Updated: Mar 10
Pressure Injuries (Bedsores or Decubitus ulcers) are one of the costliest and most physically debilitating medical conditions happening to a bedridden patient. Pressure ulcers, commonly known as bedsores, are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Therefore, constantly relieving pressure can prevent injuries and tissue damage.
The Gold standard of care recommended is to reposition bedfast patients every two hours to shift pressure acting on one particular part of the body, though this may not be a durable panacea.
A rudimentary understanding by the caretakers would result in unwholesome health outcomes. Furthermore, more than 85 per cent of the caretakers who do the repositioning have musculoskeletal disorders and 97 per cent of the patients do not receive a two-hourly repositioning, as a result of which they develop pressure ulcers. Once the pressure ulcer develops, the cost of treatment is relatively higher. What is worrisome is unhealed pressure ulcers have the potential to cause appalling injuries and even death in many cases. Scholars identify around 11 billion USD is spent annually on bedsores and more than 60000 deaths every year are due to bedsores. The prime reason is poor understanding of bedsores and lack of knowledge on preventive measures.
Why do Bedsores occur?
There are various reasons when people have to turn to bed rest. The notable one is linked to old age immobility, other reasons encompass paralysis, dementia, muscular spasms, poor health, fatal injuries like spinal cord injuries, surgical recovery, coma among others, where the person would remain immobile by the reason of unconsciousness, incapable to sense pain. Another important section of people are who suffer from diseases like diabetes and vascular diseases have a greater risk of bedsores.
Symptoms (Stage) of bedsores?
The symptoms of bedsore are mild in the initial stage and if unattended could lead to fatal injuries. According to John Hopkins Medicine, bedsores are divided into 4 stages, that range from severe to most severe.
Stage 1- the affected area(part) appears to be red and those with dark skin may notice the affected part with a blue or purple tint. The person could sense pain, burn, or itching over that area.
Stage 2- now the affected part appears to be damaged with an open sore, scrape or blister. The person could feel serious pain as well.
Stage 3- here tissue below the skin might be worn out, also the wound has the resemblance of a crater.
Stage 4- there is a huge risk of infection as the area is severely damaged and the infection might have tunnelled to muscles, tendons, bones, and joints.
What are preventive measures for bedsores?
The available resolution is relieving pressure from parts of the body and thereby preventing pressure buildup in the body for an extended period. Besides, the person should be ensured good nutrition. What to do when actually bedsore starts to appear? The wound should be protected with medicated gauze. Ensure that the wound is well taken care of and kept clean. If necessary, health professionals would remove the damaged skin and transplant it with healthy skin to the affected area. Also, medicine such as antibiotics could help.
What are the problems associated with bedsores?
We cannot afford to ignore the issues that bedridden lot has to endure, they are met with unpleasant situations and they suffer untold miseries including depression, nervousness, cleanliness hygiene among others apart from pressure ulcers. About 60 per cent were cared for by family members and the rest by other caregivers. Inexperienced caregivers have to undergo insurmountable problems. The immediate family members have to go through a great deal of emotional, physical, and psychological trauma. Repositioning every 15 minutes to 2 hours and caring for an extended period is detrimental to the desired health outcomes in addition to friction in the interpersonal ties. Our in-depth study has provided an understanding of how there is build-up frustration among the caregivers. There is a lack of steadfast loyal caregivers as well. The home-based, long-term care, with the involvement of family members, has proved to be ineffective in the long run.
The take-home message from our research is that the causes of bedsores are preventable with regular position changes, healthy diet, proper skincare and also, close inspection of skin in the risk areas is crucial.
The fact remains that bedsores are not a rare and one-off situation. People will get ill and may resort to bed, especially it is a natural concomitant (associated with) old age. So how can we obviate the risks associated with bedsore? We could take a few informed and sensible steps that could minimize the suffering of the people with limited mobility.