Causes of Bedsores
BED SORES: A RUN-THROUGH
One of the most commonly encountered medical conditions, BED SORES aka pressure ulcers or decubitus ulcers or pressure sores are skin or soft tissue injuries that come about when blood flow to the area is interrupted due to constant or prolonged pressure. Bed sores most often develop over areas where your bones are close to your skin such as your ankles, heels, hips and tailbone. This type of skin issue can develop quickly to someone with less mobility, such as frail older people or those restricted to a bed or chair.
WHAT CAUSES BED SORES?
There are many factors that contribute to the development of bed sores but prolonged pressure is the prime cause of it. Some of the main causes include –
Extended pressure on any part of your body lessens or cuts off the blood flow to tissues. Without fresh blood supply, the surrounding skin tissue dies as blood flow is essential for delivering oxygen and other nutrients to tissues. Hence, without these essential nutrients, skin and nearby tissues are damaged leading to a bed sore. Common high-pressure situations are –
- Sitting too long without shifting weight.
- Lying too long without turning.
- Not enough padding in bed (to protect bony areas of the body).
- Clothing and shoes that fit too tightly.
- Sitting or lying on hard objects.
Rubbing (friction) of your skin against clothing or bedding can also play a part in the formation of a bed sore. Repeated friction may wear away the top layers of skin causing local erosion and breaking in the epidermis and superficial dermis, which can make fragile skin more vulnerable to injury, especially if the skin is also moist. Something as simple as pulling a sheet or mattress up to position a patient in bed can cause friction.
Shear-induced skin tears can be another potential cause for a bed sore. Shear occurs when two surfaces move in the opposite direction like skin moving one way and the bone underneath it moving to another. For example - slouching while sitting, sitting at a 45° angle (as in bed), or sliding during a transfer instead of lifting your body. Shearing can also happen during spasms.
Moisture, for example, skin in prolonged contact with perspiration, urine (due to urinary incontinence), or feces (due to fecal incontinence), weakens or damage the protective outer layer of skin and leads to tissue breakdown and maceration, which can initiate or worsen bed sores. In some cases, moisture can be the primary cause of ulceration, even in the absence of any pressure.
Traction is a sideways pulling force on the skin that may also reduce blood flow to the skin. For example, when patients are placed on an incline (such as when they are made to sit up on an inclined bed) and their skin becomes stretched, leading to traction.
TRAUMA OF ANY KIND
Abrasion or friction - Cut or scratch caused by sliding across sheets or transfer board with bare skin.
Bump or fall – Injury from bumping toes into doorways, or bumping your buttocks off the tire during transfers, or bumping knees under desks.
Inadequate nutrition can lead to skin thinning and poor blood supply, meaning that skin is more fragile, increasing the risk of developing bed sores. Undernourished people may not have enough body fat to cushion the tissue.
Bed sores are staged according to their development and the signs and symptoms vary with every stage.