Bedsores are also known as pressure sores or pressures refer to skin injuries and injuries to the underlying tissues that occur as a result of prolonged pressure to a region of the skin. Bedsores commonly occur on regions where the skin overlies bony areas; such regions may include the ankles, heel, hips or buttocks.
People with medical conditions that restrict them from changing positions are usually more likely to develop bed sores. People who also use a wheelchair or are instructed to bed rest for prolonged periods are also susceptible to bed sores.
Bedsores that develop rapidly are usually difficult to treat. People with bed sores must consider serious self-care in order to prevent bedsores from taking place and allow proper healing. Managing bed sores are not covered in workplace approved training programs (register here), but similar problems including wound management and treating infections are covered in the courses.
Signs and symptoms
Deepening on their severity, bedsores fall under four main stages.
Stage 1
- Skin is intact
- Red on purple skin, light skin color, skin turns light when touched
- Darker skin tones may not show changes in skin color or blanching when touched. Skin may appear to be slightly blue, purple or ash
- The affected region may be firm, painful, soft, cool or warm compared to other regions of the skin
Stage 2: Open wound
- The outer layer of the skin or the epidermis and part of the dermis (underlying layer) may be lost or damaged
- Pressure ulcer may appear like pinkish red, basin-like, shallow wound
- May appear as a ruptures fluid-filled blister that is intact
Stage 3: Deep wound
- Loss of skin – Some fat may be exposed
- Crater-like appearance of the ulcer
- Bottom of the wound may show some yellowish dead tissue or slough
- Damage may extend beyond the initial region of the wound and affect healthy skin
Stage 4: Large scale loss of tissue
- Exposed muscle, bones or tendons from the wound
- Bottom of the wound may contain slough or dark, scaly, crusty dead tissue called eschar
- Damage will most likely extend beyond the boundaries of the initial wound and affect healthy skin
When to seek medical help
Make sure a person who is confined to a wheelchair or bed is properly checked for any wounds that may indicate bedsores. See your doctor promptly if you notice signs and symptoms of pressure ulcers. Immediate medical attention is required if the person show signs of infection including drainage form the sore, foul odor from the sore, fever, increased redness and heat of the surrounding skin area.
Treatment
Treatment for bedsores primarily involves relieving pressure.
Follow these self-care tips to reduce pressure:
- Reposition. Make sure you reposition yourself regularly in proper positions. People on wheelchairs should do this every 15 minutes, while people in bed are required to do so every 2 hour
- Support materials. Use pads, cushions, beds and mattresses to allow the person to lie in a proper position
To remove damaged tissue, the following steps may be required:
- Surgical debridement to cut away dead tissues
- Mechanical debridement using a number of methods that will loosen and remove dead tissues
- Autolytic debridement – the body’s natural mechanism of bring in enzymes to break down dead tissue – this can be enhanced using appropriate dressing
- Enzyme debridement – usage of chemical enzymes
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