If a Person has Contractures, are They at an Increased Likelihood for Developing Bed Sores?

By Nursing Home Law Center

Yes, patients with contractures are more likely to form bed sores than other patients.

What are Contractures?

A contracture occurs when a shortened or compromised muscle or tendon renders a joint immobile. They are difficult to cure and require aggressive orthopedic surgery. Since immobility is the key risk factor in developing a bed sore, contractures contribute to the problem by reducing the patient's ability to move.


What is a Bed Sore?

A bed sore is an area of the body whose tissue has died or degraded due to being oxygen deprived. When a person exerts pressure continuously on a part of the body, it restricts the flow of blood carrying oxygen to all parts of the body.

Over time, oxygen-starved tissue will open up into a wound that may seep liquid and become infected. At first the bed sore may only itch, but when it opens into a wound it will be quite painful. Eventually, the wound may deepen and reach the level of the muscle or even the bone.

At this point, infection becomes a major concern. Gangrene can eat away at the flesh and osteomyelitis may affect the bone, causing it to die and require removal. For serious bed sores, surgery is often necessary.

Where do Bed Sores Usually Develop?

Several factors can influence the location of the development of a bed sore. Fat, for instance, because it acts like a cushioning agent against the weight of the body, can reduce the likelihood of a bed sore forming. This means that, body parts without much fat are at elevated risk of developing bed sores.

Any part of the body that protrudes will naturally tend to bear more weight as the body lies immobile for long periods of time. Given this, bony protuberances on the body, which stick out and have little fat, are some of the likeliest spots for pressure sores to form. The position the patient is lying or sitting in is also a factor.

Bed sores most often form in the following areas:

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

Who is at Risk for Forming Bed Sores?

Though anyone can develop a bed sore, people who have been immobile for long periods of time are most likely to develop them. Some sectors of the population are more immobile than others, for a variety of reasons. There are also confounding factors which can make pressure sores more likely to form as well as more difficult to heal.

Some of these conditions are:

  • Paralysis. Patients with paralysis are unable to move or find great difficulty moving. People with quadriplegia cannot move any limbs and paraplegics may have difficulty moving their legs.
  • Coma. Comatose patients are not like sleeping patients. When we sleep, we can toss and turn, but a patient in a coma will not move at all.
  • Weakness. A patient may lack the energy to move. This is common among elderly patients.
  • Smoking. A person who smokes has greater difficult healing. Thus, when bed sores form, they present a more serious problem.
  • Malnourishment. Patients without the proper vitamins and minerals in their bodies are more susceptible to forming pressure sores.
  • Diabetes. A person with diabetes, like a smoker, has difficulty healing from wounds. The disease compromises the sense of touch in their extremities so they might be forming a bed sore and not even know it.
  • Atheroma. Atheroma is plaque buildup in the arteries. Such a condition can reduce blood flow. A patient with atheroma will have greater difficulty lying immobile.
  • Dehydration. Dehydrated skin is more likely to develop open wounds.
  • Incontinence. Not only is wet skin more at risk for pressure sores developing, but urine and fecal matter have a corrosive effect on the skin.


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