Bedsores are quite common in people when they are immobile, bedridden, unconscious or unable to feel pain. Bedsores, also known as pressure injuries, pressure ulcers, decubitus ulcers or pressure sores occur on areas of the skin that remain under pressure from being wheelchair-bound, lying in bed, wearing a cast for a long time.

Bedsores tend to be a serious problem, particularly in frail elderly people. It heavily depends on the care that the patient receives. If a bedridden or immobile person is not positioned correctly or turned from time to time and not given good nutrition and proper skincare, bedsores are likely to develop. People those who have lack of sensory perception, circulation problems, diabetes, and are malnourished are at higher risk of developing bedsores.

Causes

It is possible for bedsore to become deep, extending into the muscle and the bone. It may take time for bedsores to heal once they start to develop. Depending on the patient’s physical condition, the severity of the bedsores and the presence of certain diseases like diabetes, etc., bedsores may take days, months or years to get completely healed. Sometimes surgery is also needed.

Three primary causes of bedsores are:

  • Pressure
  • Friction
  • Shear

Symptoms of Bedsores

There are four stages that form the symptoms of bedsores. They range from least to most severe. These are:

  • Stage 1- The area appears red and feels warm to the touch. People with dark skin color, the area may look blue or have a purple tint. The area may start to hurt, burn, and itch.
  • Stage 2- The area would look more damaged and may have a scrape, blister or an open sore. The bedsores may start to cause significant pain and the surrounding area may be discolored.
  • Stage 3- The area would now have a crater-like appearance since the surface below the skin is damaged.
  • Stage 4- The area is highly damaged with the presence of a large wound now. Tendons, muscles, joints, and bones can also be involved. There is a high chance of infection developing at this stage.

Common Sites of Bedsores

For wheelchair-bound patients, the common sites of pressure stores are:

  • Buttocks or tailbone
  • Spine or shoulder blades
  • Backs of legs or arms where they rest against the chair

For bedridden patients, the areas include:

  • Shoulder blades
  • Sides or back of the head
  • Ankles, heels, and skin behind the knees
  • Tailbone, hip, and lower back

Complications

Bedsores can cause life-threatening conditions including other complications like:

  • Cellulitis
  • Bone  infections
  • Cancer
  • Sepsis

If the bedsores get infected, it can cause fever and chills. When the infection spread throughout the body, it can cause a fast heartbeat, mental confusion, and generalized weakness.  

Treatment

Once it is ascertained by a healthcare professional after proper inspection that a person has bedsores, the treatment would be discussed based on the severity. It gets more difficult to treat bedsores when the skin is broken. The treatment may include:

  • Removing pressure from the affected area
  • Keep the wound protected with medicated gauze or similar special dressings
  • Control incontinence as much as possible
  • Ensuring proper nutrition
  • Keeping the wound clean
  • Apply dressing
  • Removing the infected, damaged and dead tissue (debridement)
  • Doing negative pressure wound therapy
  • Skin grafts
  • Treating infections with antibiotics

The healthcare professional will document the size and depth of the bedsores and the response of the patient to the treatment.

Prevention

It is not easy to prevent bedsores even with excellent nursing and medical care. However, though challenging, it is easier to prevent than treating them.

Tips to reduce the risk of developing bedsores include:

  • Daily inspection of skin
  • Keeping the skin dry and healthy
  • Moving wheelchair-bound patients and bedridden patients every 2 hours
  • Exercising, even if they are done in the bed with assistance since they improve circulation
  • Maintaining proper nutrition to boost overall health and wound healing
  • Using soft padding in beds and wheelchairs to reduce pressure

If there is any possible bedsore developing which the patient could feel, he must inform the doctor or healthcare professional immediately.

A physical therapist can be consulted to know about the most appropriate positions to avoid bedsores.

At Nightingales, we have trained and certified nurses who offer care and support to patients in need. The stay-at-home nurses are available for 12/24-hours as per the requirements of the patient. Visit https://www.nightingales.in/services/long-term-nursing-care to book an experienced nursing care provider.

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