Bedsores (Pressure Sores)

What are Bedsores?

Bedsores are also called pressure sores or pressure ulcers. No matter what they are called, they are painful wounds which need immediate treatment or a potentially deadly infection may result. Bedsores can happen to people confined to bed or wheelchair. People with poor circulation or little feeling in their limbs (such as paraplegics) are susceptible since they cannot feel the sore starting. Sores are caused by constant pressure of the skin against a flat surface like a bed or wheelchair. Excessive moisture also can cause sores. Seniors with mobility issues and incontinence issues are prone to getting bedsores.

What are the Symptoms of Bedsores?

Bedsores develop wherever the skin rests on a flat surface, so the back, buttocks, legs, ankles, arms, elbows, feet, heels, neck and even the ears can develop sores. There are four categories of bedsores and each has different symptoms.

Stage 1

Sores resemble bad bruises. The affected skin may itch or feels sore. It may feel warmer or cooler in comparison to the surrounding skin. The sore is still closed.

Stage 2

Sores are peeling due to skin damage. They resemble blisters or popped blisters. The sores may weep fluid or bleed.

Stage 3

Sores are dangerous as the skin damage may have gone all the way to the bone. It resembles a bloody or yellowish hole in the skin.

Stage 4

Sores are medical emergencies. The skin, muscles and possibly bone has died, leaving the hole covered in black, yellow, brown tissue. The sores may or may not be crusty.

Bedsores Causes

Bedsores are caused by prolonged pressure being applied to the skin. They are most common in people who are confined to a bed for long periods of time, for example in a hospital or nursing home. The weight of the body presses skin against the bed which limits blood supply to the area and, over time, damages skin cells.

Individuals who have limited mobility and therefore cannot roll over in bed unaided are more likely to develop the sores. They can also occur with the prolonged use of a wheelchair or bedside chair.

Even mild prolonged pressure can result in sores, but they tend to occur on bony areas such as the hips, spine, tailbone, shoulder blades, heels and elbows. In those who use a wheelchair, pressure sores are most commonly found on the buttocks and the heel and ball of the foot.

How are Bedsores Treated?

Stage 1 and 2

Sores need immediate treatment so they do not get worse. The patient needs a better diet and more movement to take the pressure off of the sore areas. Incontinent patients need to be kept clean and dry. Doctor intervention is a must.

Stage 3 and 4

Sores need the dead body parts removed and the wound closed by surgery. Dressings cover the wound to prevent infection and need daily changing. Antibiotics may be given to prevent infections like gangrene or blood poisoning. Prognosis for survival is poor but possible.

Bedsores Prevention

The most important step in preventing bedsores is to change position on a regular basis to relieve pressure on the body. Carers or relatives can help with this process. It is recommended to change position every two hours in bed and every hour when in a chair. Pillows may help to raise parts of the body to relieve pressure.

Friction can worsen bedsores or make them more likely. Carers should avoid dragging a person across the sheets when helping them to change position or get out of bed. Lifting is preferable to dragging, and overhead trapeze systems can help with this process.

When cleaning the skin, it’s important to avoid scrubbing at the skin or rubbing too firmly on areas which are susceptible to sores. Beds and chairs should also be kept very clean, as particles of grit or crumbs from food can rub at the skin and cause irritation.

Gentle exercise and stretching can help to relieve pressure and encourage blood flow throughout the body, which might help prevent bed sores. Where possible, have the bedridden individual perform basic stretches and light exercises.