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Bedsores – Symptoms, Stages and Treatment

Bedsores are most commonly seen in people who are unable to alter their positions due to certain medical conditions. These disorders limit their movements and they are bound to spend most of their time over a chair or bed. Bedsores are also known as decubitus ulcers or pressure ulcers. They are defined as injuries to the internal tissues and overlying skin due to prolonged pressure. These painful ulcers are seen on bony parts of the body which include ankles, hips, heels or tailbone.

The common sites for bedsores vary for people who are bound to a wheelchair or bed. For those who are confined to wheelchair include buttocks, tailbone, spine or shoulder blades, back of the legs or arms. For those who spend most of their time in bed include sides or back of the head, lower back, hip, tailbone, shoulder blades, ankles, heels, the skin over the backside of knees. These areas are more commonly affected because they suffer from localized ischemia i.e. inadequate blood flow leading to cell death and ultimately tissue necrosis.

There are different symptoms, stages, and treatment for bedsores which include the following:

Symptoms

The signs and symptoms seen with bedsores include:

  •         Swelling
  •         Unusual changes within the skin color or skin texture i.e. dark red or purplish skin
  •         Blisters which might be blood-filled
  •         Blanching of the skin when pressed by fingers
  •         Partial skin lost
  •         Tender areas with painful skin
  •         A change in temperature of the skin i.e. warmer or cooler over that area when compared to other parts
  •         Pus-like drainage

Who are at Increased Risk of Suffering from Bedsores?

People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Risk factors include:

  • Immobility. This might be due to poor health, spinal cord injury and other causes.
  • 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 the warning signs and the need to change position.
  • Poor nutrition and hydration. People need enough fluids, calories, protein, vitamins and minerals in their daily diet to maintain healthy skin and prevent the breakdown of tissues.
  • Medical conditions affecting blood flow. Health problems that can affect blood flow, such as diabetes and vascular disease, increase the risk of tissue damage.

Stages:

There are many different stages of bedsores depending on their severity, depth, and different characteristics. The range of damage to the tissues and overlying skin varies from reddish or unbroken skin to the deeper injury which might involve bone or muscles. The four different stages of bedsores include the following:

  1. Suspected injury of the deep tissues with slight discolouration and no tears within the skin.
  2.  Reddish or warmth feel of the skin over touch which also results in itching.
  3. Painful blisters or open sores with skin discoloration around it. During this stage, partial loss of epidermis and some areas of the dermis is experienced with painful and tender sensation.
  4. Bedsores with crater-like appearance because of the tissue damage underneath the skin surface. During this stage, full-thickness loss of skin is experienced with some parts of subcutaneous tissues but not the underneath fascia.
  5. Severely damaged skin and underlying tissues of the bedsores due to infections. During these bedsores, bones, muscles or tendons might become visible. During this stage, full-thickness loss of skin is experienced with the involvement of bone, muscles, joints or tendon along with the production of pus.
  6. During this stage, the full-thickness loss is experienced with covering of the base by sloughed tissues, eschar or pus.

If bedsores are not treated on time, they can result in severe complications i.e.  Cellulitis, joint or bone infections, sepsis or aggressive cancer in the most serious conditions.

Bedsores Treatment

Bedsores can turn into a disaster if not treated on time. Treating the decubitus ulcers is not an easy task. The open wounds do not heal rapidly. However, if it does start healing it is inconsistent due to the damaging effect over the tissues or skin. Stage 1 or stage 2 bedsores might heal within a few weeks if taken care properly. However, for serious sores like diabetic foot ulcers, you might need laser therapy or a surgical procedure.

The steps for treating bedsores at home include:

  • Removal of the pressure from bedsores with the help of foam pads or altering the position of the patient. Pillows can also be used to prop up the body parts of the patient.
  • Wound cleaning by washing it with mild soap and water. Clean the open sores with saline when you plan on changing the wound dressing.
  • Removal of the infected or dead tissue as debridement is essential for bedsores
  • Application of dressings to protect the open wounds and allows proper healing. These dressings prevent wound infection and result in the dissolution of dead tissues.

For treating the severe ulcers, you need to consult the healthcare professional and choose the following modes of treatment:

1: Negative Pressure Therapy for Wound

This vacuum-assisted therapy utilizes the suction tube for treating bedsores. It withdraws the moisture from ulcers, resulting in improved healing time and chances of infection.

2: BioFlex Laser Therapy

BioFlex lasers promote rapid healing when compared to surgical procedure as it is a non-invasive procedure. It facilitates rapid wound healing procedure. It increases tissue granulation and reduces the inflammatory reaction with reduced pain sensation. Many clinical trials have been conducted to evaluate the method of laser therapy which shows increased epithelial tissue with a reduction in the size of the lesion, reduced secretions, and odor.

3: Surgical Procedure

For severe bedsores, surgical procedure is another alternative. Surgery aims at cleaning the bedsores, treats and prevents any sort of infections, reduces the loss of fluids and chances of complications. A skin, muscle or tissue pad is used from the patient’s body to cover the open wounds and offer cushioning effect to the exposed bone. This entire procedure is termed as flap reconstruction.

Bedsores can be treated easily with nursing and medical care. It’s hard to prevent vulnerable patients from bedsores or diabetic wounds but prevention is better than cure. It is therefore advised to alter the patient’s position after every 15 minutes, regular inspection of the skin, maintaining the skin in dry and healthy condition, quit smoking, exercise for improved circulation, intake of essential nutrients along with other essential care.

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