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What Are Bed Sores?

Bed sores, also known as pressure ulcers or decubitus ulcers, are sores that result from injury to the skin and tissue below it. Skin dies over parts of the body that have pressure when people sit or lie still for long periods.

What Causes Bed Sores?

The weight of the body or body part causes circulation in the skin over that pressure point to slow down. With less circulation and nutrition, skin and tissues such as fat and muscle die, and ulcers or sores develop.

Other things that contribute to ulcers are poor nutrition, wet skin from urine and stool, and friction from moving over clothes and bedding.

What Are the Symptoms of Bed Sores?

Symptoms include red skin but not broken skin (stage 1 ulcers). In stage 2 ulcers, the outer skin layer is broken, with blistering and drainage. In stage 3 ulcers, tissue under the skin is affected. Sores may have a white or black base, can be painful around the edges, and have foul-smelling drainage. Stage 4 ulcers reach muscle or bone. They can be white or black at the base and have a bone infection and foul-smelling drainage. Greater risk of developing pressure ulcers is related to stroke, spinal cord injuries, or illnesses that prevent changing positions easily. Also, people who spend long periods in bed or wheelchairs, cannot control their bowels or bladder, or cannot tell caregivers that they’re sore or need turning are more prone to getting pressure ulcers.

How Are Bed Sores Diagnosed?

The health care provider will make a diagnosis by examining the skin and tissues near the skin.

How Are Bed Sores Treated?

Prevention is by far the best treatment! Good nursing care, using pressure-relieving devices, and special dressings can prevent ulcers. Treatment depends on the ulcer’s stage.

All ulcers must be kept clean with sterile saline and an irrigation tool. Don’t use hydrogen peroxide, povidone-iodine solution, liquid detergents, and bleach.

The health care provider cleans hard scabs and dead tissue by using a scalpel or scissors (débridement). Wet-to-dry dressings and moist wound dressings can be used to pull off scabs when they are changed. Enzymes on some of the medicated dressings can help remove dead tissue.

The health care provider may prescribe antibiotic creams, pills, and injections to control infections.

DOs and DON’Ts in Managing Bed Sores:

  • DO call your health care provider if drainage, pain, or redness around an ulcer increases.
  • DO call your health care provider if drainage smells foul and looks like pus.
  • DO call your health care provider if you get fever, chills, confusion, weakness, or rapid heartbeat.
  • DO know which pressure points may have ulcers and check them often. These points usually don’t have fat padding.
  • DO use pressure relief devices, such as pillows, gel or foam cushions or mattresses, and foam or gel heel protectors.
  • DO move bedridden people or encourage them to move at least every 2 hours.
  • DO keep skin clean and lubricated but not moist.
  • DO keep down friction when moving someone. Keep the head of a bed no higher than 30 degrees to prevent sliding and friction.
  • DO promote good nutrition.
  • DON’T use a doughnut type of cushion, because they can cause pressure ulcers in other areas.

Contact the following sources:

  • American Academy of Dermatology
    Tel: (866) 503-7546, (847) 330-9239
  • MedlinePlus
  • American College of Surgeons
    Tel: (800) 621-4111

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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