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Nursing Homes Abuse Blog By Jonathan Rosenfeld

6 Most Common Causes Of Bed Sores & How Caregivers Can Help

Posted in Bed Sores, Pressure Sores, Decubitus Ulcers & Pressure Ulcers, Contractures, Dehydration

Next week attorney David Terry and I will be exchanging blog-posts on perhaps the most common– yet under-appreciated medical condition effecting patients in nursing homes and hospital– Bed Sores. Used interchangeably with the terms: pressure sore, pressure ulcer or decubitus ulcer, most people have little appreciation of the real devastation that bed sores cause until they see one first hand. Few medical conditions are as graphically disturbing as an advanced bed sore on a human being. To assist medical professionals in the assessment and treatment of wounds, a standardized ‘staging system‘ has been developed.

  • Stage 1- Initially, a pressure sore appears as a persistent area of red skin that may itch or hurt and feel warm and spongy or firm to the touch. In blacks, Hispanics and other people with darker skin, the mark may appear to have a blue or purple cast, or look flaky or ashen. Stage I wounds are superficial and go away shortly after the pressure is relieved.
  • Stage 2- At this point, some skin loss has already occurred — either in the epidermis, the outermost layer of skin, in the dermis, the skin’s deeper layer, or in both. The wound is now an open sore that looks like a blister or an abrasion, and the surrounding tissues may show red or purple discoloration. If treated promptly, stage II sores usually heal fairly quickly.
  • Stage 3- By the time a pressure ulcer reaches this stage, it has extended through all the skin layers down to the muscle, damaging or destroying the affected tissue and creating a deep, crater-like wound.
  • Stage 4- In the most serious and advanced stage, a large-scale loss of skin occurs, along with damage to muscle, bone, and even supporting structures such as tendons and joints. Stage IV wounds are extremely difficult to heal and can lead to lethal infections. If you use a wheelchair, you’re most likely to develop a pressure sore on: Your tailbone or buttocks Your shoulder blades and spine The backs of your arms and legs where they rest against the chair When you’re bed-bound, pressure sores can occur in any of these areas: The back or sides of your head The rims of your ears Your shoulders or shoulder blades Your hip bones, lower back or tailbone The backs or sides of your knees, heels, ankles and toes.
  • Unstageable- Is a term that generally refers to an extremely advanced wound where there is involvement of skin, muscle and bone.

Though commonly associated with the elderly, a bed sore can develop in patients of any age who are not properly cared for.  Put simply, bed sores are not a normal part of the aging process nor are they an inevitable part of life for patients in a long-term care setting.Unlike many medical conditions that benefit from technological advances with respect to their prevention, bed sore prevention is low-tech and labor-intensive.  To minimize the development of bed sores, medical facility staff must pay attention to patient needs, utilize patience when caring for the patient and remain diligent when implementing care.  David and I will focus our attention on the most common contributing factors to the development of bed sores:

I look forward to this exchange and particularly to David’s insights on these topics.  Follow our exchange on my Nursing Homes Abuse Blog or on David’s Terry Law Firm Nursing Home Abuse Blog.

  • http://silvercensus.com Tyson

    Thanks for the great explanation of bed sores

  • http://www.herbsonline.net/herbs-for-dehydration.html dehydration treatment

    Dehydration is major problem for Bed sores .You can solve this problem with herbal treatment. Informative stuff.

  • Jan B

    I had an experience with a stage 2, going to stage 3, while caring for my mother, mid Oct 2011. It happened when the pump to her air mattress began to fail, suddenly. Important! Do not assume that the pump is OK, just because the air cells in the mattress look full and plump. You must test the pressure of the cells by pressing on them. If there is no resistance, there is no protection! As long as my mother had a good air pump and mattress, she was fine. They are very affordable, on eBay.
    Once she had the one, there was an open sore, and it was right on the tailbone. I got it completely healed (closed wound) in a week, and in another week, the area had filled in nicely. Here is what I used, and maybe this will help some people out there. I used a soft consistency zinc oxide ointment. I’d first clean the surrounding area gently with a wipe, then dry and put on a bit of petroleum jelly. This worked as an adhesive.. I will explain later. I filled the wound with zinc oxide ointment (YES!), and to keep the ointment in place, I cut a small swatch of the felted fabric lining of a disposable bed pad, large enough to cover the wound completely and go over the edges (which were smeared with vaseline / petroleum jelly), and this held the swatch in place. The only thing the swatch does is to keep the zinc oxide ointment in place. The zinc oxide keeps should then be pressed out to the edges of the wound, using gentle pressure on the swatch. When it is all filled in, it is protected from urine, ammonia (from urine) and other contaminants, and zinc oxide is one of the most miraculous (and cheap) antibiotic remedies available. It is far better than an antibiotic ointment, in my experience. I believe that it is capable of treating MRSA sores.. I’ve used it to treat nasty staphylococcus sores, and also an open wound (on my thumb) which smelled like rotten meat and looked like it would need a skin graft. The triple antibiotic ointment was doing much of nothing. When I switched to the zinc oxide ointment, the wound smelled sweet and clean and seemingly dead tissue re-established a blood supply and healed beautifully. The other great thing about this kind of a treatment (zinc oxide) is that it allows and even encourages the wound to remain open, so that it can heal from the bottom up (as it should). That ulcerated, dead area must fill in with new cells from the bottom up. Any doctor who knows his / her stuff can tell you the same. One more thing: Some of the nasty staph infections are lying dormant under the skin in the form of a carbuncle, waiting to flare up or seed new infections. They are anaerobic, meaning that they do NOT like oxygen, but they are also somewhat resistant to oxygen. However, they will try to lay dormant and the sore may actually appear to heal over or have a scaly “roof”. This is not a healed sore. Do not try to open or squeeze such a sore as it may go into the bloodstream and cause septicemia! I did the following with such a sore (on myself). I daubed the non-open sore generously with zinc oxide ointment and covered it with a bandage, then went to bed. By the next morning, the sore had opened to reveal a gaping hole! No problem! I simply irrigated the wound with the zinc oxide ointment generously and kept it covered with a bandage. In about four days, it was almost completely healed!
    Just use an air mattress and alternating air pump, and you should not have any bedsores, but if you do, you might want to ask your doctor about the zinc oxide ointment. They might tell you, “No!”, but doctors are entitled to their opinion. I just know what worked for me!
    BTW, Please accept this sincere compliment: This is the best elder care resource I have found on the internet!

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