The Dirty Secret About Pressure Sores: An Infographic

By Nursing Home Law Center

Pressure sores, also called bedsores or decubitus ulcers, are nearly always preventable. Poor care at hospitals and long-term care facilities is responsible for how widespread bedsores are. Studies indicate that bedsores are more common now than they were ten years ago.

What Causes Pressure Sores?

• Age. Adults over 70 have thinner skin than younger people, which makes them more susceptible to forming pressures sores.
• Nursing Homes. In part due to increased immobility and frailty, nursing home residents are more likely to get bedsores than are hospital patients.
• Immobility. When the same part of the body always bears the weight of the entire body, bedsores are likely to develop.
• Desensitization. If you cannot feel the pain that comes with a forming bedsore, you are less likely to move to alleviate the problem.
• Malnutrition. Poor diets make one more prone to pressure sores, especially if the diet lacks protein, zinc and vitamin C.
• Incontinence. Urine and feces are caustic on the skin. Also, moist skin is more likely to form a bedsore.
• Diabetes. Diabetics can have compromised blood flow, which makes them more sensitive to pressure sores.
• Smoking. Smokers heal more slowly and tend to have more severe pressure sores.

Did you know that more than 1 in 10 nursing home residents will get a bedsore? Of those, only 35% whose bedsore reaches stage II will receive special wound care.

Stages of Pressure Sores

• Stage 1. Redness of the skin without breakage. Skin may be firmer and warmer than surrounding areas.
• Stage 2. Bedsore may be a serum-filled blister or a shallow open wound with a red bottom. Skin has now broken open.
• Stage 3. Skin has been lost and fat may be visible underneath.
• Stage 4. The tissue is now gone and the bone, tendon or muscle is exposed underneath.

If there is enough slough covering the bedsore, it may not be possible to determine its stage. This slough, however, is the body's natural protection for the wound and should not be removed.

Complications From Pressure Sores

Several serious and life-threatening complications can arise when bedsores go untreated.

• Gangrene. As pressure reduces blood flow to an area and a bedsore forms, bacteria may start to grow in the wound. The bacteria produce toxins which accumulate and emit a foul odor. It may also cause the skin to discolor as the tissue deteriorates.
• Osteomyelitis. In a severe bedsore the bone can be exposed, leaving it open to infection. Osteomyelitis is when bacteria infect a bone. Surgery may be necessary to cure the ailment. In adults, the most common forms of bacteria that cause osteomyelitis are S. Aureus, Enterobacter and Streptococcus.
• Sepsis. Also known as septic shock and septicemia, sepsis occurs when an infection gets into the blood stream and transports to other parts of the body. Sepsis can be fatal if left untreated.
• Necrotizing fasciitis. Because more severe pressure sores are open wounds, they leave people prone to contracting necrotizing fasciitis. Prompt medicinal and surgical treatment is necessary to save the patient's life, as the disease spreads rapidly.
• Death. All these complications can lead to the patient passing away. Sometimes, even when treatment begins, is too late and he or she expires. Approximately 60,000 people per year die due to complications from bedsores.

Pressure sores are a serious and common problem in our nursing homes and other care centers. The problem is all the more tragic due to the fact that the vast majority of these wounds should never form in the first place. Adequate training and effort are essential when caring for patients with compromised mobility.

Know the signs and symptoms of pressure sores. If you see a loved one is developing a wound, alert a health care professional so that immediate treatment can begin.

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