Bedsores are a serious concern for individuals with limited mobility. Bedsores range in severity from mild to severe and can cause serious complications, but most of them can be successfully treated. Fortunately, there are steps you can take to prevent bedsores.
Bedsores, also called decubitus ulcers and pressure ulcers, are injuries to your skin and underlying tissues caused by prolonged pressure on your skin. For wheelchair-bound individuals, pressure ulcers are most commonly seen on the shoulder blades, spine, tailbone or buttocks, and the backs of the arms and legs where the limbs rest against the wheelchair. Bedsores are most commonly seen on the shoulder blades, hips, lower back, tailbone, back or sides of the head, and heels, ankles, and backs of the knees on individuals who are confined to a bed.
Unusual changes in skin texture or color, pus-like drainage, tender areas of the skin, swelling, and an area of the skin that feels warmer or colder to the touch than other areas of your skin are all warning signs of bedsores. Physicians place bedsores into one of several stages, depending on the sore’s depth and severity. Bedsores can range from an area of red, unbroken skin to a severe injury that involves muscle and bone. Bedsores can result in some serious complications, such as cellulitis (skin infection), bone and joint infections, and sepsis. In addition, bedsores that don’t heal can develop into a squamous cell carcinoma.
Certain factors put you at an increased risk of developing bedsores. Immobility, poor hydration and nutrition, and medical conditions that affect blood flow, such as diabetes and vascular disease put you at an increased risk of developing bedsores. Additionally, a lack of sensory perception, which can be caused by neurological disorders, spinal cord injuries, and other conditions, can lead to bedsores. More specifically, an inability to feel pain or discomfort makes it difficult for an individual to recognize the need to change positions and recognize the warning signs of bedsores.
There are three main contributing factors to the formation of bedsores.
Pressure: Constant pressure on any part of the body results in reduced blood flow to that area of the body. Blood delivers oxygen and essential nutrients to your body, and when oxygen and essential nutrients cannot reach an area of the body, the skin gets damaged and may eventually die.
Friction: Friction occurs when your skin rubs against bedding or clothing. This can make fragile skin more prone to damage, especially if your skin is moist.
Shear: When two surfaces move in opposite direction, shear occurs. For instance, if your bed raises up at the head, you may slide down in your bed as it raises up, resulting in shear.
Diagnosis and Treatment
Your physician will examine your skin to determine if you have a bedsore. He will also stage the bedsore based on its depth and severity. Treatment will depend on your bedsore’s severity. Treatment may include reducing pressure on the affected part of your body, cleaning and dressing the bedsore, eating a healthy diet, taking medication to treat infection, and taking pain medication. In sever cases, surgery may be required. One surgical procedure that may be performed involves using your muscle or skin to cover the sore.
There are ways in which you can prevent bedsores.
Repositioning: If you use a wheelchair, try to shift your weight every 15 minutes and reposition yourself every hour. If you are confined to a bed, reposition yourself every two hours. If you have a bed that can be elevated at the head, don’t raise it more than 30 degrees; this can help prevent shearing. If you use a wheelchair, consider getting one that allows you to tilt it; this can decrease pressure on your body. Using cushions or a mattress that reduces pressure on your body will also help you prevent bedsores.
Skin Care: Use a gentle cleanser to regularly cleanse your skin. Pat your skin dry afterward. Put lotion on dry skin. Change your clothes and bedding often. Inspect your skin everyday for warning signs of bedsores, and talk to your doctor right away if you have any concerns.
Bedsores can be painful and lead to serious complications. By repositioning yourself often and taking good care of your skin, you can prevent the development of bedsores. If you develop a bedsore, consult your physician promptly so that it can be successfully treated.