A pressure ulcer is a breakdown of skin and underlying tissue that develops when a person is immobile or bedridden. Pressure ulcers can occur from lying in bed or sitting in a chair for long periods of time without shifting weight. They can also be caused by rubbing or friction on the skin. Unrelieved pressure on the skin squeezes the tiny blood vessels that supply the skin with nutrients and oxygen. Sliding down in a bed or chair can stretch or bend blood vessels. When skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms.
The following are risk factors that increase the chance of getting pressure ulcers:
Pressure ulcers appear over bony parts of the body where there is irritation or pressure. The symptoms develop in stages:
Treatment depends on severity of the condition. Pressure ulcers need prompt and ongoing care in the early stages to avoid tissue damage and infection.
If the skin is broken, your health care provider can recommend a product that will create a moist environment to help the ulcer heal, protect the area from infection, and protect the skin around the ulcer from moisture.
To Avoid developing pressure sores:
Pressure ulcers can take a long time to heal if they develop open sores. The rate at which the broken skin heals depends on general health, diet, and home care. Some pressure ulcers heal by forming scar tissue.
To prevent a pressure ulcer or keep one from getting worse or infected, follow these guidelines:
Bedsores occur when a person is forced to spend most of his time lying in bed because of illness, paralysis or coma. Prolonged pressure on specific parts of the body causes skin to become reddened, then ulcerated. Preventing bedsores is critical, because treating a bedsore is difficult and can require surgery.
For a person on prolonged bed rest, consider renting a special rotation-type bed, such as the Roto Rest bed. This bed automatically turns and repositions the occupant, and it is loaded with pressure-reducing devices.
Keep a written turn schedule at the bedside. Every two hours, when you turn your patient, mark down whether you left him positioned on his back, right side or left side.
Any sign of redness should be considered a potential bedsore. Don't massage reddened areas. This encourages further breakdown.
Never use a doughnut-cushion under the buttocks, because it decreases blood flow where the cushion sets against the skin.
A bedsore begins as a tender, inflamed area caused by unrelieved pressure on a bony, weight-bearing area of the body; it can quickly turn into a painful skin ulcer that usually heals slowly. The likely pressure points are the ankles, knees, heels, shoulder blades, and - particularly in wheelchair patients - the spine, hips, and lower back. The pressure need not be present for extended periods to cause inflammation; in some cases, bedsores form in a matter of hours. Patients with diabetes or other conditions that promote skin breakdown and infection are at risk, as are those who are underweight, paralyzed, or suffering from poor circulation, heart problems, spinal cord injury, or atherosclerosis.
An early bedsore may be treated with pressure relief only. There is also a variety of ointments and dressings that may be used. At most hospitals and nursing homes, the standard treatment for bedsores is to clean the wound, remove any dead skin, and cover the area with a dressing that does not stick to the damaged skin. Dead tissue may need to be removed with a fine scalpel. In severe cases, when an ulcerated bedsore is deep and difficult to stabilize, plastic surgery or skin grafts may be required to restore damaged areas.
Unfortunately, some injuries and conditions prevent bedridden patients from being moved at all. Even those who can be shifted regularly risk tearing delicate skin if they are pulled over the sheets. One option for such patients is to improve their circulation, either by massage or by controlled, low-level electrical stimulation.
Caring for invalids at home - especially aging loved ones - can be a daunting task. Some helpful tips for making each day tolerable:
When it comes to bedsores, prevention is clearly worth more than any cure. Wheelchair-bound or bedridden people should shift their positions regularly. They should be bathed frequently and dried thoroughly, and their skin should be lubricated with a mild, nonirritating lotion. They should have clean, dry, tight-fitting, unstarched cotton sheets; loose-fitting clothes; plenty of air circulation; a healthy diet; and some sort of regular exercise - even if a caregiver has to move their limbs. To cushion sensitive areas, try an "eggcrate" foam mattress overlay, a water-filled mattress, or a sheepskin pad over the bedsheets. Consider a variable-pressure mattress with separate sections that can be inflated and deflated independently to adjust pressure on the patient's body.
Call Your Doctor If:
