What is a pressure sore?
A pressure sore is one of the complications of an illness or mobility impairment that can seriously affect a patient. When the body is in a prolonged position (sitting or lying down), its weight exerts pressure on the blood vessels located under the skin, resulting in a reduction in oxygen supply to the skin tissues. If the crushing of the tissues persists, a wound may appear, this is a bedsore.
A pressure sore can appear in just 3 hours after prolonged immobilization in a chair or armchair.
Quick to appear, difficult to disappear... A bedsore takes on average 3 to 5 months to heal completely.
What does a pressure sore look like?
A pressure sore can take on different appearances depending on its stage in people with symptoms, as well as the area where it is located and how it is treated. Pressure ulcers are often associated with risk factors such as immobility even at home, malnutrition, dehydration, injuries and in aging people. Symptoms can appear as a simple redness (sometimes taking on blue or purplish hues). The bedsore can be more or less deep depending on the lesions, it can “simply” affect the superficial tissues of the skin or deepen to the muscles and bone.
In the most serious cases, the organs may be exposed; it is important to ensure adequate care depending on the stage of the bedsore to avoid infection or worsening of the wound.
How does a pressure sore form?
There are several stages of formation of a pressure sore.
What are the 4 stages of pressure ulcers?
Stage 1 : this stage is characterized by erythema. Erythema is defined as redness of the skin that does not disappear under finger pressure. The erythema area is red, warm and sometimes painful. This corresponds to damage to the epidermis and sometimes even the dermis. In the case of people with fair skin, erythema will appear as a persistent redness. In the case of more pigmented skin, the area may take on a red, blue or purplish tint.
Stage 2 : from there, deepidermization or blistering is formed. The epidermis and/or dermis atrophy, leaving a superficial wound due to the loss of these tissues at the local level . A blister is a phenomenon of detachment of the epidermis, forming a bubble (blister) which will fill with plasma (transparent liquid) or blood. This stage can also be painful. If there is no support at this stage, then stages 3 and 4 can progress very quickly.
Stage 3 : this stage is marked by necrosis . It is the death of living tissues and skin cells. At this stage, a deep wound forms in the skin reaching the epidermis, dermis and subcutaneous tissues. The necrotic skin becomes black and rigid. The bedsore is now at a serious stage.
Stage 4 : this stage corresponds to ulceration . This is the most serious stage of a pressure sore. The wound can be very deep, reaching the muscles and even the bones. Tendons and joints can even be affected depending on the area where the pressure sore develops.
Where do bedsores most often form?
Bedsores are an injury to the skin that is caused by prolonged pressure and friction . They are very painful and can take a long time to heal. The areas most susceptible to pressure sores are the joints, such as the elbows, knees and heels. Pressure sores can also form on the buttocks, lower back and hands . Pressure sores often appear as redness, blisters or open sores. Preventing pressure sores is very important. It is imperative to maintain good blood circulation and move regularly in order to avoid the formation of bedsores and to carry out a clinical examination at the first appearance or to consult your doctor.
How do you know if you have a bedsore?
The sooner the pressure sore is treated, the faster the healing process will be. To do this, it is necessary to prevent the appearance of a bedsore and to consult a doctor.
First of all, special attention should be paid to people at risk, it may be useful to control areas where the skin is in contact with a surface that exerts prolonged pressure to prevent potential signs of infections . Bed sores can affect people who are immobilized in chairs or bedridden, elderly people who have difficulty moving and who require assistance, people who have undergone an operation requiring immobilization (even for a short period), people who have after-effects of paralysis, malnourished people and those with incontinence or heavy sweating.
People most at risk
Patients suffering from cardiac and respiratory pathologies as well as diabetes have a higher risk of developing pressure sores.
When you find yourself in one of these cases, how do you know if you have a bedsore? The best is to be accompanied, it is difficult to detect a sign of the presence of a pressure sore on your own. A bedsore will manifest itself as an area of persistent redness at stage 1. Then an induration of the skin with the gradual appearance of a bubble of fluid (plasma or blood), if it reaches stage 2. Then a wound or a Necrosis appears if the development of the pressure sore continues.
How to treat a pressure sore quickly?
A bedsore will be treated differently and with varying time depending on its stage. If the bedsore is stage 1, the care to be adopted is:
– Regular change of position to avoid maintaining persistent pressure
– Installation of specialized equipment (anti-decubitus mattress, liquid healing dressing )
A bedsore is damage to the epidermis (and deeper tissues if it progresses) following an illness or mobility defect which, if it is not detected at stage 1, then it progresses quickly to stage 2. At this stage, care will focus on healing the wound. To improve healing, it is necessary to keep the wound oxygenated and hydrated. The dressings will help protect the wound, but it is preferable to choose those that allow the wound to “breathe”. Liquid dressings are now a good alternative to protect and moisturize the wound, while letting the area “breathe”.
If the wound is infected, you will then need to resort to antibiotics or local antiseptics.
If stage 4 is reached, then surgery is inevitable.
What are the complications of a pressure sore?
What are the risks of a pressure sore over time?
Pressure sore is a progressive degenerative skin condition mainly affecting the elderly and bedridden people. It is characterized by the appearance of a lesion at a point of compression between the body and an external support. In stage 1 of the pressure sore, the lesion is red and painful . If it is not treated at stage 1 of the pressure sore , it can progress and reach the subcutaneous tissues, then the muscles and bones. Prolonged bed rest is a factor favoring the appearance of pressure sores, which is why it is important to monitor subjects at risk and quickly treat any suspicious lesions.
What complications can a bedsore cause?
Complications mainly concern infections . If a wound becomes infected, then there may be an unpleasant odor coming from the wound. Pu may form in the bedsore or surrounding areas. Some patients may develop a fever , and the area around the pressure sore may be red, warm, and painful. The care there is then very unpleasant.
The infection can spread to the bone and is called osteomyelitis. If it spreads into the blood, the infection spreads throughout the body.
Psychological suffering due to pressure sores
Beyond the physiological complications of pressure sores, there is real psychological suffering. Patients risk developing a degrading image of themselves, due to the unsightly nature of the wound and the odors that may emanate from it. These discomforts are even greater when the wound is not visible to the patient himself.
Complications also concern the social handicap due to the patient's mobility impairment, the care that the wound requires and the fatigue it generates. The patient is dependent on caregivers. A pejorative image is often identified.
What are the preventive actions?
To prevent the appearance and/or worsening of a pressure sore, it is preferable to avoid prolonged pressure. You can alternate sitting, lying or standing if possible. If the patient is able to walk then they should be encouraged to do so.
Maintaining skin hygiene should not be neglected. Daily washing with careful drying of sensitive areas reduces the risk of developing a bedsore.
Does a pressure sore hurt?
A bedsore is more or less painful depending on its stage and/or potential infection. The pain can also be of iatrogenic origin, that is to say coming from the care carried out to treat the bedsore.
The act of care is often feared by health professionals and patients. However, it is necessary and must be carried out conscientiously. Additionally, some dressings can cause irritation. Changing position during treatment can also be a source of pain depending on the patient's state of health.
What would be the ideal treatment for a pressure sore?
An ideal treatment should be able to clean the wound, limit the concentration of certain molecules which slow down the healing process, limit infections (be antiseptic and antibacterial), allow the wound to be hydrated, allow the passage of oxygen and be devoid of chemical products.
Does this treatment exist?
What dressing to use for a bedsore?
Hydrocolloids
They come in the form of adhesive plates, flexible and thick. The purpose of a hydrocolloid dressing is to absorb exudates. However, this type of dressing causes occlusion of the wound making oxygenation difficult. There is therefore a risk of maceration.
Hydrogels
They are composed of 80% water and require the addition of a secondary dressing. This dressing is used in the case of dry and necrotic wounds. Its primary purpose is to moisten the wound, so it is not very absorbent.
Hydrocellulars
These are absorbent dressings made of polyurethane foam which prevent maceration and help maintain the wound in physiological conditions favorable to healing. For this type of dressing, the risk of allergy is greater and it can promote hypergranulation (this is a term that characterizes reddish, bumpy or grainy skin and which forms on the surface of the opening of a stoma).
Alginates
These are dressings that turn into gel on contact with blood and exudates. They allow their absorption, therefore, if the exudates are insufficient there is a risk of drying out of the area. The risk of irritation and discomfort is possible with this type of dressing.
These dressings can be found in different forms depending on the innovations present on the market. There are also other types of dressings (hydrofiber, charcoal dressing, etc.). It is difficult to find a solution that meets all the qualifications of the “ideal” treatment. This is why it is necessary to carefully choose the type of dressing that will best respect the type of wound to allow rapid healing and as little pain as possible.
ANTI-SCAR
ANTISCAR is a film-forming liquid dressing recommended in the treatment of bedsores and superficial chronic wounds . It is the result of 5 years of research and development.
This dressing allows the wound to be hydrated, it cleans impurities, it has an antiseptic and antibacterial action. There is no risk of maceration, because it allows oxygen to pass through. It promotes the healing process by limiting the action of certain molecules responsible for tissue damage .
