Bedsore Basics

Knowing the bedsore basics is essential for your bed ridden loved one so we have all the information for you:

Bedsores (pressure ulcers) are wounds to skin and original tissues that result from prolonged pressure on the skin or due to delicate skin dragging across a surface, causing a tear or blister of the skin. Bedsores most often form on skin that covers gaunt areas of the body, such as the heel, ankles, hips or buttocks.  People most at jeopardy of bedsores are those with illness or frailty that confines their ability to change positions, such as a bedbound person or an individual restricted to wheelchair use for mobility.  Elderly individual whom are dependent upon others for medical care are also prone to bedsores, which can become a serious condition if not treated rapidly and properly.

Bedsore Basics

Bedsore Prevention

Though bedsores are persistent and arise briskly, sometimes without warning, there are steps that can be taken in order to prevent the start of a sore.  Trying to prevent a bedsore also helps to detect one early on that may be forming and you can prevent hospitalization.

* Skin check: The skin should be checked daily for signs of a developing sore.  You will be looking for reddened areas of skin stretching over bony area of the body.

* Skin must be kept clean, dry, and moisturized: Use mild soaps and warm (not hot) water to clean the skin of the elderly individual you are caring for. Gentleness is a must, because as we age, our skin thins out and becomes very tender and fragile.  Products containing alcohol should be avoided since alcohol can cause skin irritation. Gently pat the skin dry with a towel. Do not rub with the towel, because this can cause a sore to form. A mild moisturizer should be applied to the skin to prevent dryness and irritation.

* Change Positions:  If the elderly patient under your care is confined to a bed for the majority of the day, their laying position should be changed every two hours.  If the confinement is to a wheelchair, positions should be changed every hour to prevent numbness due to the restriction of blood flow.  While helping the individual to change positions, do not slide them, but lift them to prevent skin tears.  Maintaining a written schedule documenting the times of the position changes may help you to keep track more proficiently.

* Distinctive equipment techniques: A draw sheet or large pad beneath your patient may help the process of moving higher in the bed and also lessens the toll may take on your body as the caregiver, while lifting. An overhead trapeze can help you change positions in bed. Special mattresses and overlays may help decrease the risk of bedsores. Examples include a foam mattress pad, or special air or water mattresses. Use seat pads that are specially made to decrease pressure on the buttocks and hips. Do not sit on donut-shaped cushions because they limit blood flow to the tissues of the body and increase the change of a bedsore to develop.

* Protect the skin over bony areas: Use pillows or foam wedges to keep gaunt areas from touching one another. Using a pillow or foam wedge between the knees to keep them from pressing on one another is a great prevention technique. Using a foam pad or a

pillow beneath the legs from mid-calf to ankle area keeps the heels from touching the bed when you the patient is lying on their back.

Bedsore Treatment

Once a bedsore or signs of a possible bedsore has surfaced, immediate action is required for prompt and proper healing.  If untreated, a bedsore can cause detrimental infection to the body.

* Repositioning: Frequent repositioning is required once a bedsore has formed.  Every fifteen minutes, the patient should be turned to the opposite side, and a pillow or wedge should be placed beneath the patient in order to limit direct pressure and blood flow restriction to the area.

* Surgical debridement: involves cutting away dead tissues.

* Mechanical debridement: uses one of a number of methods to loosen and remove wound debris, such as a pressurized irrigation device, a whirlpool water bath or specialized dressings.

* Autolytic debridement: the body’s natural process of recruiting enzymes to break down dead tissue can be enhanced with an appropriate dressing that keeps the wound moist and clean.

* Enzymatic debridement: is the use of chemical enzymes and appropriate dressings to break down dead tissues.

* Cleaning: It’s essential to keep wounds clean to prevent infection. A stage I wound can be gently washed with water and mild soap, but open sores are cleaned with a saltwater (saline) solution each time the dressing is changed.

* Dressings: A dressing promotes healing by keeping a wound moist, creating a barrier against infection and keeping the surrounding skin dry. A variety of dressings are available: films, gauzes, gels, foams and various treated coverings. A combination of dressings may be used. Your doctor selects an appropriate dressing based on a number of factors, such as the size and severity of the wound, the amount of discharge, and the ease of application and removal.

* Pain management: Bedsore can be very uncomfortable and painful.  Pain medication will often be prescribed to make the individual more comfortable, such as  nonsteroidal anti-inflammatory drugs — such as ibuprofen (Motrin, Advil, others) and naproxen (Aleve, others) — particularly before and after repositioning, debridement procedures and dressing changes. Topical pain medications, such as a combination of Lidocaine and Prilocaine, also may be used during debridement and dressing changes.

* Antibiotics: Pressure sores that are infected and don’t respond to other interventions may be treated with topical or oral antibiotics.  At times (according to the severity) antibiotics may be administered right away.

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