BEDSORES OR PRESSURE SORES: Causes, Symptoms and Common sites.

What are Bed Sores or Pressure Sores or Decubitus Ulcer?

Bed sores or pressure sores (known as Decubitus ulcer) is the localized injury to the skin and or underlying tissue which occurs in a bed-ridden patient over a bony prominence area due to as a result of prolonging unrelieved pressure, or pressure in combination with shear which hampered circulation.

Fig: Common sites of bed sores or pressure sores

Shear occurs when the when forces moving in opposite directions is applied to tissues in the body. This can happen when patient slide down in bed or transfer patient’s weight from one surface to another and skin is stuck to a surface, such as a bed, while gravity forces the body down on the bed.

The tissue of that part become gangrenous of dead and the skin breaks down causing an ulcer. Most often bed sores develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone.

Causes of Bed Sores or Pressure Sores:

There is two number of contributing factors which are associated with pressure ulcers. I have explained the significance of these factors below.

• Direct or immediate cause,
• Indirect or predisposing causes.

Direct or Immediate Causes of Bed Sores or Pressure Sores:

All the factors listed below as direct or immediate cause of Bed sores or pressure sores:

1. Crumbs or creases in bed,
2. Rough handling of linen and bedpan,
3. Hard surfaces of plaster cast and splints,
4. Dirty and wet clothing,
5. Same position for a long time,
6. A pressure of clothing and other things,
7. Poor back care,
8. Friction or rubbing of the skin,
9. Moist skin – for example, due to sweating or incontinence,
10. Use a wheelchair or stay in bed for a long time,
11. Shearing forces,
12. Excessive perspiration,
13. Wound drainage.

Indirect or Predisposing Causes of Bed Sores or Pressure Sores:

Following those indirect or predisposing cause lead Bed sores or pressure sores:

• Older adult,
• Long lying patients( immobility),
• Helpless and paralyzed patients( inactivity),
• Unconscious patients,
• Fecal or urinary Incontinent patients,
• Very thin or very fatty patient,
• Patients with edema,
• Malnourished patients,
• Lack of fluid (dehydration),
• Immunodeficiency,
• Diabetes or Vascular disease that affects blood flow,
• Progressive neurologic disorders (Alzheimer disease, Parkinson disease, multiple sclerosis),
• Have the fragile or dry skin,
• Smoking, alcoholism,
• Corticosteroid use,
• Cancer Malignancies,
• Muscle atrophy,
• Spinal cord injury,
• Traumatic brain injury,
• Fracture,
• Poverty or lack of access to food,
• Weak sense of smell or taste,
• Depression or psychosis,
• End-stage renal disease,
• Dementia.

Signs and Symptoms of Bed Sores or Pressure Sores:

Various sign and symptoms of bed sores or pressure sores are listed in the below:

1. Discoloration and redness,
2. Heat, pain, and tenderness in the affected area,
3. Burning and discomfort in the area,
4. The area becomes cold to touch and insensitive,
5. Local edema also present,
6. Infection,
7. Open skin(an open wound or blister),
8. Affected area become softer or firmer than the surrounding skin,
9. Changes in texture, such as rashes, dryness, or swelling,
10. Cracks, scabs, and blisters,
11. A difference in skin temperature from the surrounding.

Common Sites of Pressure Sores or Bed Sores:

When a person is bedridden, pressure sores can occur in a number of areas, Common pressure sores sites includes-

• Rims of the ears,
• Over the back or sides of the head (Occiput),
• Over the shoulder blades and spine,
• Scapula,
• Elbow,
• Ischial tuberosity,
• Sacrococcygeal region,
• Heels, ankles, and skin behind the knees,
• Greater trochanter,
• Pelvis.