Bedsores (Pressure Ulcers) – Stages, Causes, Pictures, Treatment

Bedsores are caused when prolonged pressure is applied on the skin. It is also called as pressure ulcer for this reason. It occurs on people who are confined to bed and are unable to change position on their own. Bedsores occur as skin injury on hips, buttocks and other bony areas. Bedsores develop quickly and are difficult to treat.

Bedsores Stages :

Bedsores are categorized into 4 stages according to the intensity of damage caused to the skin.

Stage 1 :

This is the first stage of bedsores and it is felt as abnormal change in skin temperature. There would be itching and pain due to the development of red pigments on the skin. It appears as small red colored blisters on fair complexioned people and as dark red or blue colored ulcers on dark complexioned people. The skin can be felt either warm or cool and the tissue can be either firm or boggy. First stage of bedsores is to be taken as a warning for caregivers. At this stage it can be treated fully but fast action is required for treatment since bedsores grow rapidly and spreads to other parts.

Stage 2 :

In this stage there will be loss of thickness of the skin. The top layer of the skin called epidermis will peel off during this stage revealing the inner layer of dermis. Ulcerous growth is superficial at this stage and immediate treatment is required. It would be difficult to treat bedsore if it passes beyond this stage. At this stage the blisters look like fluid filled sacs causing intense pain and discomfort.

Stage 3 :

The ulcer or blister becomes deep wound during this stage. The skin thickness will be fully lost during this stage causing death of subcutaneous tissue. The wound or ulcer like growth will appear as deep crater marked with red blisters with black corners. It will be very unpleasant to look and is difficult to treat. It can damage the underlying fascia or connective tissue rapidly causing more and more death of skin.

Stage 4 :

This is the final stage of bedsore and there will be extensive loss of tissue. It will damage the underlying muscles and even bones. The wound will clearly reveal the underlying bone and tissue and it damages the supporting structures like joints and tendons at this stage. Bedsores at this stage cannot be treated and is extremely disgusting to see.

Who are at risk?

People who are confined to wheelchair or bed for medical reasons have increased chance for getting bedsores. It is necessary to change positions regularly, if the person is lying on bed or make possible movements of arms and legs when he is confined to wheelchair.

People who are hospitalized as in-patients have more risk of getting bedsores than people who are treated at home for illness. It can be caused due to the neglect of hospital staffs.

Common Sites that are Affected :

The areas of skin widely affected for people who are confined to wheelchairs are shoulder blades, buttocks, back of legs and arms. For individuals who are bed-ridden it can affect shoulder blades, rim of ears, sides of head portion, hip and lower back and the part of the body behind the knees are fully affected.

It is very much necessary to check the skin condition regularly if the person is confined to bed for long periods. Bedsores are the result of neglect from the side of the family and hospital staff.

Bedsores Causes :

Bedsores are caused when a person remains immobilized for longer periods due to medical issues. A person who is bed-ridden or treated as in-patient in the hospital for long can develop bedsores. It can also be caused for a person who is confined to wheelchair making him immobile.

When there is lack of action on the arms of leg muscles it exerts great pressure on the skin causing bedsores. Damage of tissue is largely caused to people who are thin skinned. Pressure ulcers occur on old-aged people since the skin will be weak and thin making them susceptible for skin damage due to pressure.

Poor nutrition is also another cause for getting bedsores. If a person who is bed-ridden takes diet that lacks enough protein or vitamins he is likely to get bedsore. Lose of fat muscles due to illness makes one lose weight drastically. Sustained pressure on the skin and underlying tissues will cause lack of blood circulation and nutrients to the skin causing bedsores. A person who lies in the hospital bed in elevated position will naturally slide down on the bed putting great friction and shear on the tailbone area. This would cause damage to the underlying tissue and blood vessels making it vulnerable.

Bedsore Complications :

Bedsore can cause life threatening situations and even death in certain conditions. Cellulitis is an acute skin infection causing swelling of skin with pain which may lead to meningitis infecting the membrane of brain. Bedsore if left untreated can cause bone infection and joint infection which becomes chronic damaging the cartilages and tissues underneath. This can restrict movement of arms and legs. It can cause necrotizing fascilitis an acute infection that destroys the tissues surrounding the muscles leading to death within a day or two.

If left untreated, bedsore can develop rapidly destroying live tissues leading to amputation of affected part. Bedsore can cause sepsis when bacteria from the infected wound will enter into the bloodstream leading to organ failure and death. Bedsore can also become the root cause of skin cancer spreading to lymph nodes.

Diagnoses :

Your doctor will examine the bedsore closely to find out the size and intensity of ulcerous growth. He will check for bad odor indicating bacterial infection or due to death of tissues. He would examine the surrounding areas for checking spreading of infection. He would order for blood tests, tissue culture for detecting the stage of bedsore.

Treatment :

As stated earlier, bedsores can be treated in the first two stages and not on final stage. The affected person should be repositioned in the bed or wheelchair for every half an hour to reduce repeated pressure on the skin. The patient will be asked to use supporting devices like padding or cushions for relieving the pressure from vulnerable areas. The wound is washed with mild soap water or using saline water and frequent dressing should be done. The treatment should be oriented towards fast healing of open wounds.

Debridement is done for removing the dead tissues from the skin. This is done through surgical procedure or using mechanical methods or by using topical enzymes. In this process dead tissues are cut off from the live tissue gently to protect the live cells and further spreading of infection. Surgical intervention is done mainly for constructing new live tissues and for preventing cancerous growth.

At present, electrotherapy is recommended for treating painful bedsores. Anti-inflammatory drugs are prescribed for managing pain and to facilitate healing process. For some people oral antibiotics are given with health diet.

Pictures of Bedsores :

Images, Pics, Pictures and Photos of Bedsores

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Prevention :

Bedsores can be prevented by reducing the risk of applying pressure on the skin. The caretaker should inspect the skin condition of bed-ridden patients daily and give nutritious diet. It is the best to change or reposition the person in bed or wheelchair frequently. Using special mattress like foam bed or air bed is recommended to reduce friction. You can always seek help from support group for managing bedsores.

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