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Why are Some Younger Patients Prone to Develop Bed Sores?
By Nursing Home Law Center
While two thirds of patients with bedsores are 75-years-old or older, the reality is that bedsores can develop in anyone. Younger patients can even be more prone to develop them because hospital staff are used to seeing bedsores in older patients and therefore may be less vigilant in preventing bedsores in younger patients.
What is a Bedsore?
Decubitus ulcers are also called bedsores or pressure sores. They result from restricted blood flow to skin and underlying tissue, which causes the tissue to die. In normal, healthy individuals bedsores are rare because they can shift their weight and relieve the pressure on a given area. However, when a person is immobilized and unable to achieve this pressure relief, they are at risk of developing a bedsore.
Experts grade bedsores in four stages of severity.
- Stage I. At this stage the skin has not broken but has turned permanently red. It may be warm, hard and swollen as well.
- Stage II. A bedsore at the second stage has developed a blister or possibly an abrasion.
- Stage III. At the third stage the skin has been worn away and underlying tissue is now at risk.
- Stage IV. A bedsore becomes life threatening due to sepsis when muscle or bone are exposed and damaged.
Why are Younger Patients at Risk?
Constant pressure to an area is the chief factor in developing bedsores. Usually, this means immobilization, which we do not see as often in younger patients. However, younger patients can lose their mobility, and other factors can contribute to the development of pressure sores.
- Smoking. Smokers have a reduced ability to heal. Once an abrasion or blister breaks out on the skin, smokers can progress more rapidly through the stages of bedsores. This reduced ability to heal is true for all smokers, and while the young tend to heal better than the elderly, any smoker has compromised his or her body's natural healing ability.
- Diabetes. Diabetics also heal more slowly from wounds, which is why doctors instruct them to look over their feet daily for signs of developing wounds. Diabetes can also reduce sensation in our limbs, which makes us less likely to shift positions and relieve pressure. People of any age can have diabetes.
- Atheroma. Plaque buildup in the arteries will naturally restrict blood flow and hamper the body's ability to heal. This buildup occurs frequently in men and women under the age of 75.
- Paralysis. Any patient with a damaged or cut spinal cord is going to have reduced mobility. If a patient cannot move themselves to relieve pressure or has no sensation to warn them of the danger, a bedsore can develop.
- Coma. Any unconscious patients will be at high risk for developing pressure sores. If they are unconscious for a long time, someone will have to change their position at least every two hours throughout the day. Comas can occur in the young as well as the elderly.
- Dehydration. Lack of water in the skin and tissue is a risk factor for developing bedsores, and this can occur in patients of any age.
How are Bedsores Treated in Younger Patients?
There are several ways doctors can treat pressure sores.
- Debridement. Debridement is the removal of necrotic or nonviable tissue. This can be done chemically or surgically.
- Wound vacs. A pump drains fluid from a bedsore after a foam-like material fills the wound.
- Flap reconstruction surgery. Healthy skin from elsewhere on the body is used to cover open wounds like bedsores.
- Colostomy. A colostomy will prevent fecal matter from getting into affected areas.
- Amputation. In extreme cases, a limb may have to be amputated to save the life of the patient.
Though elderly patients are more at risk, bedsores can develop at any age, depending on the conditions. Nursing staff must practice thorough vigilance to prevent such an occurrence, including in their younger patients.