Preventing Bed Sores

Bed sores, also known as pressure ulcers or pressure sores, are injur ies to the skin and underlying tissue as a result of prolonged pressure on the skin. Bed sores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone. People most at risk of bed sores are those with medical conditions that limit their ability to change positions or those who spend most of their time in a bed or chair. Let us take a look at the three primary contributing factors for bed sores.

SUSTAINED PRESSURE

Constant pressure on any part of the body can inhibit an adequate supply of blood to skin and underlying tissues. When your skin and underlying tissue are trapped between bone and a surface such as a wheelchair or a bed, the pressure may be greater than the pressure of blood flowing in the capillaries that deliver oxygen and nutrients to tissues - without which the skin and its neighbouring tissues would be damaged and will eventually die. For people with limited mobility, this type of pressure tends to occur in areas that are not well-padded with muscle or fat and that lie over a bone, such as the spine, tailbone, shoulder blades, hips, heels and elbows.

FRICTION

Friction occurs when the skin rubs against clothing or beddings. This can happen when a person changes position. It can make fragile skin more vulnerable to injury; the resistance to motion is amplified if the skin is moist.

SHEAR

Shear occurs when 2 surfaces move in opposite direction. For example, when a bed is elevated at the head, the person may slide down. As the tailbone moves down, the skin over the bone might stay in place, essentially pulling in the opposite direction. This motion may damage tissue and blood vessels, making the site more vulnerable to damage from sustained pressure.

Bed sores develop in four stages. In its first stage, the skin will look red and feel warm to the touch and it may be itchy too. Into its second stage, there may be a painful open sore or a blister, with discoloured skin around it. During the third stage, a crater like appearance develops due to tissue damage below the skin's surface. When the sore reaches it's fourth stage, there would be severe damage to the skin and tissue, possibly coupled with infection. At this point of time, muscles, bones and tendons may be visible. An infected sore takes longer to heal and the infection may spread to other parts of the body. As such, preventing bed sores is easier than treating them.

If you or your loved ones are currently on bed rest, there are several things you can do to prevent bed sores:

1. Change Positions Frequently

It is important to reposition someone on bed rest once every 2 hours or once every 15 minutes if they are in a wheelchair. This will help lessen pressure on a particular part of the skin.

2. Skin Inspections

A patient's skin should be examined daily for signs of pressure damage.

3.. Keep Skin Clean and Dry

The cleaner and drier your skin is, the less likely it will develop bed sores. Dip a towel in a bucket of warm water and mild soap and clean your skin with it. Then pat your skin dry with a dry towel. Do not rub too hard as it can lead to skin irritation.

4. Use Pillows, Specialty Bedding or Materials to Reduce Pressure

Another effective way to prevent bed sores is to put pillows between parts of your body that press against each other such as under the tailbone, elbow, shoulders and heels. If' you are lying on your side, it is recommended to put your pillow between your knees and ankles. Specialty beds such as water or air mattress toppers, or special cushion paddings can provide more comfort and help reduce the amount of pressure placed on sensitive areas of the body.

5. Healthy Diet

Maintaining good nutrition will help enhance overall health and wound healing. The benefits of a well­ functioning circulatory system are only as good as the nutrients it delivers. Keeping hydrated is also a vital part of preventing bed sores.

6. Exercise

Exercise, ambulation and range of motion exercises help promote circulation of blood and circulation helps to prevent the formation of bed sores. When you can't get out of bed, the idea of exercising may seem daunting. However, performing a few range of motion exercises in bed can help reduce the risk of bed sores. For example, you can start with an arm lift. Just lift your arm as high as you can and hold it there for 10 seconds. Repeat the exercise with the other arm.

Without proper prevention or treatments, bed sores can lead to serious complications like cellulitis, bone and joint infections and sepsis. Stage 2 bed sores can heal within 1 to 6 weeks, but ulcers that reach stage 3 or 4 may take several months or they may never heal properly, especially in people with ongoing health problems. But with appropriate measures, we can still significantly reduce the risk of developing bed sores.

Source: PRIME Oct-Nov 2018 Issue

Article re-posted with permission from Prime Magazine Singapore