Bedsores, also known as pressure sores, are painful tissue ulcers that develop when an area of the body is put under excessive pressure; they rapidly worsen becoming open wounds that need to be healed. In very severe cases, surgery is required. There are many techniques to treat existing lesions and to prevent new ones from developing.
Steps
Part 1 of 4: Diagnosing Pressure Sores
Step 1. Check the skin for dark areas
Look closely at the whole body, paying particular attention to where it rests on the bed or wheelchair. Use a mirror or ask someone to help you by inspecting the back you can't see.
Also look for hard-to-touch areas
Step 2. Look for bleeding or other exudates
If the sore is bleeding or releasing other fluid, this is a serious injury, so you should see a doctor immediately to avoid worsening and manage the pain.
A bad smell could be a sign of an infection; in that case you should see a doctor immediately
Step 3. Assess your health condition
Before going to the doctor, you must be ready to answer the various questions that will be asked of you. Some may be:
- How long has the discoloration of the skin been present?
- How much do these areas hurt?
- Have you suffered from relapsing fever?
- Have you had any pressure injuries before?
- How often do you move or change your position?
- What kind of diet do you follow?
- How much water do you drink every day?
Step 4. Go to the doctor
He will ask you for more information about your health, the nature of the painful areas, your diet, and more. He will perform a physical exam and observe the body paying close attention to areas that are evidently painful, dark or hard to the touch. They may also have a blood and urine test to rule out some particular diseases and get a general picture of your health.
Step 5. Determine the severity of the ulcers
They can be categorized according to four stages. The first and second are the least serious and can be treated and cured. The third and fourth group injuries that need medical intervention and perhaps even surgery to heal well.
- First stage: the skin shows some changes in color, but there is no open wound. If the patient has a clear complexion, redness may be noted; on dark-skinned patients, blue, purple or even white areas may be seen.
- Second stage: there is a still shallow open wound. The edges of the lesion are infected or dead tissue is present.
- Third stage: the wound is wide and deep. It extends below the superficial skin layer and reaches the fat. There may be fluid or pus inside the lesion.
- Fourth stage: the sore is large and involves several layers of the skin. The muscle or bone may be exposed and the presence of eschar, that is black material that indicates necrotic (dead) tissues, is not excluded.
Part 2 of 4: Support and Protect the Body
Step 1. Relieve pressure from existing injuries
If you have a sore, move your body and make sure you don't lean on the affected area for at least two to three days. If the redness doesn't go away, contact your doctor and consider other treatments.
Step 2. Change your position often
If you are confined to bed or in a wheelchair, you need to change your position frequently throughout the day to relieve pressure on painful areas and prevent ulcers from forming. Try to do this every two hours when you are in bed and every hour when you are in a wheelchair. By doing this, you eliminate the pressure that builds up on certain parts of the body and prevent the injuries from getting worse.
Step 3. Stay active as much as possible
While bedridden or wheelchair-bound individuals may not be particularly dynamic, they can still move some of their body. This avoids putting pressure on certain areas of the skin and increases blood flow. Activity also improves mental health, a key factor in overall well-being.
Step 4. Use support surfaces and protective pads
The key to reducing the risk of pressure sores is to minimize the pressure that is constantly exerted on certain parts of the body. Use special pillows made from foam rubber or filled with water or air. Likewise, you can use protective pads, especially between the knees, under the head or elbows.
Some donut-shaped devices actually increase the chances of sores. Ask your doctor for advice on which product is best for your needs
Step 5. Ensure adequate blood circulation
The injuries are caused, in part, by poor blood supply to the skin. When the epidermis is under pressure, the blood vessels fail to do their job properly. Maintain proper blood circulation by drinking plenty of water, avoiding smoking, and changing positions.
If you are diabetic, know that the disease impairs blood circulation. Work with your doctor to find specific techniques to solve the problem
Step 6. Choose comfortable clothes
Wear clothes that are neither too tight nor too loose, as they both cause friction and irritation. Change them every day to keep your skin clean as well. Choose cotton fabrics that don't have thick seams.
Step 7. Replace the sheets often
When clean, they prevent bacteria from aggravating pressure sores in bedridden people; they also become soaked in sweat over time, which in turn can irritate the skin. Changing them often and on a regular basis reduces this risk.
Step 8. Manage pain with ibuprofen
Take an over-the-counter pain reliever such as naproxen or ibuprofen. Choose non-steroidal anti-inflammatory drugs (NSAIDs) over aspirin, acetaminophen, or opioid pain relievers.
Take ibuprofen before or after changing positions, when undergoing a debridement procedure, or while dressing the ulcer. This way, you can keep the pain at bay
Part 3 of 4: Treating the Skin
Step 1. Inspect your skin every day
Pressure sores can develop quickly and need to be treated as soon as you notice them. Pay particular attention to areas that lean against the bed, wheelchair or that are subject to friction with other areas of the body and / or with clothing.
Check the lower back, coccyx, heels, buttocks, knees, back of the head, ankles and elbows with particular care
Step 2. Keep your skin clean
Gently wash first stage pressure sores with soap and water. Pat your skin dry (without rubbing) with a cloth. Check carefully those areas that are prone to getting dirty or sweating. Moisturize them with a lotion to prevent the skin from drying out.
Pressure sores that develop on the butt or near the groin are likely to become dirty with urine and feces. Use protective and / or waterproof gauze to cover them and eliminate this risk
Step 3. Clean and medicate the wounds
Wounds should be cleansed and protected with a clean dressing. Irrigate them with a rising solution (water and salt) to wash them before bandaging them again. Ask a doctor or nurse for advice before proceeding, as medical staff sometimes prefer to perform dressings themselves.
- Do not use antiseptics, such as iodine or hydrogen peroxide, as they hinder the healing process.
- There are different types of bandages or materials to protect ulcers. Clear dressings or hydrogels help early stage injuries heal quickly and should be changed every 3-7 days. The other bandages allow for greater air circulation or protect the sore from fluids such as urine, blood or feces.
Step 4. Undergo a debridement procedure
This is an operation performed by a doctor which involves the removal of necrotized meat. It is relatively painless, as dead tissue is devoid of live nerves; however, you may feel some sensitivity because the necrotic areas are adjacent to the healthy and innervated ones. Pressure sores in advanced stages need to be treated in this way. Ask your doctor what treatment approach is best for your situation.
Step 5. Treat infections with antibiotics
Your doctor may prescribe them topically, to be applied to the ulcer, to stop the spread of the infection and help the body heal. He may also decide to give you antibiotics by mouth, especially if the wound is advanced.
If you have developed osteomyelitis, an infection of the bones, you will have to take antibiotics for a long time. This complication requires more incisive medical intervention
Step 6. Check how ulcers heal
Monitor them closely to make sure they heal and don't get worse. If you don't notice any improvement, contact your doctor.
Part 4 of 4: Changing the Diet
Step 1. Eat lots of vitamin-rich foods
It is essential to follow a correct diet to keep the body healthy and avoid pressure sores. When you are healthy, your body is able to heal wounds faster and prevent new ulcers from forming. If you have nutritional deficiencies, especially iron, zinc, vitamins A and C, you run a greater risk of these injuries. Take supplements, as well as eat foods with lots of vitamins.
By taking in a lot of protein, you help your body stay healthy
Step 2. Stay hydrated
Drink lots of water every day. Men should consume 13 8-ounce glasses of fluid and women at least 9 each day. This doesn't mean you only have to drink water. Many foods have a very high liquid content and healthy ones can meet up to 20% of the daily requirement. Eat foods that are high in water, such as watermelon, to increase your fluid intake.
- You can also contribute to hydration by sucking on ice cubes, as well as drinking water.
- Do not consume alcohol as it increases dehydration.
Step 3. Maintain a healthy weight
If you are underweight, you have fewer tissues that can protect those areas of the body that are particularly prone to pressure sores; in this case, the skin tears more easily. Being overweight causes similar problems, as it makes it difficult to move and change positions to relieve pressure.
Step 4. Don't smoke
Smoking contributes to dehydration of the skin and is considered an unhealthy habit. It also reduces blood circulation, a factor that can increase the risk of pressure ulcers.
