Preventing Bedsores and Pressure Sensitive Ulcerations

Bedsores can be a serous problem for bed-ridden or wheelchair-bound persons. Bedsores are better described as pressure sores or pressure sensitive ulcers. A pressure sore is the result of an injury to the skin and the tissue below caused by a constant pressure to the area, as can occur in an elderly person who is in bed or seated most of the time. Bedsores can occur anywhere on the body, but they are most common in boney areas such as the heel, elbow, ankle or hip — and the pressure points on the back, legs, shoulders and buttocks. Pressure sores can be serious, even life threatening. Pressure sores are typically difficult to heal, and in the elderly population made more so due to diabetes and other conditions that affect wound healing. Doctors agree that it is far better to prevent bedsores than to treat them.

"Preventing pressure ulcers is a 24/7/365 kind of job and it takes tremendous consistency." — Jeff West, Qualis Health

According to a recent article in The New York Times, experts estimate that 2 million Americans suffer from pressure ulcers each year. That same article suggested that preventing bedsores in health care settings requires a team approach, "enlisting everyone from nurses and assistants to laundry workers, nutritionists, maintenance workers and even in-house beauticians." Jeff West, a clinical reviewer at Qualis Health in Seattle, who helped organize the study cited in the article said, "Preventing pressure ulcers is a 24/7/365 kind of job and it takes tremendous consistency."

Who is most at risk for bedsores?

The risk for bedsores is increased in senior patients who:

• Have had them before
• Are unable to move without help, or have uncontrollable movements
• Have diabetes or other circulatory issues
• Have skin that is exposed to frequent wetness for example from sweating or incontinence
• Need to stay in bed or in a chair most or all of the time
• Have "neuropathy" — the loss of feeling to a part of the body, which can be damaged without knowing it
• Are suffering from dementia and may not be cognizant of the need to move or change positions
• Are using medications that can decrease alertness
• Are "boney" without much skin for padding

Preventing bedsore

For patients who are wheelchair bound or permanently bedridden — one of the surest ways to prevent bedsores is to relieve the pressure by using an air pressure relief mattress or seat cushion. These devices relieve pressure on the skin with a series of chambers that alternatively inflate and deflate. If this type of device cannot be obtained, the individual's caregiver must change his or her position frequently. If one is unable to do so, it is important to make sure the nursing staff follows a regular "turning regimen." Discuss turning frequency with the doctor and make sure the nursing team follows it. There are other devices such as turn sheets or an overhead trapeze that can help individuals move in bed. Other ways to prevent bedsores include:

• Checking the skin daily
• Keeping the skin dry
• Keeping the skin clean
• Using padding to protect the skin over boney areas
• Trying to keep the bed sheets free from wrinkles

Good nutrition also makes a difference in preventing bedsores. Eat a healthy diet rich in protein, vitamin C and zinc. Drink a lot of fluids (at least eight 8-ounce cups of water a day) to ensure the body is properly hydrated.