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Bedsores, also called pressure sores or decubitus ulcers, are ulcers (sores) caused by prolonged pressure or rubbing on vulnerable areas of the body. Vulnerable areas in this case include bony/cartilaginous areas prone to moisture and friction. Examples include pressure points on the lower back (near the tail bone or sacrum or iliac crest), hips, ankles, heels and elbows, as well as the ear.
A simple example of a mild pressure sore may be experienced by healthy individuals while sitting in the same position for extended periods of time. The dull aches are indicative of impeded blood flow to affected areas. Within hours, this may lead to tissue death. The sore will initially start as a red, painful area, which eventually turns purple. Left untreated, the skin may break open and become infected. Moist skin is more sensitive to tissue ischemia and tissue death, and is also more likely to get infected.
Classification
The ulcers are categorized into four stages, subject to size and depth:
- Stage I is the most superficial, with only superficial irritation
- Stage II is blistering of the skin
- Stage III involves the whole skin, often complicated by infection
- Stage IV the deepest (usually extending into the muscle, tendon or even bone)
Epidemiology
Some studies suggest that three to 10 percent of hospitalized persons have pressure sores, with two-thirds occurring to patients over the age of 70. Younger people with neurological impairments also develop pressure sores, because they remain in one position and cannot feel irritation or building pressure. Between five and eight percent of these people have pressure sores during a year.
Prevention
The condition is prevalent in sedentary individuals, such as those living with paralysis or confined to a bed because of illness or impairment.
Nursing homes and hospitals usually set programs to avoid the development of bedsores in bedridden patients (e.g. moving them every two hours, ensuring dry sheets, etc.). Poor nutrition is also a major factor in the formation of pressure sores.
Complications
Pressure sores can trigger other ailments. Some complications include autonomic dysreflexia, bladder distension, osteomyelitis, pyarthroses, sepsis, amyloidosis, anemia, urethral fistula, and very rarely malignant transformation. Sores often recur because patients do not follow recommended treatment or develop seromas, hematomas, infections, or dehiscence. Paralytic patients are the most likely people to have pressure sores recur.
Complications from pressure sores can be life-threatening. The most common causes of fatality stem from renal failure and amyloidosis.
Famous victims
Movie star and stem cell research advocate Christopher Reeve died from complications related to a pressure sore.
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