Bedsores

Bedsores are also named pressure sores, decubitus or pressure ulcers. These are the result of constant pressure on the skin, particularly on weight bearing parts of the body.

Causes of Bedsores

Bedsores occur due to lying or sitting in one position for long periods of time without changing position. Thus, pressure is generated constantly on that area, affecting the blood supply leading to oxygen deprivation. When cells and tissue do not get sufficient oxygen supply for 2 to 3 hours, the skin of that area begins to become necrotic, resulting in the development of these sores. The skin often opens up, leading to bacterial infections.

Bedsores can also be a result of the following factors:

  • Irritation from poor support
  • Friction
  • Wrinkled bedding
  • Shear forces

Description

Bedsores occur in those patients who become bedridden due to severe illness or due to leg or hip fractures. Immobility is the main cause of these ulcers and can result in pain and distress. Bedsores have a tendency to extend into muscles and underlying bone. If these become infected, the infection can spread to the whole body.

Common Sites of Bedsores

Bony areas are the most common places upon which bedsores develop. These include the sacrum, buttocks, hips, and heels.

Other areas such as the lateral sides of the knees, occipital areas, shoulder blades or base of the spine are also prime areas in which bedsores can occur.

Pathophysiology

Bedsores result from a decrease in the supply of blood to skin tissues causing reperfusion injury. If a person lies in the same position for more than 2 hours, the blood supply is cut off which leads to the development of ischemia, tissue damage and death of the cells. Sores appear on the skin shortly afterwards and are red in color and very painful. These sores turn purple eventually and if not treated, can lead to infections and more damage.

Symptoms of Bedsores

Bedsores are characterized by color changes, pus formation, swelling and pain. Infections can lead to more drastic conditions or lesions as well as pain and swelling. Fever, chills, malaise and rapid heartbeat also occur. Untreated ulcers may lead to the development of dead cells and eschar.

When to See a doctor?

If you or anyone else you know of is likely to develop these sores due to immobility, do discuss this with your doctor as soon as possible to avoid further complications.

Diagnosing Bedsores

Bedsores are easily diagnosed based on a history of immobility and a physical examination.

Treatment of Bedsores

Treatment is based on the severity of the bedsores. First and foremost treatment should be administered to relieve the pressure from the area where sores have formed. The sores then need to be treated with drugs. The lesions should then be protected with medicated gauze and be kept clean and hygienic at all times. Antibiotic therapy should be started, and proper nutrition followed to aid in healing. The dead area should also undergo surgically debridement.

Risk Factors

Anyone who sits or lies in the same position for a long period of time may develop these sores. Bedridden people usually develop them, thus named bedsores. A person who uses a wheelchair is also likely to develop bedsores. Other risk factors include

  • Loss of pain and pressure sensations as seen in the case of a spinal injury
  • Paralysis
  • Injury
  • Spasticity resulting in repetitive friction or pressure to the body area
  • Malnutrition
  • Anemia
  • Disuse atrophy
  • Infections

Prevention

Prevention is the best treatment to help stop the formation of bedsores and can easily be done by changing position regularly. Avoiding sitting or lying in the same position can also prevent their formation. Eating a well balanced diet and sleeping in comfortable bedding can help lessen the chances of developing bed sores.

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