08/08/2025
A bed sore, also known as a pressure ulcer or decubitus ulcer, is an area of damaged skin and tissue caused by prolonged pressure on the skin, typically over bony prominences. These sores develop when blood flow to the skin and underlying tissue is reduced due to sustained pressure, leading to tissue damage and potentially even death.
Causes and Risk Factors:
Prolonged Pressure:
The primary cause is sustained pressure on the skin, often from lying in bed or sitting in a wheelchair for extended periods without shifting weight.
Immobility:
Individuals with limited mobility, such as those who are bedridden or use wheelchairs, are at increased risk.
Friction and Shear:
These forces can also contribute to bedsores, especially when combined with pressure.
Other factors:
Poor nutrition, inadequate hydration, and underlying medical conditions can also increase susceptibility.
Signs and Symptoms:
Changes in skin color: Redness, purple or bluish discoloration on lighter skin, or purple/blue discoloration on darker skin may be the first sign.
Swelling: The affected area may appear swollen or puffy.
Warmth or coolness: The skin around the sore may feel warmer or cooler than surrounding skin.
Tenderness or pain: The area may be painful or tender to the touch.
Open sores or blisters: In more advanced stages, the skin may break open, forming an open sore or blister.
Pus or foul odor: If infection develops, pus or a foul odor may be present.
Stages of Bedsores:
Bedsores are typically categorized into stages based on the severity of tissue damage:
Stage 1: Non-blanchable erythema (redness that doesn't turn white when pressed).
Stage 2: Partial thickness skin loss involving the epidermis and/or dermis.
Stage 3: Full thickness skin loss, potentially extending to subcutaneous tissue.
Stage 4: Full thickness tissue loss with damage to muscle, bone, or supporting structures.
Prevention:
Regularly change position: Shift weight every 15 to 30 minutes if possible, or as directed by a healthcare professional.
Use pressure-relieving devices: Mattresses, cushions, and pads can help distribute pressure and reduce the risk of sores.
Keep skin clean and dry: Avoid prolonged exposure to moisture from urine or perspiration.
Maintain good nutrition and hydration: Ensure adequate intake of protein, vitamins, and fluids.
Inspect skin daily: Check for any signs of redness, swelling, or breakdown.
Treatment:
Relieve pressure: Avoid pressure on the affected area and use pressure-relieving devices.
Clean the wound: Gently cleanse the area with mild soap and water.
Apply dressings: Use appropriate dressings to protect the wound and promote healing.
Consider topical creams: Antibacterial or barrier creams may be used as directed by a healthcare professional.
Address underlying conditions: Treat any underlying medical conditions that may be contributing to the problem.
Seek medical attention: If the bedsore is deep or infected, consult a healthcare professional for appropriate treatment, which may include antibiotics or surgery.
Complications:
Infection: Bedsores can become infected, potentially leading to serious complications like cellulitis or sepsis.
Bone infection: In severe cases, bedsores can extend to the bone, causing osteomyelitis.
Slow healing: Severe bedsores can take a long time to heal, potentially requiring surgery.
