Bed sores, also called pressure sores, pressure ulcers, or decubitus ulcers, are confined injuries to the skin and its underlying tissue as a result of prolonged and consistent pressure to the skin. This prolonged pressure against the skin inhibits blood supply, which causes the death of underlying tissue. While there are several stages of severity of bed sores, ranging from Stage 1 to Stage 4, It is important to note that in certain cases, bed sores can be life threatening.
Most commonly, bedsores are seen on areas of skin that cover more bony areas of the body, such as the hips and buttocks. But they can also develop on the heel and ankles, also bony areas. While anyone can develop a bed sore, they are most often experienced by the elderly and people with a medical condition that limits their mobility and ability to change positions.
Because bed sores can develop rapidly and can be difficult to treat, it is important to take steps to prevent them and treat appropriately to promote swift healing.
Risk Factors of Bed Sores
Bed sores are more likely to develop in people who have one or more risk factors of developing them.
- Confinement to wheelchair, chair or bed. Being confined to these, without alleviating prolonged pressure, can bring on a bed sore in as little as one or two hours.
- Dehydration or poor nutrition. Because the skin and tissues aren’t adequately hydrated or nourished, bed sores are more prone to develop.
- Loss of bladder or bowel control. Excess moisture on the skin can cause irritation, making the area more likely to develop a bed sore.
- Medical conditions. People who are paralyzed, in a coma, or recovering from a knee or hip injury or surgery, who don’t change positions frequently, can develop a bed sore. In addition, people who have a neurological condition or spinal cord injury may lose sensation and the inability to feel discomfort and pain — thereby not knowing they should be changing position. Further, certain conditions, such as vascular disease and diabetes, may affect circulation and proper blood flow, causing an increased risk of tissue damage.
- Smoking. Because smoking can decrease circulation, there’s an increased risk of tissue damage in those who smoke.
Preventing Bed Sores
The best treatment for bed sores is to prevent them from developing in the first place. Here are a few things you can do to help to prevent bed sores in yourself or a loved one.
- Repositioning. Whether in a chair, wheelchair or bed, repositioning is key to preventing bedsores. If confined to a wheelchair, the Mayo Clinic recommends that you should be repositioned every 15 minutes. Repositioning should be done every two hours if confined to a bed.
- Special cushions. Foam, water, air or gel-filled cushions are helpful in relieving pressure for those confined to a chair or wheelchair.
- Special mattresses. Water-filled, air-filled, or foam mattress pads can help protect vulnerable areas from tissue damage and relieve pressure, according to the Mayo Clinic.
- Bed elevation. Adjustable beds can be elevated at the head to 30 degrees or less to prevent shearing, which can cause tissue damage.
- Bony areas protection. For example, instead of lying directly on your hip, lie at an angle using a cushion to support your back and/or front. Cushions placed between the knees and ankles can also help to relieve pressure.
- Proper skin care. Skin should be dried thoroughly after bathing. Dry skin should be soothed with lotion. Bowel and urinary continence should be monitored closely to prevent moisture exposure to the skin.
- Proper nutrition. Getting enough nutrients and staying hydrated is important to keep your skin and tissue healthy.
- Stop smoking. If you smoke, quitting can decrease your risk of developing pressure-related sores.
- Staying active. Last, but not least, movement is the key for decreasing pressure sores. Daily exercise helps improve circulation and blood flow to vital tissues. For those bed or wheelchair bound, a physical therapist can design an exercise program that fits your situation.
Both preventing and treating pressure sores is demanding to all involved, including the person at-risk, family, friends, caregivers, and medical personnel. However, any development of a bed sore should receive immediate and follow-up medical treatment.
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