Bedsores
Bedsores, also known as pressure ulcers or decubitus ulcers, are injuries to the skin and underlying tissue resulting from prolonged pressure, particularly over bony areas. They occur when blood flow is restricted, leading to skin tissue damage and, if untreated, can progress to severe wounds. Individuals at higher risk include those who are bedridden, use wheelchairs, or have limited mobility, such as the elderly and those with certain chronic conditions like diabetes or vascular disease. Initial symptoms of bedsores include red, soft, warm skin, which may heal if pressure is relieved. Without intervention, these sores can develop into open wounds that may become infected, leading to more serious health complications.
Preventive measures are crucial and include regularly changing body positions, maintaining skin hygiene, and ensuring adequate nutrition. Treatment typically involves cleaning the wound, applying appropriate dressings, and possibly removing dead tissue to promote healing. In more severe cases, medical interventions such as antibiotics may be necessary to address infections. Proper care from caregivers is essential, especially for vulnerable populations, to prevent the development of bedsores and ensure effective management should they occur.
On this Page
Subject Terms
Bedsores
Also known as: Decubitus ulcers, pressure sores, pressure ulcers
Anatomy or system affected: Blood vessels, immune system, muscles, skin
Definition: Sores caused by sustained pressure with restricted blood flow to the skin
Causes and Symptoms
Bedsores are caused by sustained pressure on the skin, blocking blood flow. Impaired circulation causes the skin tissue to die and tear.
Persons at risk for bedsores include people who are bedridden, use wheelchairs extensively, are immobile, or are unconscious. People with paraplegia and others with spinal cord disease or neuromuscular injuries are at risk because of their inability to sense pain in affected limbs or because of sitting in a wheelchair. Bed-bound persons who lie in one position for extended lengths of time may develop bedsores. The malnourished may experience bedsores as a result of little padding over bony areas. The elderly prove more vulnerable to bedsores because of thin skin, decreased circulation, and restricted mobility. Chronic diseases such as diabetes, urinary incontinence, or vascular disease can increase the risk of bedsores.
Bedsores typically occur in the skin over bony areas such as the elbows, heels, ankles, back, lower spine or tailbone, hips, shoulders, and back of the head. In the early stage, the skin becomes red, soft, and warm to the touch. If pressure is relieved by changing body position, the skin will heal. If the pressure continues, however, then the skin may blister and then break down, leaving an open wound. Without intervention, the bedsore can progress to skin cell death, with damage to deeper levels of skin or muscle. An advanced bedsore smells odorous and becomes infected without proper treatment. Unattended, the bedsore can result in infection leading to fever, confusion, and death.
Treatment and Therapy
Certain measures can prevent or minimize the development of bedsores in at-risk persons. Relief from pressure on the skin by frequently changing body position is critical. Other approaches include keeping the skin clean and dry, minimizing friction against the skin, and maintaining healthy nutrition. For older adults, who may be unable to provide the necessary level of care, it is essential that competent caregivers take measures to effectively prevent bedsores.
Treatment for bedsores includes monitoring the skin for redness and taking immediate measures to minimize further breakdown. The bedsore should be cleansed and covered with a dressing as prescribed by the healthcare provider. Dead tissue can be removed to prevent infection and encourage healing through surgical debridement or mechanical debridement by gentle scrubbing or wound irrigation. Enzyme preparations are available to dissolve dead tissue. Antibiotic solutions can be applied to the bedsore, and oral antibiotics can be taken to decrease the risk of secondary infections.
Bibliography
“Bedsores.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/bedsores. Accessed 20 July 2023.
Brown, Pamela. Quick Reference to Wound Care. Sudbury: Jones, 2009. Print.
Ousey, Karen. Pressure Area Care. Malden: Blackwell, 2005. Print.
Pieper, Barbara. Pressure Ulcers: Prevalence, Incidence, and Implications for the Future. Washington, D.C.: National Pressure Ulcer Advisory Panel, 2012. Print.
“Pressure Sores.” MedlinePlus. NIH, US Natl. Lib. of Medicine, 8 Jan. 2016. Web. 27 Apr. 2016.
Webster, J. G. Prevention of Pressure Sores: Engineering and Clinical Aspects. New York: Taylor, 1991. Print.