Bedsores, or pressure sores and ulcers, are wounds that develop from prolonged pressure on the skin. They are most likely to occur when someone is bedridden or wheelchair-bound for extended periods of time. According to The Federal Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the United States suffer from bedsores each year. In addition to prolonged periods of immobility, moisture, friction and traction that pulls on the skin can also cause bedsores. Because the skin becomes thinner and more fragile as we age, bedsores are more prevalent in older patients and also more difficult to heal. This article will explain what a bedsore is, the different stages of bedsores, the treatments for each stage, and some guidance on how to prevent pressure sores from ever developing.
What Is a Bedsore and How Do They Form?
Extended pressure on the skin cuts off blood flow, causing skin cells to deteriorate. As these dying cells break down, a pressure ulcer or sore develops. Bedsores typically form on areas where the skin is closest to the bone, including: elbows, buttocks, heels, hips, tailbone, back and ankles. Bedsores are more likely to form when moisture from sweat, urine or feces is also present or if there is pulling from any sort of traction. This can include an inclined bed, where the patient is sliding down, or when a patient is sitting in a wheelchair for long, unbroken periods of time. Bedsores are serious because infection can develop and left unattended, these injuries can be life-threatening.
Bedsores are more prevalent in patients who are comatose or in a vegetative state, those who are suffering from paralysis, anyone confined to a wheelchair or even wearing a cast, splints or a prosthetic device. There are also medical conditions that increase the likelihood of developing a bedsore including patients with cancer, cerebral palsy, dementia, diabetes, heart failure, kidney failure, malnutrition, spinal cord injury, chronic venous insufficiency, and peripheral heart disease. These are all situations where it is critical that caregivers pay attention to any sign of a bedsore developing and take action before they get worse.
Stages of Bedsores
Understanding who is at risk for developing a bedsore and recognizing the first signs are critical for early intervention and safeguarding the patient. Early detection of bedsores allows for effective treatment. The following are stages of a pressure sore and what to look for in each stage:
1️⃣ Stage One
The skin looks pink or red but an open wound has not developed. For darker skinned patients there may be discoloration and the skin looks darker, so it’s important to consult a health professional if you have questions. If the skin is tender or feels different than other parts of the body – such as warmer or cooler, softer or firmer – these could also be signs that a bedsore is forming. If you press on the skin and the red or darker color does not change, it is also a sign a bedsore is developing.
2️⃣ Stage Two
The penetration of the epidermis, or outer layer of the skin, makes the signs more evident in this stage. A shallow wound may appear with a broken top layer of skin and a developing red or pink base. There can also be skin loss, an abrasion and blisters with some fluid oozing or pus forming.
3️⃣ Stage Three
This is a more serious stage where the bedsore becomes deeper extending into the fatty tissue below the surface. You may notice a foul odor, pus or fluid, or the patient may have a fever. These are all signs of an infection that requires more specialized care from a health professional.
4️⃣ Stage Four
This stage is critical because the infection has now extended into the muscle and may go far enough to impact the bone and tendons. At this stage, the wound has a high probability of infection, often requiring surgery.
Necrotic or dead tissue may completely cover some wounds, making it impossible to determine the stage. Removal of the dead tissue allows for the assessment of whether the bedsore is stage three or stage four.
In other instances, the bedsore is deep and serious but there is no wound at the epidermal level. There may be a bruise or other discoloration and the patient may be in pain. A health professional needs to determine the treatment for this type of pressure sore and decide if surgery is necessary to prevent further injury.
Bedsores Can Have Serious Complications
Although initially, bedsores may seem like minor injuries, if left untreated, complications can occur ranging from serious infections to amputation and even death. Bacterial infections such as cellulitis, which affects the skin and underlying tissue, and septicemia, a systemic infection that spreads through the bloodstream, can have severe consequences. Septicemia can lead to sepsis which is a critical condition requiring immediate medical intervention. In fact, bedsores or pressure injuries kill thousands of people worldwide each year. That’s why it’s so important to recognize bedsores in the early stages and take action or, better yet, prevent bedsores from ever developing.
Treating Bedsores
If you spot a stage one or two bedsore, special products can help it heal and prevent it from getting worse. Honest Medical has a wide range of products designed to treat bedsores and pressure ulcers. The following suggestions include links to product recommendations that can aid in the treatment of bedsores.
First:
If there is an open wound, it’s important to clean it thoroughly. Irrigate the wound with saline solution to remove debris and bacteria.
Next:
After cleaning, the open wound needs to be covered using special bandages that are designed to support healing. The type of bandage you use depends on the type of wound and how much fluid is present:
- Hydrocolloid dressings are ideal for wounds that aren’t too deep and are non-infected. They are recommended to create a protective barrier and also maintain acidic pH levels and a consistent temperature. These combined effects promote tissue healing.
- Semipermeable film dressings are also a good choice if the bedsore isn’t too deep or wet. These are thin and flexible bandages with an adhesive backing. They keep bacteria out while allowing oxygen, water vapor and carbon dioxide to pass through.
- If the bedsore is exuding fluids, you may want to use an alginate dressing, which is made from seaweed and contains sodium and calcium to accelerate healing. These dressings can absorb drainage up to 20 times their weight.
- Foam Dressings are also capable of absorbing a lot of fluid and are a good choice for a bedsore that needs drainage.
- Another option for exuding bedsores is hydrofiber dressings. These bandages are made of fibers that absorb fluid from the wound and create a gel-like covering that helps promote healing.
- For dry wounds that are sloughing or have a build-up of dead tissue, you should use a hydrogel bandage, which is a water-based gel dressing. Hydrogel dressings help remove dead tissue painlessly and promote complete healing.
Finally:
Always consult with a healthcare professional if you have any questions or concerns about bedsores. It’s imperative to call your doctor if a bedsore is deep, oozing and painful – especially if the patient has a fever. For severe cases, surgical debridement may be required to remove dead tissue, along with a course of antibiotics to combat infection.
Preventing Bedsores
Dealing with bedsores and pressure ulcers can be daunting. If the wound has been developing for a long time, healing can be a difficult process. Ideally, preventing bedsores from ever occurring is the best approach.
Patients who are confined to a bed or a wheelchair – some for their entire lives – have the highest risk of getting bedsores. Conditions such as paralysis, where there is loss of feeling, can exacerbate the situation. But even though the patient doesn’t feel pain, a bedsore can still be a deadly event if it goes undetected and untreated. Here are some steps you can take to decrease the risk of your patient or loved one getting bedsores.
📌 Reposition the Patient
Because bedsores are most likely to form where pressure is on the skin nearest the bone for an extensive period of time, changing the patient’s position is critical. Remember to change the patient’s position every two hours to relieve pressure on the bony areas.
📌 Check the Skin
In stage one of a bedsore, the skin discolors and may feel warmer or cooler than usual. That’s why it’s important to check the skin of patients on a regular basis. Position the patient differently if skin changes, pain, or tenderness occurs until the skin returns to normal and pain subsides.
📌 Keep the Skin Clean and Dry
Sweat, urine, or stool can increase the risk of bedsore formation. Make sure the skin is always clean and dry and use barrier creams to protect the skin.
📌 Avoid Friction
When moving your patient, you should avoid dragging the body, which increases friction on the skin. Use lifting devices when helping the patient move to and from a bed or wheelchair.
📌 Use Physical Therapy
Physical therapists often prescribe physical therapy for people with disabilities that confine them to a bed or wheelchair. Doing exercises recommended by a physical therapist can be an opportunity for patients to move, which can promote circulation and reduce the risk of bedsores.
📌 Make Sure Beds and Seats are Soft and Comfortable
Many mattresses and cushions are designed to lessen pressure on the skin and can help prevent bedsores from forming.
📌 Wash and Change Sheets and Clothes Frequently
Keeping the patient’s clothes and bedding clean is important to reduce the risk of infection should a bedsore form.
📌 Eat Healthy and Avoid Smoking
It’s vitally important that the patient have a nutritious diet, because good overall health reduces the risk of an infection. Avoiding smoking is important because nicotine interferes with healing.
Honest Medical is Here to Help
Preventing bedsores on your patient or loved one is important, but it’s not always easy to keep pressure wounds from developing. If you are dealing with a bedsore, it’s vital to consult your healthcare professional to determine your best course of action. Need supplies for your patient’s treatment plan? We have what you need. Visit our site and browse through thousands of health and wellness products. You can also speak to an Honest Medical Care Specialist at (833) 933-2323. We’re here to provide you with product knowledge, support, and expertise to ensure you get the right products for your unique needs and budget. Check out our other published articles on caregiving , wound care and more!
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