What are bedsores? Why is it important to prevent and how to prevent?
A bedsore is a dark or red area, a breach on the skin or crater like wound in the skin caused by prolonged pressure, shear or friction on the skin. Bedsores usually develop over bony surfaces of the body such as the tailbone, heels, elbows, wrists, shoulders or back of the head.
How bed sores are formed and why it’s important to prevent bed sores?
Bedsores or pressure ulcers or pressure sore happen when blood flow to the skin is cut off for more than 2-3 hours. Initially it starts as a red, painful spot which eventually turns purple due to the lack of oxygen. If left untreated, they can become infected and even spread to the surrounding muscles and bones. Depending on other underlying medical conditions such as diabetes or compromised immunity, they can take months or even years to heal.
Anyone can develop a bedsore for being in the same position on a bed or chair for long hours. People most affected belong to the older age group who are immobile due to some disease and their movement is restricted to one place.
While most bedsores take days to develop, some of them develop over hours depending on the person's physical health. Bedsores are much easier to prevent than to treat. One can take precautions to reduce the likelihood of its occurrence.
What are the causes of bedsores?
- Pressure –When a person is bedridden, there is constant pressure on the skin owing to lying down and being in the same position for prolonged periods. This constant pressure can adversely affect the blood circulation to that area leading to reduced or no oxygen and nutrient supply to the affected area. Over time, the lack of oxygen and nutrients can damage the skin and cause it to die.
- Friction – This is also a major contributor to bedsores. When skin that is already susceptible to damage rubs against clothing or bedding, it can result in sores especially if the skin is moist. In people who are bedridden, this can pose a real problem. Moreover, the bed ridden patients pass urine and faeces in their diapers which makes the skin moist and increases friction leading to development of bed sores.
- Shear – Shear happens when skin and bone move in opposite directions. When a person slides downs, the tailbone moves downward while the skin above it doesn’t. This causes damage to the skin in that area that may lead to development of bed sores.
- Moisture - Causes softening the upper layers of the skin and makes skin vulnerable to erosion. Moisture on skin increases its coefficient of friction thus increases risk of bed sores.
How can bedsores be prevented?
Inspecting the skin for signs of redness, especially the skin covering bony areas Measures listed below can help in prevention:
- Repositioning
Repositioning and turning the patient every 2-3 hours on bed is still the primary practice in effective prevention of bedsores. This ensures proper blood circulation and helps in diffusing prolonged pressure in a particular area of the body.
- Support surfaces
Providing soft padding on bed or wheelchairs to reduce pressure on skin. If the patient is wheelchair bound, change position every few minutes to facilitate blood flow. A more effective option would be the use of dynamic surfaces/mattresses which are motorised. They are designed to change the pressure of the surface periodically under the patient.
Ensuring proper skin care by keeping the skin dry and clean lessens the probability of friction. Applying barrier creams or gels on pressure prone areas reduces the friction on the skin thereby prevents formation of bedsores. Water repellent barrier creams prevent accumulation of moisture thereby reducing friction on the skin.
- Nutrition
Having a poor nutrient and fluid intake can increase the risk of bed sores. The risk increases in those who are underweight or overweight. Maintaining a healthy weight and eating a balanced diet can reduce the risk of developing bed sores.
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