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Bedsores

Bedsores are also called pressure sores or pressure ulcers . Bedsores are injuries to skin and underlying tissues resulting from prolonged pressure on the skin. Bedsores generally develop on skin that covers bony areas of the body, such as heels, ankles, hips or buttocks.

Most people at risk of bedsores are those with a medical condition, that limits their ability to change position, requires them to use a wheelchair or confines them to bed for prolonged periods.

Bedsores can develop quickly and are often difficult to treat. Several care strategies can help prevent some bedsores and promote healing.

References:

Symptoms of a bedsores are:
  • Red skin that worsens over time.
  • Appearance of blister.
  • open sore
Pressure sores most commonly occur on:
  • Ankles
  • Back of head
  • Back
  • Buttocks
  • Elbow
  • Hips
  • Heels
  • Shoulders
Pressure sores are categorized as deep tissue injury which may be purple or maroon. Bedsores may be an area of skin or blood-filled blister, caused due to damage of soft tissue from pressure. The area around may be sore, firm, mushy, boggy, warmer, or cooler compared with tissue nearby.
 
References:

Pressure on the skin leads to  reduced blood flow to the area. Without enough blood skin dies, leading to formation of ulcer.
 
One may get a bed sore if :
  • One uses a wheelchair or is bed ridden for a long time.
  • If one cannot move certain parts of body without help because of a spine or brain injury or disease such as multiple sclerosis.
  • One is suffering from disease that affects blood flow, including diabetes or vascular disease.
  • One has  Alzheimer's disease or other condition that affects mental status.
  • Have fragile skin
  • Have urinary incontinence or bowel incontinence
  • Lack of nutrition or malnourishment.

References:

If one is bedridden or wheelchair, observe for signs of bedsores. The severity of skin breakdown may be categorized as follows:

Stage 1: Abnormal redness of skin. Skin is intact. This stage is reversible.

Stage 2: The redness progresses to an abrasion, blister, or shallow crater. This stage is also reversible.

Stage 3: A crater-like sore or ulcer that has begun to extend beneath the skin. This stage may be life-threatening.

Stage 4: Skin loss with extensive destruction or damage to muscle, bone, or supporting structures such as tendons or joint capsules. This stage may be fatal.

References:

The treatment of bedsores depends on the severity (i.e. the stage) of the wound. Depending on the severity, a variety of approaches may be used to promote healing. They include synthetic dressings, saline dressings, acetic acid compresses, and various antibiotic dressings (bedsores are particularly prone to infection).

For more severe wounds, surgery may be necessary to remove areas of dead skin. The most important step in both treatment and prevention of bedsores is relieving pressure by frequent repositioning.

References:

  • The best way to prevent bedsores is by changing position frequently to avoid constant pressure against body and to redistribute body weight. It also promotes  blood flow to the tissues. If one can't move, he or she should be helped to reposition at least every 2 hours, or every 15 minutes if you are seated in a chair. Pillows or foam wedges can help to shift weight if one is unable to move. Range of motion (exercise machine) exercises can help prevent contractures, improve circulation; and maintain joint integrity, mobility, and muscle mass.
  • The  bed should not be elevated more than 30 degrees (except when you are eating)

  • CREATED / VALIDATED BY : NHP CC DC
  • LAST UPDATED ON : Feb 05, 2016

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The content on this page has been supervised by the Nodal Officer, Project Director and Assistant Director (Medical) of Centre for Health Informatics. Relevant references are cited on each page.