Preventing Bedsores

Bedsores are skin ulcers that appear in areas constantly subjected to pressure. Bedridden pa¬tients, those with paralysis and/or spinal cord injuries who can’t change their posi¬tion often develop bedsores at pressure points in the lower back, buttocks, elbows, knees, shoulders, heels and ankles. Other high risk groups are adults over 60, those with poor circulation, malnourished patients, and heavy individuals.

“They may develop in any area where the bones are next to the surface and continuous pressure is exerted, as in the case of a bedsore on the buttocks in a neglected wheelchair patient. Prolonged pressure against the bed, chair, a cast, or a splint obstructs the circulation and causes the skin to break down. Soiling of the bedclothes with food residues, urine, feces, or sweat is a primary factor in the development of bed¬sores," according to the late Dr. Morris Rshbein, the former editor of the journal of the American Medical Association, in his “Popular Illustrated Medical Encyclopedia.”

Pressure sores usually start as red and shiny spots in the body which are called threatened bedsores. As constant pressure reduces the blood supply, the area becomes dark blue and the condition is called an inevitable bedsores. Ulcerated bedsores, on the other hand, are characterized by broken skin and are pain¬less, but they can be infected and lead to osteomyelitisn(the infection of the bone.)

With the right treatment, bedsores are curable al¬though their healing time varies depending on the site and size of the sores and the patient's general health. The doctor may prescribe antibiotics to fight infection, medicated ointments and dusting powders for the skin, vitamin supplements and a high-protein diet to promote fast healing. In severe cases, surgery may be required to remove diseased tissues.

Prevention, however, is your best defense against bedsores. But the paralyzed or crippled patient cannot do this alone. He or she needs the support of his family, friends or relatives in the absence of a nurse. As Fishbein stressed:

"In the prevention and treatment of bedsores, nurs¬ing care is the most important consideration. The pa¬tient should never be allowed to lie constantly on his back, but should be shifted to the prone and side posi¬tions from time to time. A fluffed pillow or rolled blanket under the knees may help by shifting the pres¬sure areas. The sheets should be smooth and un¬starched and unwrinkled, scrupulously clean and free from soiling and crumbs, and smoothed out frequently.

“When bed baths are employed, the patient should be dried and powdered thoroughly and damp bed linen should be replaced. Routine alcohol rubs of the back and pressure areas, combined with cleanliness of the skin and gentle massage, are imperative. A foam rubber or air mattress and an inflated rubber ring may protect the sensitive area," he concluded.

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