Patient care

Stages of Bedsores
Risk Factors of Bedsores
Complications from Bedsores
Treatment of Bedsores
Prevention of Bedsores


Treating bedsores is challenging which is why prevention is the best treatment. Open wounds are slow to close, and because skin and other tissues have already been damaged or destroyed, healing is never perfect.

Conservative treatment
Although it may take some time, most Stage I and Stage II bedsores will heal with conservative measures. The first step in treating a bedsore at any stage is relieving the pressure that caused it.

Changing positions in bed often reduces pressure on any one spot. Caregivers need to follow a schedule for turning and repositioning - approximately every 15 minutes if you're in a wheelchair and at least once every two hours when you're in bed. Using sheepskin or other padding over the wound can help prevent friction when you move. Using support surfaces such as special cushions, pads, mattresses and beds that relieve pressure on an existing sore and help protect vulnerable areas from further breakdown. It is essential to keep wounds clean to prevent infection. A stage I wound can be gently washed with water and mild soap, but open sores should be cleaned with a saltwater (saline) solution each time the dressing is changed. Avoid antiseptics such as hydrogen peroxide and iodine, which can damage sensitive tissue and delay healing.

Debridement. The removal of damaged tissue (debridement) is a necessary but painful way to repair Stage II and higher bedsores. To heal properly, these wounds need to be free of damaged, dead or infected tissue. This can be accomplished in several ways - the best approach depends on your overall condition and the type of wound. One approach is surgical debridement, a procedure that involves using a scalpel or other instrument to remove dead tissue. Surgical debridement can be effective, but it is extremely painful because the dead tissue is connected to the live tissue, and to remove all of the dead tissue the live tissue will be painfully cut into as well. For that reason, your doctor may use one or more nonsurgical approaches such as a high-pressure irrigation device (mechanical debridement), allowing your body's own enzymes to break down dead tissue (autolytic debridement), or applying topical debriding enzymes (enzymatic debridement).

A variety of dressings are used to help protect wounds and speed healing - the type usually depends on the stage and severity of the wound. The basic approach, however, is to keep the wound moist and the skin surrounding it dry. Stage I bedsores may not need any covering, but stage II lesions are usually treated with semi-permeable dressings that retain moisture and encourage skin cell growth.

Aggressive/Surgical Treatment
Even with the best medical care, once bedsores get started they can quickly reach a point where they require surgical intervention. Most bedsores are repaired using a pad of muscle, skin or other tissue that covers the wound and cushions the affected bone (flap reconstruction). The tissue is usually harvested from a healthy area of your own body. Before the operation, the wound is extensively debrided, much more than it is in nonsurgical treatments. In addition to dead tissue, the fluid-filled sac that serves as a gliding surface between bone and muscle (bursa) is removed, along with any diseased bone. In spite of every precaution, flap reconstruction has one of the highest complication rates of any surgery, and the recovery period is long and arduous. You must have a strong social support system, optimal nutritional status, state-of-the-art resources such as a pressure-release bed, and the ability and motivation to participate in your own recovery to be a candidate for this operation.

Other treatment options
Researchers are actively searching for more effective bedsore treatments due to the fact that current treatment is so slow and painful. Under investigation are hyperbaric oxygen chambers, electrotherapy, and the topical use of human growth compounds. Growth compounds - proteins that stimulate cell growth - have been approved for the treatment of diabetic ulcers but not, as yet, for bedsores. And while all this scientific effort is intriguing, the best treatment is still prevention.

If you have a loved one in a nursing home, hospital or other care facility, check that person's skin condition, weight and general care every time you visit. If you notice any sign of bedsores or neglect, alert the nursing staff and attending physician or nursing home director immediately. You and other family members are in the best position to monitor and assess a loved one's condition. Be persistent, because if the administration and staff are slow to respond your loved one could develop bedsores. Bedsores are a sign of neglect! If you have a loved one who is being neglect, contact York Law Corporation to act on your behalf today!

Copyright 2008. York Law Corporation