What Are Bedsores? Why Is It Important To Prevent and How To Prevent
Bedsores are also known as pressure ulcers which develop as a result of injury to skin and underlying tissues after prolonged exposure to pressure on the skin. This is the reason why most bedsores develop in that area of the skin that cover bony areas elbows, heels, ankles, tailbone etc. as the bones can add to the pressure on the skin.
Although anyone can develop a bedsore due to being confined in the same position on a bed or chair, people most affected belong to the older age group who are bed ridden with medical conditions such as diabetes, peripheral vascular disease, very low blood pressure and other physical conditions that limit their abilities such to move or change positions resulting in them spending most of their time confined to the bed in the same position.
While most bedsores take days to develop, some of them develop over hours depending on other existing ailments and ability to heal. Most of these sores heal with treatment and can be prevented, but some never heal completely.
What are some of the usual causes of bedsores?
Pressure on skin – To maintain health skin, healthy blood circulation is essential. When a person is bedridden, there is constant pressure on the skin owing to lying down and being in the same position for prolonged periods of time. This constant pressure can adversely affect the blood circulation to that area which means compromised oxygen and nutrient supply to the area. Over time, the lack of oxygen and nutrients can damage the surrounding skin and cause them to eventually die.
In older people, the lack of proper padding with muscle or fat over the bone makes them prone to such pressure on the skin that covers such areas.
Friction – This is also a major contributor to bedsores, especially in vulnerable patients. When skin that is already susceptible to damage rubs against clothing or bedding, it can result in sores especially if the skin is moist. In people who are bedridden, this can pose a real problem as their health is already fragile and their limited mobility renders them bed bound.
Shear – Shear happens when skin and bone move in opposite directions. When a person slides downs, the tailbone moves downward while the skin above it doesn’t. This causes damage to the skin in that area.
Bedsores happen when blood flow to the skin is cut off for more than 2-3 hours and initially starts as a red, painful spot which eventually turns purple due to the lack of oxygen. If left untreated, they can become infected and even spread to the surrounding muscles and bones. Depending on other underlying medical conditions such as diabetes or compromised immunity, they can take months or even years to heal.
How can they be prevented?
By carefully monitoring bedridden patients, bedsores can be effectively managed or even prevented. This includes inspecting the skin for signs of redness, especially the skin covering bony areas. Simple measures listed below can help in prevention:
Repositioning and turning the patient every 2-3 hours on bed is still one of the primary practices in effective prevention of bedsores. This ensures proper blood circulation and helps in prolonged pressure in a particular area of the body.
Installation of soft padding on bed or wheelchairs to reduce pressure on skin.
If the patient is wheelchair bound, helping them sit upright and change position every few minutes to facilitate blood flow. Wheelchairs that have a tilt facility can also help as they help relieve some pressure.
A more expensive but effective option would be the use of dynamic surfaces/mattresses which are motorised. They are designed to change the pressure of the surface periodically under the patient. Air- fluidised mattresses that are filled with silicon beads that liquefy when air is pumped through them are also available for patients who are at risk for developing bedsores.
Encouraging patients to move or shift positions regularly if they are in a physical condition to do so and adjusting head elevation on bed to not more than 30 degrees to prevent sliding and thus preventing skin shearing.
Skin care and nutrition
Ensuring proper skin care by keeping the skin dry and clean lessens the probability of friction which is a major risk factor for bedsores.
Providing good nutrition with enough calories and adequate proteins is also crucial as nutrition plays a pivotal part in healing irrespective of other topical and care measures.