Pressure ulcers are commonly referred to as bed sores. These are areas of damaged skin that ulcerate, causing painful, slow-healing sores. Most often bedsores occur in those who face mobility issues, such as individuals who are paralyzed, bed-ridden or restricted to a wheelchair. These persons are often elderly, but anyone who has difficulty in changing positions can suffer from these ulcers. Bedsores are difficult to treat, which makes prevention extremely important.
The elderly are at greater risk for developing bed sores as their skin is thinner than that of younger individuals. Long stays in nursing homes or spending several weeks in a hospital also predispose people to pressure ulcers, mostly due to immobility issues. Other risk factors include thinness, malnutrition, smoking, loss of pain sensation (such as when suffering a spinal cord injury) and incontinence, which leaves the skin moist and causes it to break down.
Symptoms and Stages
There are four stages of pressure ulcers. Each stage is progressively worse. Stage one is superficial, with a reddened, warm area of skin. In stage two, the ulcer has began to enter the dermis layer of skin and is an open but not deep sore. Stage three is a larger, deeper sore that has extended to tissue underneath the skin. By stage four, much skin has been lost and there is damage to the muscle and bone.
For those who are bed-ridden, pressure ulcers often appear on the back, hips, tailbone as, well as the back or side of head, shoulders and even the knees, ankles and heels. Individuals in wheelchairs often have buttock ulcers as well as sores on their shoulders, spine and areas of their arms and legs that are in constant contact with the chair.
Treatment depends on the stage of the bedsore. Stages one and two sores often heal in a few weeks once the pressure is removed from the affected area. Cleaning, application of topical antibiotics and dressing the wound may be all that is required. For sores that have reached stages four and five, treatment is much more difficult. Surgery may be needed to debride the wound (remove dead, infected or damaged tissue). A non-surgical treatment of deep bedsores is mechanical debridement, in which a high-pressured irrigating tool is used. Water therapy may also be employed to help rid the sore of infected material. If the ulcer is infected, antibiotics will be prescribed.
The best way to prevent pressure is to change positions frequently. If a patient is unable to do so herself, someone needs to make sure she is assisted at least every two hours in assuming a new position. Pressure-reducing mechanical devices can help alleviate pressure in certain areas. Other preventative measures include a healthy diet, exercise, quitting smoking and having a strong support system of family, friends and healthcare professionals.
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