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Wound Care for Bed Sores

Proper Wound Treatment for a Bedsore

wound-care-bed-sore-nursing-homeDid your loved one develop preventable bedsores while under the care of a doctor, nursing care home, or health care provider? Did their progressive Stage III bedsore advance to a deadly Stage IV decubitus ulcer?

Our personal injury lawyers at Nursing Home Law Center, LLC, represent injured hospital patients in nursing caregiving residents who have suffered harm at the expense of the nursing staff.

Call our negligence injury law office at (800) 926-7565 (toll-free phone number) or use the contact form or email address today for additional health information and schedule a free consultation.

Wound care for pressure sores (bedsores, pressure wounds, pressure injuries, pressure ulcers) usually requires extensive education and training of residents, healthcare providers, and families to ensure the patient's health.

In addition, taking steps to prevent bedsores is essential, as is appropriate, timely intervention when bedsores appear.

Wound management is extensive, often involving developing a comprehensive sore care plan that considers every factor creating the risk of acquiring sores. The factors involved contribute to and affect the outcome of the pressure sore and the patient's health.

Because the response to treatment is different for everyone, no single discipline and methodology can meet every patient's needs with a pressure injury.

Providing Optimal Care for Bed Sores

The best type of wound care for pressure sores usually involves a well-educated, dedicated team of multi-discipline caregivers working in unison to assist with the patient's access to the best sore treatment.

Treating Pressure Sores

Bedsores, pressure sores, decubitus ulcers, and pressure ulcers refer to the same medical condition affecting the skin. Typically, the bedsores arise from pressure, traction, or shearing to skin and underlying tissue on the body's bony prominences.

These areas can include an ankle, hip bones, sacrum, tailbone, heel, shoulder blades, shoulders, back, or any area with minimal body fat.

When the skin sore is left untreated or poorly managed, a mild or moderate bedsore can quickly progress to advancing stages, causing life-threatening problems for the patient. Because of that, a competent doctor needs to provide the best wound care possible.

Moisture barrier cream can help cushion the skin from excess wetness due to sweating or wounds' fluid, leading to a sore.

Standard methodologies involved in pressure ulcer management include:

Preventing a Pressure Ulcer

Nearly every type of bedsore can be minimized or eliminated by repositioning the patient every 15 to 30 minutes. In addition, frequent turning can prevent pressure ulcers risk caused by pressure that produces ischemia (lack of blood flow) to underlying skin and tissue.

Numerous factors are contributing to the development of pressure ulcers risk. Some of these include:

Providing adequate support to the patient's skin surface and adjusting their position every one to two hours alleviates pressure to the body. Both shear and friction must be reduced.

Sharing mechanical forces by gravity interplay and friction by dragging the body against a course surface can cause significant damage and increase the potential of bedsore development.

Wound Bedsores

Bedsore prevention requires a care team to adequately assess, evaluate, and diagnose the decubitus ulcer to stop the damage and promote sore healing.

For example, the medical staff might stage the skin ulcers at Stage I (initial damage), Stage II (progressing), Stage III (degrading), and Stage IV (advanced/life-threatening).

A diagnostician will assess the pressure sores' temperature, note excess exudates, signs of infection, foreign bodies, necrosis (dead tissue), and recurrent trauma from pressure or friction.

The healthcare provider must look for signs of tunneling or undermining along with eschar, necrosis, granulation (tissue with new blood vessels). The care team must also assess adjacent tissue looking for any signs of tissue pain, tenderness, unusual odor, sweats, chills, and fever.

Optimizing the bedsore environment is essential to ensure the ulcer heals. To promote sore healing, the health service provider must ensure the patient is receiving essential bedsores care, including:

  • Adequate hydration & nutritious menu
  • Removal of all nonviable tissue at the sore site. The other name for nonviable tissue is necrotic
  • Adequate balance of humidity on the skin
  • Wound protection using proper dressings content based on the stage of the bedsore
  • Proper moisture barrier cream designed to protect against dampness content and adhesives
  • Pain management
  • Bedsore cleansing and irrigation into underlying skin layer tunnels and cavities
  • The prevention or management of infection

Removing nonviable tissue is often performed through debridement (autolytic, chemical, sharp, surgical, mechanical) to prevent infection and remove undesired skin growth. Typically, debridement stimulates new healthy skin growth during the healing process.

Pressure ulcers during the advancing stages are often very slow to heal. In addition, adverse contributing factors could lead to a pressure sore, including poor nutrition, pressure on the body part, or a pre-existing medical condition.

Substandard care could spread bedsores deep into tissues, causing localized or systemic infection, including osteomyelitis or sepsis, potentially ending when the patient dies.

Pressure Ulcers and Comorbidities

According to the National Pressure Ulcer Advisory Panel and the National Institute of Health, developing pressure sores are common in frail older people, especially people suffering from chronic diseases.

In addition, studies show that comorbidities increase degrading skin integrity, placing patients at risk for developing decubitus ulcers.

Researchers concluded that comorbidities are crucial to developing bedsores involving restricted blood supply, including:

  • Alzheimer's disease
  • Diabetes
  • Cardiovascular problems
  • Chronic pulmonary disease
  • Neurodegenerative disorders
  • Renal disease
  • Other health conditions

Also, pre-existing health problems can lead to skin breakdown, skin irritation, and skin injury resulting in sores. These conditions might involve:

  • Infectious disease
  • Anemia
  • Degenerative diseases
  • Diminished immune protection
  • Malnutrition due to poor food menu
  • Dehydration
  • Frailty
  • Hormonal changes
  • Impaired blood perfusion
  • Incontinence
  • Sarcopenia (muscle tissue loss)
  • Hospitalization
  • Extended nursing care homestays
  • Disability
  • Polypharmacy

These acute and chronic conditions are often contributing factors increasing the elder patient's susceptibility to bedsores. In addition, the damaged skin might result from internal strain and stress interaction, leading to a decubitus ulcer due to a perfusion injury, ischemia, cellular deformation, or impaired lymphatic drainage.

If you'd like to press charges on bedsores, kindly visit our website to access our contacts for the various areas we operate in and the legal services we provide our clients.

Treatment of Pressure Ulcers

According to the American College of Physicians, bedsores at any stage require immediately removing pressure from the affected area. The offloading of pressure restores restricted blood flow, preventing skin irritation and tissue damage.

The patient must reposition their body at least once every two hours to alleviate pressure in any area where skin damage could occur.

If the patient cannot turn without assistance, their health care provider may recommend using foam pads, gel mattresses, foam mattresses, or alternating pressure cushions. Unique beds are also available to prevent pressure injuries complications.

Avoid placing a pillow under the needs because it puts pressure on the heels. Instead, wear clothing and use sheets that do not wrinkle but provide a smooth and dry surface.

Avoid friction and shearing injuries by not sliding when getting in and out of bed or wheelchair. Dragging the feet, ankles, legs, buttocks, or hands across any bed or armchair can cause skin breakdown.

Have a physical therapist or health care provider check how you fit in your wheelchair at least once every year to prevent injuries or restricts blood flow.

Then, rotate your position in a wheelchair every 15 to 20 minutes to relieve pressure, ensuring that the wheels are locked before making any adjustment.

Oxygen therapy entails subjecting the wounds to 100% oxygen, thereby quickening the wound's healing process.

Skin grafts can also come in handy in facilitating wound healing. Skin grafting involves taking healthy skin from a location unaffected by the sore, which is then used to cover the wounds.

Pressure Injury Prevention Strategies

Pressure ulcer prevention strategies likely involve pain medications, extensive skincare, skin grafting, debridement, and negative pressure therapy.

The doctor will likely prescribe pain control medications to alleviate the irritation. Some of these drugs might include NSAID (nonsteroidal anti-inflammatory drugs like aspirin, Motrin (ibuprofen), and Aleve (naproxen).

Other drugs prescribed for nerve pain might include gabapentin and pregabalin or opiates/narcotics for severe pain. However, these medications have potential side effects, including drowsiness, dizziness, swelling in the hands and feet, in suicidal ideation (thinking about suicide).

However, body repositioning can help alleviate discomfort by offloading pressure on the affected area. Avoiding long periods in the same position at a 30°, 45°, or 90° angle could cause increased pressure leading to bedsores.

Wound Cleaning and Debridement

Daily wound cleaning and applying dressings is an effective treatment for ensuring that the area remains clean and dry. The doctor or specially trained nurses will use dressing and bandages over the area when the bedsore is draining and requires protection with moisture barrier creams.

Good wound management involves extensive dressing changes as the healing process takes place.

According to Johns Hopkins Medicine, the doctor may recommend surgery that cuts necrotic (dead) tissue away, allowing new cells to form. Then, the surgeon removes the unhealthy tissue and bacteria, inspects the wound bed and edges, and protects bedsores to allow them to heal.

Negative Pressure Wound Therapy

Bedsores with a high drainage level typically require negative pressure wound therapy (NPWT) to heal completely. The nurse will use a vacuum pump attached to a sealed wound dressing that draws the bedsore edges together, promoting healthy tissue regrowth.

Patients with bleeding issues complications after blood vessel or heart surgery or those taking blood thinners might have an increased risk of bleeding when using NPWT.

Also, the therapy might create an environment for a treatment-acquired infection that might be detected by a swollen, red, or sore area or a fever over 101°F.

Hiring Legal Representation When Treatment Fails or is Never Used

The presence of infections in the skin sores can significantly increase the potential of the patient dying. Fortunately, nearly all types of bedsores are preventable.

Developing bedsores might be an indicator of caregiver neglect or abuse. As a result, family members of loved ones suffering from skin ulcers will seek treatment for the victim and hire legal representation to stop the neglect while seeking justice.

Did your loved one suffer severe skin breakdown while under the care of medical staff, doctors, nurses, nursing aides, or other healthcare providers?

Please speak with Nursing Home Law Center LLC at (800) 926-7565, use the contact form, or email us to schedule a free case review.

Our skilled affiliated nursing home abuse attorneys provide a free initial consultation to discuss legal options to stop the neglect immediately.

Resources:

Nursing Home Abuse & Neglect Resources

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