Decubitus ulcer
Bedsores are the skin lesions caused due to prolonged pressure resulting in the death of skin and dermatic tissue. Bedsores are also called as Pressure sores or pressure ulcers. Main cause of pressure sore is sitting or lying in the same position for prolonged time.
Mechanism of Bedsore development
When an individual stays on single position for prolonged time, the pressure is exerted between the body skin and the other surface such as Bed. The pressure cut offs the blood supply to particular area and leads to tissue damage of skin and underlying tissue, resulting in Bedsores, or pressure ulcer.
Bedsores are caused by number of factors such as prolonged pressure, friction, humidity in the skin, old age, wrinkled bed and friction, increased temperature, and bony prominences with less adipose tissue are at risk. Bedsores worsens the life of individuals if proper care is not taken.
Due to illness, when a single position is maintained for long time, pressure exerts between body skin and bed. Increased pressure creates a force which resists blood flow to that area. Decreased blood flow to particular area leads to cell death, so the skin tissue and underlying tissue damage occurs. This is called as bedsores, due prolonged stay on bed, or Pressure sore, because the sore is occurred due to excess pressure.
Causes of Bedsore
- Various factors causes bedsores, such as
- Staying on wheel chair or being bed ridden for long time,
- Fragile skin
- Reduced blood flow to skin in conditions such as diabetes and vascular disease,
- Malnourishment leads to less adipose tissue and causes Bedsores,
- Inability of person to get aware of skin lesions or irritation, in chronic conditions such as stroke, alzheimers disease,
- Wrinkled skin in old age which undergoes pressure,
- Urinary incontinence,
- Bowel incontinence,
- Poor hygiene and wrinkled bed, etc
Factors causes Bedsore
Pressure : Prolonged single position or decubitus, compresses the skin and underlying tissue between bony prominences of body and Bed. The pressure is exerted between bed and body skin. Increased pressure reduces blood flow to the area, decreases tissue perfusion, ischemia occurs and causes tissue necrosis i.e. Bedsores.
Sheer force : A force created between body skin, when patient in same position as a deep fascia and skeletal muscle slided down with gravity. Resistance developed by this force, reduces blood flow and leads to tissue necrosis, causes bedsore.
Friction : Friction occurs between body skin and bed while jerking the body on bed causes Bedsores.
Symptoms of Bedsores/ pressure ulcer
Stage 1 : Red patch is found on the skin, when pressed on patch, it doesn’t change to white. Is the starting stage of bedsore.
Stage 2 : Blisters are formed on the skin, later blisters may become open, red irritating area is found.
Stage 3 : sore or lesion is formed on the skin, even the underlying tissue damage occurs.
Stage 4 : Deep ulcer is formed along with damage to muscles and bone. Usually the bony prominences at joints are affected with bedsore or pressure ulcer.
Treatment of Bedsores
Group of health care team provides care to treat Bedsores.
Nurse places a major role in treating Bedsores.
Change the position of patient as the bedsore area get relief.
Dress the wound cleansing with betadine and other antibiotic solutions.
Improve the nutrition of patient,
If needed with doctors order administer the antibiotics.
Prevention of Bedsores
As we know prevention is better than cure, with proper health care Bedsore can be prevented.
Change the position of patient fro every two hours,
Bed should be soft and neat with no wrinkles,
Pressure reducing things such as pillows, sheepskin, foam padding and powders to be used to prevent bedsores.
Range of motion exercises are provided for immobile patients, daily.
Provide orange juice and Vitamin C rich food to enhance healing,
Provide special care for unconscious patients, patients with urinary and bowel incontinence
