Bedsores Health Article

Definition

Bedsores are the result of inflammation and damage caused by irritation to the skin and inhibited blood flow. The condition occurs when skin is rubbed against a bed, chair, cast, or other hard object for an extended period of time. Bedsores can range from mild inflammation to deep wounds that involve muscle and bone. Infections can be a serious complication to the condition.

Description

Bedsores are also called decubitus ulcers, pressure ulcers, or pressure sores. They often start out with shiny red skin that becomes itchy or painful, then quickly blisters and deteriorates into open sores. Once there is a break in the skin, there is a strong possibility of the sore becoming infected, causing further medical problems. Bedsores are most apt to develop over the bony prominences of the ankles, the hip bones, the lower back, the shoulders, the spinal column, the buttocks, and the heels of the feet. Bedsores are most likely to occur in people who must use wheelchairs or who are confined to bed.

Bedsores are medically categorized by stages:

• Stage I: The skin reddens, but it remains unbroken.
• Stage II: Redness, swelling, and blisters develop. There is possibly peeling of the outer layer of the skin.
• Stage III: A shallow open wound develops on the skin.
• Stage IV: The sore deepens, spreading through layers of skin and fat down to muscle tissue.
• Stage V: Muscle tissue is broken down.
• Stage VI: The underlying bone is exposed, and there is danger of severe damage and infection.

Causes & symptoms

Bedsores most often happen when the most superficial blood vessels are pressed against the skin and squeezed shut, closing off the flow of blood. If the supply of blood to an area of skin is cut off for more than an hour, the tissue will began to die due to lack of oxygen and nutrients. Ordinarily, the layer of fat under the bony areas of the skin helps keep the blood vessels from being compressed in this way. Also, people have a normal impulse to change positions frequently when they are sitting or lying down, so the blood supply is usually not kept from any area of the skin for very long. Bedsores are most likely to occur in people who have lost the protective fat layer or whose movement impulse is hindered.

Friction or rubbing from poorly fitted shoes or clothing and wrinkled bedding often cause a sore to develop. Constant exposure to the moisture of urine, feces, and perspiration may also cause the skin to deteriorate. In such cases there is an increased the risk of skin infection as well as sores.

Risk factors for bedsores:

• older than 60 years of age
• heart disease
• diabetes
• diminished tactile sensation
• incontinence
• malnutrition
• obesity
• paralysis or immobility
• poor circulation
• prolonged bed rest
• spinal cord injury
• anemia
• disuse atrophy

Diagnosis

Physical examination of the skin, medical history, and patient and caregiver observations are the basis of diagnosis. Any sign of reddening of the skin will be closely monitored.

Treatment

Contrasting hot and cold local applications can increase circulation to problem areas and help flush out waste products, speeding the healing process. Hot compresses should be applied for three minutes, followed by 30 seconds of cold compress application, repeating the cycle three times. The cycle should always end with the cold compress. In addition, zinc and vitamins A, C, E, and B-complex should be taken to help maintain healthy skin and repair injuries.

Herbal remedies

A poultice can be made of equal parts of powdered slippery elm, Ulmus fulva; marsh mallow root, Althaea officinalis; and Echinacea spp. The herbs should be blended together with a small amount of hot water and applied to the skin three or four times per day to relieve inflammation. Poultices used on broken skin or infected areas should never be reused.

An infection-fighting rinse can be made by diluting two drops of essential tea tree oil, Melaleuca spp., in eight ounces of water. This should be used to bathe the wound when bandages are changed.

An herbal tea made from Calendula officinalis can be used as an antiseptic wash and a wound healing agent. Calendula cream can also be applied to the affected area.

A poultice made from goldenseal, Hydrastis canadensis, and water or goldenseal ointment can be applied to areas of inflammation several times per day to heal the skin and prevent infection.