Decubitus Ulcers, Bedsores (Pressure sores)

Also called “bedsores” or “pressure ulcers,” decubitus ulcers can be more than a nuisance. Left untreated, they can lead to deadly infection. Here’s how to prevent or manage decubitus ulcers.

WHAT IS A DECUBITUS ULCER?

The term “decubitus ulcer” comes from the Latin word for “to lie down.” That’s why these skin wounds often are called bedsores. Like other ulcers they occur due to persistent strain on the skin tissues.

A decubitus ulcer occurs on the skin, usually where it stretches over bony prominences like the hip or sacrum (the bottom of the spinal column). When a person puts constant pressure on these skin areas (such as from sitting in a wheelchair for hours at a time), the cells can break down and die. This results in an open sore on the skin. Decubitus ulcers can be hard to treat, so the focus usually is on prevention.

RISK FACTORS FOR PRESSURE ULCERS 

Anyone can get a decubitus ulcer. However, some people are more at risk than others. Some risk factors for pressure ulcers include:

  • Acute hospitalization
  • Being bedridden
  • Using a wheelchair
  • Being elderly
  • Being unable to change position frequently on your own
  • Eating a poor diet, in combination with any of the other risk factors
  • Having existing skin breakdown

DECUBITUS ULCER PREVENTION

For decades, pressure ulcers were considered a sign of neglect — by nursing home staff, family members or hospital nurses. Today, however, decubitus ulcers are known to arise very quickly even in people with the best possible care.

If you are at risk of developing a decubitus ulcer (or if you care for someone at risk), here are some ways you can try to prevent a pressure sore from occurring:

  • Eat a healthy diet that includes foods rich in protein plus Vitamins C and A. These nutrients aid in wound healing.
  • Keep skin clean and dry. In some ways, keeping the skin dry is even more important than keeping it clean. Damp skin cells break down much more quickly than dry ones do.
  • Change positions at least every two hours. More frequent position changes are better.
  • Use pillows or products to help relieve pressure on vulnerable areas of skin. Note: do not apply padding directly to the skin. Padding, itself, can exert undesirable pressure on the skin.
  • Enlist the help of nurses or certified nurse assistants. They can demonstrate how to position yourself or someone else in bed, in a chair, and so on, for maximum pressure relief.
  • Be alert for signs of an impending decubitus ulcer before the skin breaks down. These signs include discoloration of the area (the skin may look bruised, red or darkened); the skin does not blanch (turn white) briefly when touched; the area is painful.

TREATMENT OF DECUBITUS ULCERS

If a pressure sore develops despite your best efforts, do not delay in getting treatment. Pressure ulcers rarely heal on their own, and they can develop into larger, serious wounds very quickly.

Decubitus ulcer treatment depends on the “stage” of the ulcer. However, for any type of decubitus ulcer, it’s crucial you first relieve pressure on the affected area. Mild wounds usually are treated with debridement (removal of dead tissue), gentle cleansing on a regular basis and general wound care techniques. More advanced wounds may require a negative-pressure (vac) device to assist in healing. Keep all pressure off the wound area until it is completely healed.

DECUBITUS ULCER MANAGEMENT

For those chronically confined to a bed or wheelchair, it’s almost inevitable a pressure sore will develop at some point. By vigilantly practicing prevention measures and seeking swift treatment, you can avoid any of the serious complications (including death) a decubitus ulcer can bring.