What Are Bed Sores? Stages, Treatment, and Prevention

Understanding Bed Sores (Decubitus Ulcers)

In the medical field, the term "bed sores" refers to pressure ulcers or decubitus ulcers that can develop on areas of the body subjected to prolonged pressure from lying in bed or sitting for long periods. Bed sores are a serious potential complication for immobile or bedridden patients.

Causes of Bed Sores

Bed sores form when constant pressure cuts off blood circulation to an area of skin. Without adequate blood flow, the skin becomes damaged and begins to break down and rot. Common problem areas include:

Back of the Head

Constant pressure against the pillow can cause sores for bedridden patients.

Shoulder Blades

Lying on the back places weight on the protruding shoulder blades.

Elbows

Weight on the elbows when lying on the side can lead to sores.

Tailbone

Sitting puts pressure on the tailbone, especially for wheelchair users.

Hips and Buttocks

The largest areas of weight-bearing when lying supine lead to some of the most common sores.

Heels and Ankles

Even with special boots, pressure on the feet from immobilization can cause sores.

Stages of Progression

Bed sores are classified into four progressive stages based on severity:

Stage 1

Reddened skin that does not blanch or whiten with pressure indicates the early onset of damage.

Stage 2

The skin breaks open, forming a shallow ulcerated wound with pink granulation tissue exposed.

Stage 3

The sore worsens, forming a deeper crater in the skin that exposes subcutaneous fat tissue.

Stage 4

The most advanced stage involves extensive damage extending through the skin into muscle and bone.

Risk Factors

Those at highest risk of developing bed sores include:

• Prolonged immobility or bed confinement
• Advanced age with fragile skin
• Limited sensation due to paralysis or neuropathy
• Conditions affecting blood flow like atherosclerosis
• Poor nutrition status
• Bowel or bladder incontinence
• Debilitating diseases such as cancer or sepsis

Complications

Serious complications can result from severe, chronic bed sores:

Local Infection

Bacteria rapidly colonize open wounds, leading to opportunistic infections like cellulitis.

Osteomyelitis

Infection can spread to the bone underneath deep stage 3-4 sores.

Sepsis

Widespread systemic infection known as sepsis can result from unchecked local infection.

Cancer

Longstanding chronic wounds increase the risk of developing squamous cell carcinoma.

Treatment

Effective treatment focuses on preventing new sores and managing existing ones:

Pressure Relief

Frequently repositioning immobile patients reduces pressure on any one area.

Cushioning

Pillows, foam pads and mattresses redistribute pressure points.

Cleaning

Gently cleaning and debriding wounds prevents infection while promoting healing.

Dressings

Advanced dressings like hydrocolloids maintain a moist environment to stimulate wound healing.

Nutrition

Adequate protein, vitamins and minerals supports tissue regeneration and fights infection.

Prevention

Preventing bed sores involves:

• Frequent repositioning every 1-2 hours
• Regular skin inspection
• Moisturizing dry skin
• Using pressure redistribution devices
• Managing moisture from sweat, urine, etc.
• Optimizing nutrition status

Outlook

Small stage 1 sores often heal within a week or two with proper care. But deeper ulcers may require months to fully close. Severe bed sores may never fully resolve in debilitated patients. With attentive nursing care and early intervention, most bed sores are preventable complications.

While the term bed sores may sound alarming, being informed about the causes, staging, and treatment of decubitus ulcers helps patients and caregivers be proactive about prevention and early treatment.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.