Bedsores are lesions which are typically caused by periods of prolonged immobility. A mild bedsore can generally be easily treated, but more severe sores can cause serious problems, and they require surgical intervention. Bedsores strike people who are bedridden, paralyzed, or dealing with other limited mobility issues, and prevention of bedsores is a major part of training for health providers who deal with at-risk individuals.
These lesions are also known as pressure ulcers, decubitis ulcers, or skin ulcers. If left untreated, bedsores can cause sepsis, cellulitis, gangrene, and deep infections of the bones and joints. Bedsores have also been linked with carcinoma and necrotizing fasciitis, an infection which literally eats away otherwise healthy tissues. People in wheelchairs or people who are bedbound are at risk for skin ulcers, as are long-term hospital patients, individuals in nursing homes, and people with conditions such as diabetes, which interferes with circulation.
There are three primary causes for bedsores. The first is simply prolonged pressure, which can cause bedsores to appear on places like hips and shoulder blades. Bedsores also form through friction and shear as the patient’s body rubs against a bed or wheelchair. Active people rarely get such sores because they make small adjustments to their position throughout the day and while they sleep. Someone who has a limited range of motion can get a bedsore in only a few hours if he or she is positioned in a way which cuts off circulation.
There are four different stages of bedsores. A stage one bedsore manifests as an area of tenderness and mild inflammation, and it generally vanishes shortly after the pressure on the area is relieved. A stage two bedsore is characterized by some skin loss, forming an open blister or wound which is also discolored; with rapid treatment, this type of sore generally heals quickly. Stage three bedsores are deeper, while stage four bedsores can be extremely deep fissures surrounded by dead tissue. A stage four bedsore is also characterized by damage to the underlying muscle and bone, and it represents a serious medical problem.
There are a number of ways to avoid bedsores. The first is frequent positional changes such as turning, accompanied by the use of supportive pads which can reduce pressure on problem areas like the hips. Caregivers also need to carefully inspect their patients for the early signs of bedsores, and patients generally benefit from nutritional support and physical therapy as well.