Definition: What Is A Bedsore?
Bedsores refer to broken skin which is caused by constant pressure on an area. The heels and the sacrum are the parts of the body which are most commonly affected, as well as the nape of the neck, elbows, or the top of the head.
Bedsores mainly affect older people, in wheelchairs or who are bedbound. Essentially, layers of skin are put under constant pressure. This can cause blood vessels in the skin to contract which cuts of the blood circulation to the superficial tissues (skin) or deeper tissues (muscles). They suffer from a shortage of oxygen. This is what is called tissue hypoxia.
Symptoms of bedsores
If tissue hypoxia lasts for a long period of time, the tissue begins to deteriorate. The pressure sores first develop in the muscles and then read layers of the skin.
We can distinguish between 4 distinct stages of pressure sores.
Stage 1: Erythema or skin rashes which do not disappear when there is pressure. This is the first visible sign.
Stage 2: The formation of a phlycten (blister), possibly open.
Stage 3: skin deep damage with necrosis of the epidermis (destruction of tissues). This manifests through a ‘crater’ in the skin.
Stage 4: Profound muscle and bone damage
It is very important to immediately treat the damage in the first stage because the development of bedsores is very quick (usually just a few hours). When the skin begins to hollow, bone and muscle damage is already profound. This is why prevention is essential.
In order to put prevention methods in place, it is necessary, to first evaluate the risks of getting a pressure sore. This involves studying the patient’s mobility, nutritional health, skin healthiness, medical history and age. Several scales can be used to establish an evaluation of the patient such as the Norton, Waterloo, or Bradon scales.
Preventing bed sores aims to reduce the pressure which the skin suffers during long periods of immobility. In order to do this, the patient much regularly change position and this is planned in, whilst avoiding friction and scrapes which are favourable conditions for bedsores. Resting with cushions and a mattress is also recommended, as well as maintaining good skin hygiene (avoiding maceration) and a balanced diet.
There is not really a clear procedure for how bedsores should be treated, especially after they have developed beyond stage 1, and require a specialist’s opinion. Dressing can help to heal the wound and prevent new lesions from forming. Bedsores are to be kept warm and cleaned regularly to help the healing process.
Moreover, physiotherapy can help with a person’s mobility whilst a healthy diet can overcome any lack of nutrients.
In the case of serious necrosis (stage 4), surgery is vital to repair the muscle and bone damage.