Bedsores — also called pressure ulcers and decubitus ulcers — are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most frequently develop on skin that covers bony areas of the body, like the heels, ankles, hips and tailbone.
People most in danger of bedsores have medical conditions that limit their ability to vary positions or cause them to spend most of their time during a bed or chair.
Bedsores can develop over hours or days. Most sores heal with treatment, but some never heal completely. You can take steps to assist prevent bedsores and help them heal.
Warning signs of bedsores or pressure ulcers are:
Ø Unusual changes in skin color or texture
Ø Pus-like draining
Ø An area of skin that feels cooler or warmer to the touch than other areas
Ø Tender areas
Bedsores fall under one among several stages supported their depth, severity and other characteristics. The degree of skin and tissue damage ranges from red, unbroken skin to a deep injury involving muscle and bone.
When to see a doctor
If you notice warning signs of a bedsore, change your position to alleviate the pressure on the world . If you do not see improvement in 24 to 48 hours, contact your doctor.
Seek immediate medical aid if you show signs of infection, like a fever, drainage from a sore, a sore that smells bad, or increased redness, warmth or swelling around a sore.
Bedsores are caused by pressure against the skin that limits blood flow to the skin. Limited movement can make skin susceptible to damage and cause development of bedsores.
Three primary contributing factors for bedsores are:
• Pressure - Constant pressure on any a part of your body can lessen the blood flow to tissues. Blood flow is important for delivering oxygen and other nutrients to tissues. Without these essential nutrients, skin and nearby tissues are damaged and might eventually die.
For people with limited mobility, this type of pressure tends to happen in areas that are not well padded with muscle or fat which lie over a bone, such as the spine, tailbone, shoulder blades, hips, heels and elbows.
• Friction - Friction occurs when the skin rubs against clothing or bedding. It can make fragile skin more susceptible to injury, especially if the skin is additionally moist.
• Shear - Shear occurs when two surfaces move within the other way . For example, when a bed is elevated at the head, you can slide down in bed. As the tailbone moves down, the skin over the bone might stay in place — essentially pulling in the opposite direction.
Your risk of developing bedsores is higher if you've got difficulty moving and can't change position easily while seated or in bed. Risk factors include:
Ø Immobility. This could be thanks to poor health, medulla spinalis injury and other causes.
Ø Incontinence. Skin becomes more vulnerable with extended exposure to urine and stool.
Ø Lack of sensory perception. Spinal cord injuries, neurological disorders and other conditions can result in a loss of sensation. An inability to feel pain or discomfort can result in not being aware of warning signs and the need to change position.
Ø Poor nutrition and hydration. People need enough fluids, calories, protein, vitamins and minerals in their daily diets to take care of healthy skin and stop the breakdown of tissues.
Ø Medical conditions affecting blood flow. Health problems which will affect blood flow, like diabetes and vascular disease, can increase the danger of tissue damage like bedsores.
Complications of pressure ulcers, some life-threatening, include:
• Cellulitis - Cellulitis is an infection of the skin and connected soft tissues. It can cause warmth, redness and swelling of the affected area. People with nerve damage often don't feel pain within the area suffering from cellulitis.
• Bone and joint infections - An infection from a bedsore can burrow into joints and bones. Joint infections (septic arthritis) can damage cartilage and tissue. Bone infections (osteomyelitis) can reduce the function of joints and limbs.
• Cancer - Long-term, nonhealing wounds (Marjolin's ulcers) can become a kind of epithelial cell carcinoma.
• Sepsis - Rarely, a skin ulcer leads to sepsis.
You can help prevent bedsores by frequently repositioning yourself to avoid stress on the skin. Other strategies include taking excellent care of your skin, maintaining good nutrition and fluid intake, quitting smoking, managing stress, and exercising daily.
Tips for repositioning
Consider the subsequent recommendations associated with repositioning during a bed or chair:
Ø Shift your weight frequently. Ask for help with repositioning about once an hour.
Ø Lift yourself, if possible. If you have enough upper body strength, do wheelchair pushups — raising your body off the seat by pushing on the arms of the chair.
Ø Look into a specialty wheelchair. Some wheelchairs allow you to tilt them, which may relieve pressure.
Ø Select cushions or a mattress that relieves pressure. Use cushions or a special mattress to alleviate pressure and help make sure that your body is well positioned. Do not use doughnut cushions, as they will focus pressure on surrounding tissue.
Ø Adjust the elevation of your bed. If your bed are often elevated at the top , raise it no quite 30 degrees. This helps prevent shearing
Tips for skin care
Consider the following suggestions for skin care:
Ø Keep skin clean and dry. Wash the skin with a gentle cleanser and pat dry. Do this cleansing routine regularly to limit the skin's exposure to moisture, urine and stool.
Ø Protect the skin. Use moisture barrier creams to guard the skin from urine and stool. Change bedding and clothing frequently if needed. Watch for buttons on the clothing and wrinkles in the bedding that irritate the skin.
Ø Inspect the skin daily. Look closely at your skin daily for warning signs of a bedsore.
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