Bed sores (also known as pressure ulcers and decubitus) are caused by unrelieved pressure on any part of the body, usually on the back or any bony or cartilaginous area. They can also occur on areas that do not have the benefit of body fat as padding. The pressure is due to lying or sitting down in one position for an extended period of time, resulting in that area having to bear the full weight of the body. Due to the pressure, the blood supply is cut off. Shortage of blood for an extended period of time may cause tissue damage or cell death. When blood is re-introduced to the tissue, it may result in reperfusion injury.
People who are bedridden, in a coma or are largely paralyzed and can’t move their body are the usual victims of this condition. Bed sores can be treatable if found early, but if they are not given medical attention right away, they can become very serious and even life-threatening. The sores start out as a reddish, painful area that then becomes purple. Left alone and untreated, the skin may break out, causing infection to set in.
Bed sores are classified in four stages, according to their severity, as given by the National Pressure Ulcer Advisory Panel.
Stage I is the most superficial. The most telling indication of sores in Stage I is redness that does not go away when pressure is relieved. The skin can feel hotter or cooler to the touch than normal and may have an odd texture. It can also be painful.
Stage II is damage to the epidermis (the outermost layer of the skin) and may extend to the dermis (the layer under the epidermis), but not beyond it.
Stage III is damage to the whole skin but not through the subcutaneous tissue layer. At this layer, the wound may mask greater underlying damage than what it is showing on the outside. In this layer, blood supply is poor and healing can be difficult.
Stage IV is the deepest of the pressure ulcer and can extend even down to the bone.
Healing time is prolonged the higher the stage is. For example, at Stage II, healing can take eight weeks, while at Stage IV, roughly 62% ever heal, with 52% of them within one year.
Depending on the stage of the sore, there are things you can do to get rid of the sores or, at the very least, ease the condition.
Relieve the pressure. Pressure is the main cause of sore aggravation for patients with the condition. Once a bed sore has been found, the patient should be turned around at least once every two hours to relieve the pressure on the afflicted area. For patients who are paralyzed or unable to move, constant supervision is especially necessary since they need to be assisted in order to shift positions. There are also pressure-distributive mattresses like Repose that can also be used to reduce the pressure on bony areas of the body.
Use mattresses or equipment that reduce or address pressure problems. Natural sheepskin, in particular, is comfortable and soft. It is friction-free due to natural fibers that are also protected with natural oils. Weight redistribution over a large area is also one of sheepskin’s qualities that helps ease the pressure. On top of that, the springy wool fibers are high-density, making for comfortable and relatively reduced pressure on body parts.
Padding made of sheepskin also reduces the moisture produced on the skin when you lie in one position or area for too long. Sheepskin fibers can hold 30 to 36% of the moisture without becoming damp. The elimination of moisture from the skin and into the fibers is another way of relieving or even preventing bed sores from happening.
Improve your diet with added nutritional support. Malnutrition is one of the worst things that could happen to a person afflicted with bed sores. You need the proper assortment of vitamins and minerals—especially vitamin C and zinc—in order to make the sores heal faster and resist infections more. A healthy, nutritional diet also protects your skin and guards it against breakdown. Get enough calories and protein as well.
If you think you’re malnourished, consult your physician or dietitian so they will be able to give you a good dietary program based on the severity of your condition. A dietitian can also make sure that what you’re currently eating will not get in the way of your recovery.
Clean the wounds and sores often. Cleaning the sores is important to minimize the risk of infection. Use a saline solution every time the dressing is changed. Saline solutions can be bought at any drugstore or can be made at home. Boil one teaspoon of salt in one quart of water for about five minutes. Let the solution cool and store in a clean and sterile container. Hydrogen peroxide is not recommended since its toxicity is pretty difficult to balance with respect to the wound.
When dressing the wound, the basic rule of thumb is to keep the wound moist but the skin around it dry. For sores in the earlier stages, a covering may not be needed, but those in the second stage usually need gauze that retains the moisture and encourages the growth of skin cells.
Remove damaged tissue. For wounds or sores that are relatively more serious, removal of the dead tissue (called debridement) is essential for faster recovery and healing. Damaged tissue removal will depend on what type of wound you have and your overall condition. There are several ways your physician can remove damaged or necrotic tissue:
- Autolytic debridement: the use of moist dressings to remove dead tissue.
- Biological debridement: medical maggots feed on the dead tissue. While it may sound unhygienic and gross, this method is approved by the United States Food and Drug Administration.
- Chemical debridement: the use of approved enzymes that promote removal of the dead or damaged tissue.
- Mechanical debridement: outside forces are used to remove damaged tissue. This is wholly unpopular because it has the chance of removing the healthy tissue; it involves packing the wound with wet dressing that is allowed to dry. Once the dressing is dry, it is removed. The result can be quite painful as well.
- Sharp debridement: the use of sharp instruments like scalpels to remove dead or damaged tissue.
- Surgical debridement: allows a surgeon to surgically remove the dead tissue. It is the most popular of all the debridement methods.
- Ultrasound-assisted wound therapy: ultrasound used to separate damaged and healthy tissues.
Bed sores can be a very serious and inconvenient condition when they get worse. As always, prevention is the best option when it comes to bed sores. In the late stages of the condition, healing takes time, so you need a lot of patience, not to mention willpower, to get through it.
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