If discovered early, bed sores are treatable. However, they may sometimes be fatal. According to health authorities in the UK and USA, bed sores are the second iatrogenic cause of death, after adverse drug reactions. Iatrogenic cause of death means unexpected death caused by medical treatment - death caused by the action of a physician or a therapy the doctor prescribed.
Pressure ulcer prevention strategies are applicable to all anatomical
sites; however, the main focus of this article is heel ulceration in
the nursing home setting.
One of the first signs of a possible skin sore is a reddened, discolored or darkened area (an African American’s skin may look purple, bluish or shiny). It may feel hard and warm to the touch.
You may need to learn new ways to change your position to prevent too much pressure. Pressure sores can occur, for example, when you sit or lie in one position too long. Shearing is also a kind of pressure injury. It happens when the skin moves one way and the bone underneath it moves another way. An example of this is if you slouch when you sit.
Studies have shown that getting ahead of wounds before they become dangerous can dramatically improve outcomes.
A review of programs to prevent bedsores, or pressure ulcers, published in the current issue of Skin and Wound Care, found that following certain routines, including assessing patients for bedsore risk, turning them frequently in hospital beds to redistribute pressure on the skin, and monitoring skin for signs of a developing chronic wounds, can help reduce their incidence and severity.
Wound and Pressure Ulcer Management.
“We set out to create a type of bandage that could detect bedsores as they are forming, before the damage reaches the surface of the skin,” said Michel Maharbiz, a UC Berkeley associate professor of electrical engineering and computer sciences and head of the smart-bandage project.
No one likes to think of the nasty terms, "pressure sores" or "bedsores", but they are a fact of life for residents in nursing homes. The question is whether anything can be done to prevent pressure sores for bedridden residents of nursing homes. The answer is an unequivocal "YES".
Common sites include the sacrum (tailbone), back, buttocks, heels, back of the head, and elbows. If not adequately treated, open ulcers can become a source of pain, disability, and infection.
The National Pressure Ulcer Advisory Panel (NPUAP) serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.
Answers for families coping with pressure sores developed in nursing homes, hospital or care facilities.
Family members with someone in long-term care need to be knowledgeable and vigilant about decubitus ulcers -- the dreaded bedsores.
Pressure sores most often form on the skin over bony areas where there is little cushion between the bone and the skin. Most pressure sores form on the lower part of the body, including over the tailbone and on the back along the spine, on the buttocks, on the hips, and on the heels. Other common spots are the back of the head; the backs of the ears; the shoulders, elbows, and ankles; and between the knees where the legs rub together.
There are 4 stages of pressure sores. Symptoms at each stage include the following:
Stage 1. The affected skin looks red and may feel warm to the touch. The area may also burn, hurt or itch. In people who have dark skin, the pressure sore may have a blue or purple tint.
Stage 2. The affected skin is more damaged in a stage 2 pressure sore, which can result in an open sore that looks like an abrasion or a blister. The skin around the wound may discolored. The area is very painful.
Stage 3. These types of pressure sores usually have a crater-like appearance due to increased damage to the tissue below the skin's surface. This makes the wound deeper.
Stage 4. This is most serious type of pressure sore. The skin and tissue is severely damaged, causing a large wound. Infection can occur at this stage. Muscles, bones, tendons and joints can be affected by stage 4 pressure sores.
Pressure sores are areas of damaged skin caused by staying in one position for too long. They commonly form where your bones are close to your skin, such as your ankles, back, elbows, heels and hips. You are at risk if you are bedridden, use a wheelchair, or are unable to change your position. Pressure sores can cause serious infections, some of which are life-threatening. They can be a problem for people in nursing homes.
Prognosis is excellent for early-stage ulcers; neglected and late-stage ulcers pose risk of serious infection and are difficult to heal. Treatment includes pressure reduction, avoidance of friction and shearing forces, and diligent wound care. Sometimes, skin grafts or myocutaneous flaps are needed to facilitate healing.
It's estimated that just under half a million people in the UK will develop at least one pressure ulcer in any given year. This is usually people with an underlying health condition – for example, around 1 in 20 people who are admitted to hospital with a sudden illness will develop a pressure ulcer.
People over 70 years old are particularly vulnerable to pressure ulcers, as they are more likely to have mobility problems and ageing skin.
There is no conclusive research evidence to guide clinicians' decision-making about which dressings are most effective in pressure ulcer management.