16.09.2020

Bedsores preventive treatment

What is a bedsore?

Bedsore is a skin condition arising from the exposure to the following factors:

• Pressure causing local ischemia – cells which are deprived of oxygen die, and repeated periods of skin affecting pressure lead to inflammation – that can quickly lead to developing a bedsore.
• Friction – rubbing peels the epidermis, making the skin weaker or even damaged. Skin irritation or damage promotes bedsore development.

• Maceration – occurs when the skin is constantly exposed to moisture, what softens it, making it easy to get infected. Agents causing macerations are:

1. sweat
2. urine
3. wound exudation

What promotes bedsore development?

• Limited mobility – confinement, physical disability, etc.
• Epidermis injury or abrasion
• Improper skin care
• General health problems – malnutrition, deficiency of protein, electrolytes and blood compounds
• Atherosclerosis, diabetes
• Prolonged exposure to wetness, which can be caused by choosing wrong incontinence management products
• Too high ambient temperature causing excessive perspiration and skin chafes
• Garments and bedclothes made of artificial, skin irritating materials
• Internal seams in clothes, buttons, food bits on the mattress.

The most common places where bedsores occur

5 stages of bedsores

Bedsores are rated in stages – there are 5 depending on the level of development:

STAGE I – redness, which fades after eliminating the pressure; there is no skin damage.

STAGE II – redness which does not fade after relieving the pressure; surface swelling, skin erosion; painful epidermis injury.

STAGE III – deep skin damage reaching to the dermis (deeper skin structures); visible, swelling, rash; the bottom of the wound may be covered with dissolving tissue (yellow mass) or red granulation.

STAGE IV – the damage reaches down to the bone, skin necrosis occurs; dead tissue is present, and the bottom of the wound may be filled with black necrotic tissue.

STAGE V – this is the most advanced stage – necrosis reaches down to the muscles, what may lead to sepsis.

Bedsore preventive treatment

Healthy people, who are able to control their muscles, and are able to react to discomfort caused by pressure never develop bedsores. Their development in the case of people with limited mobility can be considerably reduced by following the rules of bedsore preventive treatment.

Do not ignore the symptoms

Skin redness, which doesn’t disappear after relieving pressure, blisters developing in the area under pressure, damaged epidermis – these symptoms should alert the carer. Constant skin observation is a crucial element of bedsore preventive treatment.

Try to eliminate risk factors

• Body repositioning should be carried out regularly every 2–3 hours.
• Decrease the pressure on the skin if bedsores start to develop the person you look after should not sit or lie on the body part affected by the changes.
• Remember to separate the legs with a pillow when positioning on one’s side.
• Get rid of rubber underpads – they tend to crease and fold – this puts pressure on the skin and blocks the air circulation.
• Bedclothes should never be wet – if the person you look after wets the bed you should change the bedding.
• Prevent injuries – this also includes scratches – clip your loved one’s nails short and file them.

Use special bedsore preventive equipment

• Pressure reducing (anti bedsore) mattress
• Anti bedsore pillows
• Special bed underpads and mattress covers
• Slip mats and sliding equipment used to reposition the person on the bed.

Try to activate your loved one as much as possible

• Encourage the person under your care to do as many activities as possible.
• Try to work on increasing mobility.
• Do not relive the person you look after from every activity.

Use skin care

• Delicately cleanse the skin using special cosmetics.
• Avoid using products which affect the skin too much. Also avoid using powder with greasy products such as oil or rich cream.
• Remember about intimate hygiene of the person you look after – cleanse these parts with delicate products and apply protection in those areas.
• Check the skin condition every day – react promptly if you come across something disturbing.
• Activate the skin through massage – it is best to use an activating gel – avoid using spirit because it makes the skin dry.

Ensure healthy diet for the person you look after

• Daily diet should supply the organism with all the necessary nutrients, vitamins and microelements.
• The diet should include cereals, dairy products, legumes, meat, fish, fruit and vegetables.
• If bedsores start to develop it is advised to introduce a diet high in protein for some time.
• Sweets, animal fat and salt consumption should be cut down or avoided.

If bedsores develop you need to consult a doctor immediately to plan the treatment. Treatment of bedsores takes time. It is a difficult process, however if you follow the doctor’s advice, it is possible to cure them.

Remember: the sooner you start to employ proper action, the quicker and more effective will be the treatment. Remember that it is easier to prevent, than cure.

You can find more information on proper skin care here. Get to know the practical advice for carers looking after their loved ones.