are several different methods of debriding a wound.
- Wound Vacs. A wound vac applies suction to a wound to drain fluids. A foam-like substance is packed into the wound to keep it clean and infection free.
- Flap Reconstruction Surgery. If a bedsore is serious, flap reconstruction surgery may be necessary. This surgery takes healthy skin from another part of the body and covers over the wound.
- Colostomy. A colostomy bag may be necessary to prevent fecal matter from infecting a wound.
- Amputation. In the most severe cases, a limb may be partially or totally lost due to bedsores. This is a last step if doctors simply cannot save the body part.
Debridement can come in several varieties. Again, it is up to the doctor to determine which measure is appropriate for the patient after considering all relevant factors.
- Chemical Debridement. With this method, doctors apply enzymes to a wound to wash away the dead tissue and promote healthy tissue growth.
- Autolytic Debridement. A moist dressing covers the wound and allows the body’s own enzymes to go to work. This method may not be viable in very weak individuals whose bodies cannot heal on their own.
- Surgical Debridement. A surgeon can cut away the dead tissue. Usually, flap reconstruction surgery will follow, to close the wound and allow the body to finish healing.
- Biological Debridement. Maggots can be placed in the wound to eat away the dead tissue. This ancient method was approved for modern use not long ago. The maggots excrete chemicals which prevent infection and hasten tissue growth.
- Mechanical Debridement. Perhaps the most brutal form of debridement, mechanical debridement involves applying a damp dressing to the wound, and then ripping it away like a band aid once it has dried. This will tear away the dead tissue but may tear some living tissue as well.
While treatment is possible, prevention is always preferable. Not only does this spare the patient the suffering of enduring bedsores, it saves the hospital or nursing home money. It can also save on legal costs and man hours spent in lawsuits.
While there is some evidence that bedsores are less of a burden on health care now than they used to be, we need to do more to eliminate the problem.
- Acknowledging the Dangers and Expense of Pressure Sores
- Physician Group Gives Advice on Reducing Pressure Sores
- Kansas Hospitals Penalized over Bed Sore Development