Bed sores

What are Bed sores?

Bed sores are known by different names such as pressure sores, decubitus ulcers and pressure ulcers. An ulcer is a break or a sore on any surface of the body that can be present in the inner or outer surface. Bed sores are ulcers present on the skin of a person. 

What are the symptoms of Bed sores?

There are seven most common symptoms observed or felt by the patient with bed sores. One of them is the change in color of the skin. The skin gets discolored. The skin or area which is involved in formation of a bed sore goes through a tear formation. These tears are common on skin that are next to bony prominences. Presence of bone increases the pressure built up. The skin gets infected and contains the signs of bed sores which can be detected by the doctor. The skin starts go give off bad smell, the skin gets moist. Also due to infection the area gets inflamed causing formation of swelling and in some patients pus accumulates in the area. 

What are the causes of Bed sores?

There are several reasons why bed sores form in a patient. They can be caused due to continuous friction produced between the surface of the body and the external surface to which it comes in contact with. Bed sores are caused by any factor that increases the pressure in the area and is sustained for a long time. When there is increase friction in skin and the components of body under the skin or friction between the skin and external surface tends to form a bed sore. When different forces are applied at different angles on the body they cause lesion formation and cause bed sores.

They can also form due to humidity surrounding the skin.  Higher temperature compared to normal body temperature can also cause formation of bed sores. They can also form due to voluntary restraining the fecal matter or urine, resulting in an increase in the pressure build-up in the urinary system and intestinal system. Some of the medication given to the patient can also be the cause of it. Shearing forces affecting the body can also cause a bed sore. Shearing forces are any forces that are not aligned. Age of the patient and unrelieved pressure built in the body can also cause bed sores. Bed sores tend to form in patients who are sick and are bed prone for a long time, hence increasing all these pressure increasing factors.

What are risk factors for development of Bed sores?

There are several factors that can increase the chances of a patient developing a bed sore. While some patients are sick they tend to go through weight loss hence the bones start coming in contact of the skin and produce pressure built up. If a person is bed prone for a longer duration of time due to any sickness of injury which makes them immobile increase their chances of developing bed sores compared to other patient. Poor health also acts as a risk factor. Patients who are comatose are immobile and cannot move, so they tend to remain in same position unless someone changes their position hence the pressure builds up and is sustained. Abnormal moisture of the skin whether it's excess moisture or dryness of the skin. It will cause a bed sore.                

A person who has bad diet and not eating a balanced and healthy diet will be prone to developing a bed sore. Person who is not hydrated properly and drinks less water compared the body requirement result in dehydration. Which causes dryness of the skin and tissue acting as a risk factor? Just like comatose patients some patients with nerve injuries or problems cannot feel properly. Hence they do not feel pressure build up or discomfort due to lesion or tear formation on the skin. This is common in diabetic patients. Geriatric or elderly people are more prone to developing a bed sore, as they are more likely to be less mobile, restricted to bed and with decrease sensory perception. Also, they tend to have poor health. 

Complications of Bed sores

There are few but serious complications associated with the bed sores. Bed sores can develop into skin or mucosal cancers. If the skin gets infected by bacteria or virus it can develop into cellulitis. Which requires intensive treatment? Infection also spread through the blood into the entire body causing the bacteria to increase and form difficulty in fighting it off. It is known as sepsis. The bones or joints surrounding the skin involved in bed sores can get infected. This is known as osteomyelitis. This complication can have permanent infect on bones and joints if not dealt on time. 

Diagnosis of Bed sores

The doctor diagnosis a bed sore through examination and tests, The diagnosis involves complete physical examination of the ulcer. The size, depth, border, site, dimension, presence of infection, fluid or whether its healing on itself and if there is bleeding present is checked in detail. Few tests may be ordered by the doctor if considered important. These tests involve some blood test. These blood tests are used to assess the nutrition status of the person and whether the person is healthy or not. The ulcers that are not healing with treatment that requires tissue cultures, sample form the ulcer is taken and cultured in a lab to check the presence of specific bacteria or fungus that is causing infection of the ulcer and delaying its healing. An ulcer which is at fourth stage, which means that is large in size and cannot heal on its own and requires approximation done by a doctor, also require tissue culture test. If through history of the patient it is determined that the ulcer is present for a long time and is not healing, it is suspected for cancer. Hence a tissue biopsy is done. It is sample of ulcer is taken and observed under a microscope for any cancerous cells. 

Treatment of Bed Sores

There are multiple approaches to treating bed sores. These include homeopathic treatment, acupuncture and acupressure, treatment through conventional or allopathic means, surgical procedures, dietary and herbal treatments, and others. 

Homeopathic Treatment of Bed Sores

Homoeopathic remedies have been of much use in both preventive cares as also curative effects for ulcers, wounds on the skin and bedsores. It helps to cure dry skin with ulcers that discharge sticky fluid. Some of the homeopathic remedies for bed sores are Acidum Hydrofluoric, Apis Mellifica and Graphite’s. 

Acupuncture and Acupressure Treatment of Bed Sores

Acupuncture can be used to improve blood and energy flow to the affected area-including the shoulder blades, buttocks, and hips which may help bedsores heal faster. 

Conventional or Allopathic Treatment of Bed Sores

Allopathic treatment involves relieving pressure on the area and keeping the skin clean and dry. When the skin is broken, a non-stick covering may be used. A saline solution is often used to clean the wound site whenever a fresh bandage is applied. Disinfectants are applied if the site is infected. The doctor may also prescribe antibiotics, special dressings or drying agents, and ointments to be applied to the wound.

Surgical Treatment of Bed Sores

Surgical debridement involves cutting away dead tissues. Most of the time surgical debridement is only considered in cases involving advanced stage bed sores. In this surgery, surgeon uses a scalpel to remove the dead tissue, bone and fluid from the area around the bed sore.

Dietary and Herbal Treatment of Bed Sores

A diet should include protein, vitamins and minerals in your diet. Aloe vera, applied topically in ointment, gel, or cream form, is effective in healing sores.

What are the precautions and prevention of Bed sores?

Smoking tends to affect the health of the patient and is known to cause slow healing. Cessation and giving up the habit of smoking can prevent formation of bed sore. A person should remain active as it improves the blood circulation in the body. Frequent drinking of water which is adequate for daily requirement keeps the skin hydrated also acts as prevention. Skin should be kept clean and dry to avoid the conditions which help in over growth of bacteria and causing skin infection. It keeps the humidity and moisture of the skin in normal range and acts as a precaution. A patient, who is restricted to the bed or is immobile, Should be kept in comfortable position with frequent changing of the posture and position of the body. Patient should be provided with soft cushions to increase comfort. These will decrease the risk factors associated with immobility and act as a precaution.

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