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