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    • Bed Sores

    PRESSURE ULCERS (BED SORES)

    Bed sores can affect people who spend a long time in one position, for example, because of paralysis, illness, old age, or frailty. Also known as pressure ulcers and pressure sores, bed sores can happen when there is friction or unrelieved pressure on one part of the body.

    The sores can affect any part of the body, but the bony areas around the elbows, knees, heels, coccyx, and ankles are more susceptible.

    Bedsores are treatable, but, if treatment comes too late, they can lead to fatal complications.

    The prevalence of pressure sores in intensive care units in the United States (U.S.) is estimated to range from 16.6 percent to 20.7 percent.

    FAST FACTS ON PRESSURE SORES

    Here are some key points about pressure sores. More detail is in the main article.

    Pressure sores, pressure ulcers, or bedsores commonly affect people who cannot move easily.

    They are more likely to affect the bony parts of the body.

    The sores develop in stages. Identifying them in the early stage enables treatment and reduces the risk of complications.

    Moving patients frequently is key to preventing pressure sores.

    TREATMENT

    Treating pressure ulcers involves reducing pressure on the affected skin, caring for the wounds, controlling pain, preventing infection and maintaining good nutrition.

    REDUCING PRESSURE

    The first step in treating a bedsore is reducing the pressure and friction that caused it. Strategies include:

    • Repositioning. If you have a pressure sore, turn and change your position often. How often you reposition depends on your condition and the quality of the surface you are on. Generally if you use a wheelchair, try shifting your weight every 15 minutes or so and change positions every hour. If you’re in a bed, change positions every two hours.
    • Using support surfaces. Use a mattress, bed and special cushions that help you sit or lie in a way that protects vulnerable skin.

    CLEANING AND DRESSING WOUNDS

    Care for pressure ulcers depends on how deep the wound is. Generally, cleaning and dressing a wound includes the following:

    • Cleaning. If the affected skin is not broken, wash it with a gentle cleanser and pat dry. Clean open sores with water or a saltwater (saline) solution each time the dressing is changed.
    • Putting on a bandage. A bandage speeds healing by keeping the wound moist. This creates a barrier against infection and keeps the surrounding skin dry. Bandage choices include films, gauzes, gels, foams and treated coverings. You may need a combination of dressings.

    REMOVING DAMAGED TISSUE

    To heal properly, wounds need to be free of damaged, dead or infected tissue. Removing this tissue (debridement) is accomplished with a number of methods, such as gently flushing the wound with water or cutting out damaged tissue.

    OTHER INTERVENTIONS

    Other interventions include:
    • Drugs to control pain. Nonsteroidal anti-inflammatory drugs — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — might reduce pain. These can be very helpful before or after repositioning and wound care. Topical pain medications also can be helpful during wound care.
    • Drugs to fight infection. Infected pressure sores that aren’t responding to other interventions can be treated with topical or oral antibiotics.
    • A healthy diet. Good nutrition promotes wound healing.
    • Negative pressure therapy. This method, which is also called vacuum-assisted closure (VAC), uses a device to clean a wound with suction.

    SURGERY

    A large pressure sore that fails to heal might require surgery. One method of surgical repair is to use a pad of your muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).

    TREATING AND PREVENTING BEDSORES AT HOME

    • Re-position your body every one to two hours in bed and every 15 minutes if in a wheelchair. Be careful while moving yourself or someone else. Tugging on the skin can cause friction, which can worsen bedsores.
    • Special mattresses and assistive devices can help relieve pressure on the body. Specially designed foam, low air pressure mattresses, and sheepskin overlays can reduce skin irritation. Ask your doctor for suggestions on pressure-relieving devices and methods.
    • The friction from slipping in bed or a chair can worsen bedsores. Make sure to position yourself so you won’t slide.
    • Keep skin clean and dry, especially of bodily fluids.
    • Look to make lifestyle changes. Losing weight, controlling your blood sugar, and quitting smoking may help the healing process.
    • Ask your doctor about light stretching exercises that can help improve blood circulation.
    • If you believe you or a loved one is suffering from bedsores, contact a doctor right away for guidance.
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