Bedsores, also known as pressure ulcers or pressure sores, can form when your skin and soft tissue press against a harder surface, such as a chair or bed, for a prolonged time. This pressure reduces blood supply to that area, which can cause the skin tissue to become damaged or die. When this happens, a pressure ulcer may form.
Bedsores are some of the most commonly encountered medical conditions in patients requiring long-term care. Roughly 2.5 million bedsores are treated each year in the United States.
Bedsores are common in older people who live immobilized or bedridden in assisted-living care. Pressure ulcers can provoke infections, sepsis, and loss of muscle. If left untreated, even the slightest pressure ulcer can develop into a critical and sometimes fatal condition. The good news is that a few simple steps can keep many bedsores from reaching that critical stage.
How Do Bedsores Develop?
Most people move around a lot when they sleep. That movement continually redistributes the pressure between the body and the mattress. However, when people are confined to bed due to illness, injury, or while anesthesia for an operation, they may move very little.
As a result, pressure builds up on specific areas of the body, particularly those where the bones are prominent. That pressure can quickly squeeze shut the capillaries that deliver blood to the skin and underlying tissue. Without fresh blood to bring in oxygen and flush out metabolic waste, skin and other nearby tissues falter and may eventually die, leaving a bedsore in their wake.
For people who use wheelchairs, bedsores often occur on skin over the following sites:
- Tailbone or buttocks
- Shoulder blades and spine
- Backs of arms and legs where they rest against the chair
For people who need to stay in bed, bedsores may develop on:
- The back or sides of the head
- The shoulder blades
- The hip, lower back or tailbone
- The heels, ankles, and skin behind the knees
Bedsores can be painful and like open wounds, create a ready opportunity for infections that can spread to the surrounding skin, deeper tissue, bone, and blood. The breakdown of tissue from large bedsores can lead to fluid and protein loss, leaving you dehydrated and malnourished.
Who is at Risk of Developing a Bedsore?
You have a risk of developing a pressure ulcer if you:
- Spend most of your day in a bed or a chair with minimal movement
- Are overweight or underweight
- Are not able to control your bowels or bladder
- Have decreased feeling in an area of your body
- Spend a lot of time in one position
How Can You Prevent Bedsores?
You can help prevent bedsores by frequently repositioning yourself to avoid stress on the skin. Other strategies include taking good care of your skin, maintaining proper nutrition and fluid intake, quitting smoking, managing stress, and exercising daily.
1) Immobility: Preventing periods of prolonged immobility is the most important step in preventing and healing pressure ulcers. This includes making sure you change position while in bed and lifting off of a wheelchair at least every two hours.
2) Maintain Proper Cleanliness: Incontinence is one of the most significant factors associated with the development of pressure sores. When bowel movement or urine stays in contact with the skin, acids and enzymes begin to cause excoriation and degradation of the skin faster than usual. Keeping the body clean and dry, particularly the folds of the skin, is critical to preventing bedsores.
2) Malnutrition: Poor nutrition can cause loss of fatty tissue, which serves as a cushion over pressure-sensitive areas. It also leads to decreased resilience of skin tissue and reduced exposure time to develop a pressure ulcer. Eating a healthy, balanced diet is essential to keep your skin as healthy as possible.
3) Reduced Blood Flow in the Skin: Any reduction in blood flow to the skin can cause hypoxia (decreased oxygen) in the skin tissues, which can increase the risk of developing bedsores. Measures to prevent poor blood flow can include offloading pressure from the wound site to prevent pressure-induced ischemia, interventional procedures, and hyperbaric (oxygen) therapy.
4) Sensory Loss: Poor sensation in specific areas of your body won’t allow you to feel when pressure is building up. Efforts aimed at increasing sensory awareness in your body are essential.
5) Avoid Excess Moisture: Increased moisture over prolonged periods can lead to skin maceration and cause your skin to be more prone to injury from pressure and other forces.
6) Friction/Shear: Friction or shear-induced ulcers or skin tears are additional sources of bedsores and arise from moving skin over the surface of a fixed object. It can involve something as simple as pulling a sheet over a patient. Therefore, extra care needs to be taken, especially by caregivers completing transfers. When drying patients, the nursing staff should gently pat the skin dry and refrain from rubbing vigorously, as the friction can damage the skin.
For more information on how to prevent bedsores, please feel free to contact us.