Bed sores: Causes, Symptoms, Risk Factors, Stages, Diagnosis, Treatment and Complications

Bedsores are skin and subcutaneous tissue lesions caused by persistent pressure on the skin. Other names for them are decubitus ulcers and pressure ulcers. The skin above the body's bony structures, such as the tailbone, hips, and the heels and ankles, is where bedsores most usually develop.

Those who are most at risk for bedsores are unable to change positions due to their medical conditions, or they are compelled to spend the majority of their time in a chair or bed.

It may take hours or days for bed sores to develop. While therapy helps most wounds heal, some never fully heal. With the aid of several techniques, bed sores can be avoided and treated.

Causes Of Bedsores

Pressure against the skin that restricts blood flow to the skin is what causes bedsores. Bed sores can occur as a result of restricted movement damaging skin.

The top three reasons for bedsores are as follows:

• Pressure. Constant pressure can restrict blood flow to any part of your body. Blood flow is required for tissues to receive oxygen and other nutrients. Without these essential nutrients, skin and surrounding tissues suffer harm and may even die.
• For people with restricted mobility, this type of pressure typically develops in areas that lie over a bone and aren't adequately cushioned by muscle or fat, such as the spine, tailbone, shoulder blades, hips, heels, and elbows.
• Friction. Skin rubbing across clothing or bedding causes friction. Particularly if the skin is damp, it might render delicate skin more prone to damage.
• Shear. Two surfaces moving in opposing directions cause shear. For instance, if a bed is elevated at the head, you could slip down in bed. The skin that covers the tailbone may not move when the bone descends; instead, it may pull in the opposite way.

Symptoms Of Bed Sores

The risk of developing a pressure ulcer or bedsore is:

• Unusual alterations in skin tone or texture
• Swelling
• Pus-like drainage
• An area on the body's surface that is colder or warmer to the touch than other areas.
• Tender areas

Based on the depth, severity, and other factors, bedsores can be classified into one of several stages. Skin and tissue injuries can range in severity from slight colour changes to serious injuries that affect bone and muscle.

Typical sites for pressure ulcers

In wheelchair users, bedsores frequently form on the skin over the following areas:

• The backs of the arms and legs as they are resting on the chair
• The buttocks or the tailbone
• The spine, and the shoulder blades

Where Can Bedsores Develop?

Bedsores can develop on:

• The sides or back of the skull
• The shoulder blades
• the hip, lower back, or tailbone
• the tissue around the knees, heels, and ankles

Risk Factors Of Bedsores

If you have trouble getting up and changing positions when seated or in bed, your chance of developing bedsores is higher. Risk elements include:

• Immobility. This could be brought on by ill health, a spinal cord injury, or other factors.
• Incontinence. With prolonged urine and stool contact, skin becomes more susceptible.
• Lack of sensory perception. Loss of sensation can be brought on by spinal cord injury, neurological illnesses, and other conditions. Being unable to feel pain or discomfort can make it difficult to recognise warning signs or the need to adjust one's position.
• A lack of water and proper diet. To maintain good skin and stop tissue degradation, people must consume enough calories, protein, vitamins, and minerals everyday.
• Medical problems that alter blood flow. Diabetes and vascular disease, two medical conditions that can impair blood flow, can raise the risk of tissue damage, including bedsores.

Stages Of Bedsores

The four stages of pressure sore development are as follows:

• The skin is warm to the touch. There can be a colour change, like redness, and the region might itch.
• A painful open sore or blister forms and the surrounding skin turns discoloured.
• As a result of tissue destruction beneath the skin's surface, the lesion takes on a crater-like look.
• There is serious tissue and skin damage, possibly accompanying an infection. It is possible to see the muscles, bones, and tendons.
• A sore that is infected takes longer to heal. There is a chance that the infection will spread throughout the body and cause significant harm.

Diagnosis Of Bedsores

You might go to a wound specialist for diagnosis and treatment. Medical practitioners stage and diagnose bedsores based on how they appear. Your doctor will take a photo of the sore in order to monitor how the wound is healing.

You may undergo specific tests to check for infections, such as:

• Biopsies.
• Blood tests and cultures.
• MRIs or X-rays

Treatment Of Bedsores

Altering your position frequently may help in healing and stop the emergence of new sores.

When sores are still in the early stages, people may be able to treat them at home. Ulcers that are more severe require professional medical care.

Various further steps depend on how severe the sore is. The following general strategies, however, are effective:

• Relieve the pressure by shifting the body's position and utilising foam pads or cushions to support the pressure-sensitive areas.
• The wound should be cleaned by rinsing it with warm water and a mild soap. Cleanse the open wounds with a saline solution before changing the dressing.
• To hasten the healing process, cover the lesion with dressings. The best options can be hydrocolloid-based, antimicrobial, or contain alginic acid. Dressings are available for online purchase.
• Use topical creams: Barrier creams can protect skin that has been harmed or is vulnerable, while antibacterial creams can aid in the fight against an infection.
• Use faecal management systems, incontinence pads, barrier creams, cleansers, and other methods to deal with incontinence. These products are available for online purchase.
• Remove dead tissue to help in the healing of a wound. A medical professional might utilise a high-pressure water jet or surgical tools.
• Examine the bedding: Certain mattresses, such as dynamic models or those constructed of static foam, aid in pressure relief. Some mattresses also contain a pump that maintains an even flow of air into the mattress. The best kind may be suggested by a doctor. Online retailers sell specialised mattresses.
• Taking any necessary antibiotics These may be recommended by the doctor to treat infections of the skin, bones, or blood.
• A change in diet may be necessary. While there is little proof that any particular diet may effectively treat pressure sores, adding more protein may hasten healing and shrink wounds. It can be beneficial to consume enough necessary nutrients and water to maintain overall health.
• A discussion of surgical options Remove dead tissue, clean the incision, and seal the edges as much as you can are a few examples of these. To make the repair, the surgeon could use tissue from a healthy area of skin.

Further advantages for a person with bedsores include:

• Electric stimulation
• Vacuum-assisted wound closure
• Using high-pressure oxygen

Complications Of Bedsores

Pressure ulcer complications, some of which are life-threatening, consist of:

• Cellulitis. An infection of the skin and nearby soft tissues is known as cellulitis. The affected area may become heated, swollen, and inflamed. When a person has nerve damage, they frequently do not experience pain in the cellulitis-affected area.
• Infection of the bones and joints. An infection from a pressure sore has the potential to reach bones and joints. Cartilage and tissues can be harmed by joint infections (septic arthritis). Osteomyelitis, a bone infection, can have a detrimental influence on joint and limb function.
• Cancer. Squamous cell carcinomas of a certain type can arise from chronic, non-healing wounds (Marjolin's ulcers).
• Sepsis. Sepsis from a skin ulcer occurs infrequently.

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