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What to Know About Pressure Ulcers (Bed Sores)


Pressure sores or bedsores may develop if a person spends prolonged periods in the same position for various reasons. Also known as pressure ulcers, these lesions are caused by persistent pressure in certain areas of the body. They can develop anywhere, but the bony parts of the elbows, knees, heels, tailbone and ankles are usually more sensitive. Wound treatment is possible, but full recovery is not always possible. Without treatment, lesions can eventually lead to potentially fatal complications.
Frequently changing positions can help heal wounds and prevent new ones. When the wounds are at an early stage, they can treat them at home. A healthcare professional is needed to deal with more severe ulcers. Other specific measures depend on the general health of the patient, but the following holistic strategies may be helpful. This article contains information about bedsores.

What are Pressure Ulcers & Bed Sores?What to Know About Pressure Ulcers (Bed Sores)

Pressure ulcers (also known as pressure sores, bedsores, and decubitus ulcers) are areas of skin that are constantly under pressure that cause damage to the skin and tissue. Continuous pressure on a vulnerable area of ​​the body leads to an interruption of blood circulation, which leads to bruising of the affected area. Prolonged pressure occurs when a person sits or lies in a certain position on a static surface for an extended period of time.

Pressure ulcers causes

So what causes pressure ulcers? The pressure causing the ulcer can be a large amount of pressure over a short period of time or a small force over an extended period of time. In both cases, the extra pressure reduces and sometimes stops blood flow through the skin. When there is insufficient circulation, the skin starves for oxygen and nutrients and begins to break down, forming ulcers. Ulcer worsens if pressure is maintained and deepens when tissue deteriorates. If left untreated, there is a high risk of the ulcer becoming infected by bacteria.

Who Are Affected by Pressure Ulcers?

A healthy person with ordinary mobility will not develop a pressure ulcer (bed sore), as their body makes hundreds of regular movements preventing pressure on certain parts of the body. Even while sleeping, it can move subconsciously because the pressure areas send signals to the moving brain, telling the body to move to relieve the affected area.
A person with only partial mobility is at risk of developing a pressure ulcer. The risk can be greatly reduced by moving the person himself or a caregiver or assistant wherever possible. The risk can be virtually eliminated by using pressure relief equipment and accessories. Choosing the right pressure maintenance equipment for the specific conditions is absolutely essential, and in such a wide range of possibilities, it is essential to take the time to make the right choice and, if possible, seek expert advice.
Immobile or paralyzed individuals are those at greatest risk of pressure sores. While regular repositioning by caregivers helps, advanced pressure care equipment is a vital component to defeat pressure ulcers. A nurse or clinician will need to evaluate the individual to determine the risk of developing wounds, and then identify equipment and establish a care plan to prevent ulcer formation.

Pressure Ulcer Grading

What to Know About Pressure Ulcers (Bed Sores)There are four degrees (types) of pressure ulcers that define the severity of the ulcer, with the fourth being the most severe. Fifth grade is also used in the United States, but the criteria for this grade are so stringent that in the UK it is better known as ‘unclassified’ or ‘ungraded’.
1st Degree
Redness on the skin that persists after the pressure is relieved is scientifically defined as erythema that cannot be bleached on intact skin. The ulcer does not cause skin loss, but it can cause pain and often bypasses the temperature. On darker skin, the ulcer may be blue or purple.
2 degrees
It is a superficial wound that appears as an abrasion or blistering with partial skin loss. The ulcer penetrates the deeper layers of the skin and is likely to appear as a small, red, crater-like scar. These ulcers do not penetrate any tissue but cannot be repaired and can cause dead skin.
3rd Degree
Full thickness skin loss that can reveal subcutaneous fat but not bone, tendon and muscle. Grade 3 ulcers are usually not painful, despite their scary appearance. They can be a shallow crater or extremely deep, depending on how much tissue is in the affected area. Deep ulcers are usually covered by a layer of dead skin in the wound bed.
Grade 4
It is a deep wound with full thickness skin loss and extensive tissue damage exposing muscle and bone. It usually involves draining the wound area. The depth of the wound changes according to the amount of subcutaneous tissue in the affected area. Grade 4 ulcers can spread to muscles or supporting structures.

Prevention and Treatment in Pressure Ulcer Care

Pressure ulcers, bedsores, are the most expensive chronic wound for the NHS, costing between £ 1.4 billion and £ 2.1 billion each year. Where ulcers were allowed to develop, costs for an individual case amounted to as much as £ 100,000. With the right equipment and nursing, prevention is possible, and the initial cost of purchasing equipment is far more affordable than the excessive costs incurred to heal the ulcer. The cost of pressure maintenance can be kept affordable if the right equipment to suit the individual’s clinical needs is purchased for the first time.

Pressure Maintenance Equipment

Pressure ulcers are the result of staying in the same position for a long time. This is usually sitting or lying down. For this reason, pressure maintenance equipment focuses primarily on mattress solutions with pressure relief mattresses and solutions for cushioned and custom seated chairs. There are also pressure care accessories for daily relaxation. If a person is at risk or suffering from pressure ulcers, purchasing the right equipment to provide the best pressure care is the most important factor in care. Some factors need to be considered for the prevention and care of wounds. These factors can be listed as follows;What to Know About Pressure Ulcers (Bed Sores)
Pressure reduction
This may include using foam pads or pillows to alter the affected areas, thus changing the position of the body.
Cleansing wounds
Very small wounds should be washed gently with water and mild soap. Open wounds should be cleaned with saline solution with each dressing change.
Dressing
The dressing protects the wound and speeds up healing. Alternatives that are antimicrobial or hydrocarbons, or contain alginic acid, may be best.
Using topical creams
While antibacterial creams can help cope with an infection, barrier creams can protect damaged or weakened skin.
Care of areas affected by urinary incontinence
This may include using a cleanser, protective cream, incontinence pad, and fecal management system. These products can also be easily purchased online.
Removal of dead tissue
This can help a wound heal, removing dead tissue. A healthcare provider may use high pressure water jets or surgical instruments.
Bed selection
Some mattresses, such as those made from moving static foam yarns, help reduce pressure. In addition, some beds have a pump that provides a continuous flow of air to the mattress. A doctor can help suggest the best type. Special mattresses can be purchased online.
Use of necessary antibiotics
Doctors may prescribe these to treat skin, bone, or blood infections.
Dietary regulation
While there is limited evidence that any particular diet can help treat pressure sores, protein supplementation can speed healing and reduce wound size. Getting enough essential nutrients and plenty of water can help maintain overall health.
Evaluating surgical treatments
These may include removing dead tissue, cleaning the wound, and closing the edges as much as possible. The surgeon may take tissue from healthy skin to perform the repair.
A person with a bed ulcer may also benefit from:
Vacuum assisted wound closure
Electrical stimulation
Hyperbaric oxygen therapy
Pressure sores develop in four stages
• The skin feels warm to the touch. Color changes such as redness and itching may occur in the area.
• A painful open throat or blister develops with surrounding discolored skin.
• It looks like a crater in the wound due to tissue damage under the skin surface.
• Possible damage is accompanied by serious damage to the skin and tissue. Muscles, bones, and tendons can be seen.
• An infected throat takes longer to heal. The infection can spread to other parts of the body and cause significant damage.
Tips for reducing the risk of pressure sores include:
• Positions that change frequently every 15 minutes to every 2 hours, depending on a person’s needs
• Daily skin examination
• Keeping the skin clean and maintaining good nutrition
• Quitting smoking and avoiding second-hand smoke
Exercising in bed to increase blood circulation
• Anyone who may be under pressure should inform their caregiver or healthcare professional as soon as possible.
Anyone who stays in one position for a long time is at risk of developing bed sores. These people are often those who need to change positions to help. A person at risk of developing pressure sores can reduce the risk if he pays attention to certain points. You should be careful not to spend too much time sitting on a chair or lying in bed, and mobility should be increased by using prosthetics or surgical devices. In addition, elastic shoes or clothing should be worn. These lesions occur when tissue and blood vessels are compressed, then deformed. Therefore, it may cause tissue necrosis and infection by causing poor blood circulation. Wounds may occur due to significant pressure in the short term or low pressure in the long term.

References:
https://www.nhs.uk/conditions/pressure-sores/
https://www.medicalnewstoday.com/articles/173972
https://www.hopkinsmedicine.org/health/conditions-and-diseases/bedsores

Writer: Ozlem Guvenc Agaoglu


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