Bedsores Health Article

Allopathic treatment

A healthcare provider should be consulted whenever a person develops bedsores. An emergency situation may be indicated if sores become tender, swollen, or warm to the touch, if the patient develops a fever, or if the sore has pus or a foul-smelling discharge.

For mild bedsores, treatment basically involves relieving pressure on the area and keeping the skin clean and dry. When the skin is broken, a non-stick covering may be used. A saline solution is often used to clean the wound site whenever a fresh bandage is applied. Disinfectants are applied if the site is infected. The doctor may also prescribe antibiotics, special dressings or drying agents, and ointments to be applied to the wound. Heat

lamps are used quite successfully to dry out and heal the sores. Warm whirlpool treatments are sometimes also recommended for sores on the arm, hand, foot, or leg.

In a procedure called debridement, a scalpel may be used to remove dead tissue or other debris from the wound. Deep sores that don't respond to other therapy may require skin grafts or plastic surgery. If there is a major infection, oral antibiotics may be given. If a bone infection, called osteomyelitis, develops or infection spreads through the bloodstream, aggressive treatment with antibiotics over the course of several weeks may be required.

Expected results

With proper treatment, bedsores should begin to heal two to four weeks after treatment begins. Left untreated, however, gangrene, osteomyelitis, or a systemic infection may develop. In the United States, about 60,000 deaths a year are attributable to complications caused by bedsores.

Prevention

Prompt medical attention can prevent pressure sores from deepening into more serious infections. People whose movement or sense of touch is limited by disability and disease should be monitored to insure that the skin remains clean, dry, healthy. A bedridden patient should be repositioned at least once every two hours while awake. A person who uses a wheelchair should remember to shift the body's position often or they should be helped to reposition the body at least once an hour. To avoid injury, it is important to lift, rather than drag, a person being repositioned. Wheelchair users should sit up as straight as possible, with pillows behind the head and between the legs if needed. Donut-shaped seat cushions should not be used because they may restrict blood flow.

Even slight friction can remove the top layer of skin and damage the blood vessels beneath it. Pillows or foam wedges can be used to keep the ankles from rubbing together and irritating each other; pillows placed under the lower legs can raise the heels off the bed. To minimize pressure sores, there should be adequate padding in beds, chairs, and wheelchairs. Those who are bed-ridden can be protected by using sheepskin pads, specialized cushions, and mattresses filled with air or water. In addition, a 1997 study indicates that topical use of essential fatty acids can help the skin stay healthy.

BOOKS

Berkow, MD, Robert, editor-in-chief, et al The Merck Manual of Medical Information, Home Edition. New York: Pocket Books, 1997.

The Editors of Time-Life Books The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments Virginia: Time-Life, Inc., 1996.

PERIODICALS

Declair, V. Ostomy Wound Management 43, no. 5 (1997): 48-52.

ORGANIZATIONS

International Association of Enterstomal Therapy, 27241 La Paz Road, Suite 121, Laguna Niguel, CA 92656

National Pressure Ulcer Advisory Panel, SUNY at Buffalo, Beck Hall, 3435 Main Street, Buffalo, NY 14214 <http://www.npuap.org.>

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