Is Necrotizing Fasciitis Related to Bed Sores?

By Nursing Home Law Center

Bed sores are painful medical conditions that can arise from nursing home negligence. When a patient spends too much time in one position, pressure under the skin builds and damages the tissue of the skin and muscle. A bed sore, or pressure ulcer, is most likely to occur on areas of the skin that cover bony parts of the body – for example, the hips, shoulders, tailbone, ankles, and heels.

People at the highest risk for bed sores are those who have a medical condition that limits their ability to ambulate. Bedridden patients require frequent turning to keep bony prominences from damaging what could already be delicate skin and tissue.

Unfortunately, bed sores can develop quickly. While many heal with appropriate treatment, some may never heal. In more serious cases, pressure ulcers can lead to conditions like cellulitis, sepsis, and other life-threatening complications like necrotizing fasciitis.

How do Bedsores Occur?

To understand how necrotizing fasciitis can develop, it’s essential to know how bedsores occur in the first place. Three main contributing factors exist:

• Pressure. On any part of the human body, pressure can restrict blood flow to tissues, which impedes the amount of oxygen able to reach the area. Blood is essential in the delivery of nutrients to your tissues. Without nutrients, the skin becomes damaged and might begin to die.
• Shearing. This occurs when two different surfaces run in different directions. For example, when a person remains upright in bed, his or her head slides down, and the tailbone moves down, but the skin covering the bone stays in place. The opposing forces are damaging when left unchanged for extended periods.
• Friction. When a person’s skin rubs against clothing or the bedsheets, it causes the skin to become fragile and more prone to injury. This especially applies if the skin is moist from incontinence or other factors.

Necrotizing Fasciitis – A Complication From Bedsores

The best way to prevent the occurrence of bed sores is through frequent movement. When providers fail to turn bed-ridden patients or provide basic care like changing bed sheets or soiled clothing, dangerous side effects can occur. A rare, but life-threatening complication of bed sores is necrotizing fasciitis.

Necrotizing fasciitis is a condition that could be linked to any number of bacterial infections, though most providers think Group A strep is the main cause. When the bacteria enter the body – say through the broken skin of a bed sore – rapid tissue death can result.

The infection spreads quickly and is accompanied by severe pain and a fever, among other symptoms, including:

• Blisters or black spots, indicating tissue death
• Sudden changes to the skin’s color
• Fatigue
• Nausea or diarrhea
• Dizziness
• Discharge from the area of infection

Necrotizing fasciitis can quickly become lethal. As the infection spreads, it can lead to sepsis, multi-system organ failure, shock, and death. Early identification and intervention is essential.

Who is at Highest Risk for Complications From Bed Sores?

Necrotizing fasciitis is not a common complication from bed sores. However, it’s good to know who is at the highest risk for pressure ulcers so providers and family members can monitor them carefully. The people at highest risk for bed sores are:

• Immobile patients
• People who have sensory perception issues, such as those suffering from a spinal cord injury
• Those dealing with malnutrition or dehydration
• Patients who have medical conditions that affect blood flow, such as diabetes and some vascular conditions

Bed sores and the subsequent risk for complications are slightly more common in such patients. Providers must remain vigilant and offer prompt treatment to damaged areas of the skin, so patients are not at risk for further infection such as necrotizing fasciitis.

Related Information

• What is surgical debridement of bed sores?
• What is ultrasound assisted wound therapy?
• What is a ‘deep tissue’ injury?

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