OsteomyelitisUnderlying osteomyelitis is often associated with pressure sores. The pressure sore is not a direct cause of the development of osteomyelitis (infection in bone). However, the open wound can lead to an increased rate of the area becoming infected. A pressure sore is often referred to as a decubitus ulcer, pressure ulcer or bedsore.
Osteomyelitis is an infection of bone material caused by bacteria, which can delay healing of shallow bedsores. Nearly one in three cases of pressure ulcers in advanced stages has an associated prevalence of osteomyelitis.
The infection in bone material often develops in the first 14 days of a developing pressure ulcer. When the infection is involved in advancing stages (stage III & stage IV) of a decubitus ulcer, it often increases the length of hospitalization or medical care. In some cases involving pressure ulcers in lower extremities, amputation of the limb may be the only remedy.Defining a Pressure Sore
Pressure sores are areas of necrotic (dead) tissue due to compression on a bony prominence of the body against an external surface. Pressure on the skin can come from a mattress, wheelchair, chair, prosthetic, equipment and even another body part. The compression stops blood flow to the area, restricting the delivery of oxygen and nutrients, which can cause mild to significant damage to tissue.
The damage involved by the compression might be relatively minor, or could lead to complete destruction of deep tissue, increasing the rate of morbidity and mortality. The National Pressure Ulcer Advisory Panel categorizes pressure sores by severity, classified from stage I to stage IV. Osteomyelitis often occurs at advancing stages when the necrosis affects deeper layers of skin along with bone, muscle and joint structures.Detecting a Serious Infection after a Pressure Ulcer Develops
Infected pressure ulcers can produce an unpleasant odor emitting from the area. The accumulation of pus is often visible around or in the ulcer. Some individuals experience a fever as the body fights the condition. Usually the area surrounding the decubitus ulcer becomes reddish in color and warm to touch.
The infection can easily cause cellulitis, when it radiates out to surrounding skin. Deeper sores tend to be life threatening, especially if the infection is allowed to creep into the bloodstream, causing sepsis, shaky chills and fever.Patients Most Susceptible to Advanced Bed Sores and Complications Like Osteomyelitis
Patients most susceptible to developing osteomyelitis in a pressure sore are those suffering dementia, are confined to a bed or are wheelchair bound. In addition, patients receiving inadequate hydration and nutrition also have a higher rate of infection compared to those consuming a healthy diet. Other co-morbidities of bedsores infected with osteomyelitis are atherosclerosis and peripheral vascular disease, both severe heart diseases.Proper Diagnosis and Treatment Crucial to Prevent the Development and Advancement of Wound Complications
In a clinical setting, there are seven proven steps of protocol when providing care for patients susceptible to osteomyelitis in a pressure sore. They include:
- Acknowledging a higher risk of patients developing osteomyelitis in stage IV bedsores
- Clinical evaluation for systemic or local indicators of infection when the patient is admitted into, or presented to, a medical facility
- Diagnosis through imaging, including bone scans or MRI (magnetic resonance imaging)
- Surgical debridement for removal of infected bone, scarred bone, and all nonviable (necrotic) tissue
- Assessment of pathology reports on deep microbial cultures or sterile bone biopsies
- Systemic antimicrobial therapy targeted when necessary
- Tissue reconstruction after the infection has been resolved
The medical community has long established that most advancing pressure sores are avoidable, especially in a hospital or nursing home setting. Because of that, osteomyelitis in a pressure sore can be the result of medical malpractice, or negligence of the medical staff in providing standards of care to the patient.
Misdiagnosing the condition can lead to life-threatening medical conditions. As a result, family members are filing lawsuits on behalf of their love one in a nursing home, assistant living facility, hospital or group home who has suffered with stage III or stage IV pressure ulcers.
If you suspect your loved one experienced osteomyelitis in a pressure sore as the result of negligence of the medical staff or facility, you likely have the right to file a claim or suit for financial compensation.
Contact Nursing Home Law Center LLC at (800) 926-7565 for a free evaluation of your case. Our reputable law firm is well versed in Illinois elder law and handles medical malpractice cases involving neglect or abuse. Our skilled team can take legal action to stop the negligence immediately while seeking options for financial recovery to compensate your loved one for the injuries endured.Nursing Home Abuse & Neglect Resources