Bedsores, also called pressure ulcers or decubitus ulcers, are the result of prolonged pressure on the skin leading to a loss of blood flow. Diminished blood flow causes the skin to die and can lead to bedsores.
Pressure ulcers are often referred to as bedsores since they are more likely to develop in individuals who have limited mobility. Those in wheelchairs or who are confined to a bed may remain in a certain position too long creating prolonged pressure over bony areas.
Bedsores are more likely to develop on parts of the body that have little tissue between the skin and the bone, such as the heels, ankles, hips and tailbone. Decubitus ulcers develop quickly particularly in those who are:
- Confined to a bed or wheelchair for long periods of time
- Paralyzed or partially paralyzed
- Immobile or who have limited mobility due to a chronic health condition such as multiple sclerosis
- Suffering from dementia
- Underweight or malnourished
- Suffering from diabetes or peripheral vascular disease
Bedsores are categorized by the severity of the wounds.
- Stage I – This is the earliest stage of bedsore development. The affected skin appears reddened and does not blanch when touched. Skin may also be tender or painful.
- Stage II – A fluid-filled blister develops or the skin may be broken. Surrounding skin appears reddened
- Stage III – The ulcer becomes deeper and crater-like. Deeper skin layers and tissue are damaged.
- Stage IV – The wound becomes quite deep and bone, muscle, and tendons may be exposed. The bedsore becomes crusty and dark.
If dead tissue is covering the surface of the bedsore, the wound may be unstageable.
Treatment of Bedsores
Decubitus ulcers are best treated in the early stages. If skin is not broken, relieve the pressure immediately and clean the area with mild soap and water. Check skin daily and report any open wounds to your dermatologist right away.
Even minor ulcers (Stage I or II) should be treated medically. Your dermatologist will instruct you on cleaning the bedsore with saline and applying a special dressing depending on the condition of the ulcer.
Deeper or more severe bedsores may require debridement (removal of the dead tissue). This may be done with a pressurized irrigation device, enzymatically, or surgically. If the bedsore still doesn’t heal, surgical repair may be needed.
Nonsteroidal anti-inflammatory drugs such as ibuprofen or topical ointments may be used for pain control and antibiotics may be prescribed if infection is present.
Prevention of Bedsores
To prevent skin breakdown, individuals in a wheelchair should shift their weight every 15 minutes and relieve pressure points by tilting the chair or cushions. Bedridden patients should be repositioned at least every 2 hours.
Air or water filled mattresses may be beneficial and skin should be kept clean, dry and protected from moisture.