une personne disposant un pansement sur la cuisse d'une autre personne

How to avoid bedsores

Apr 28, 2022

1. What is a pressure sore?

Pressure sores can occur when a person is bedridden or immobile , unconscious or unable to feel pain. Pressure sores are ulcers that occur on areas of skin that are under pressure from lying down, sitting in a wheelchair, or wearing a cast for an extended period of time. Pressure sores are also called pressure sores , pressure sores , pressure ulcers , or decubitus ulcers .

Pressure sores can be a serious problem in frail elderly people . They may be linked to the quality of care the person receives. If a immobile or bedridden person is not turned, positioned correctly, fed and cared for, pressure sores can develop. People with diabetes , circulation problems and poor diet are at greater risk.

2. What are the causes of pressure sores?

A pressure sore develops when the blood supply to the skin is interrupted for more than 2 to 3 hours . When the skin dies off, the eschar first presents as a red, painful area , which eventually turns purple. If left untreated, the skin can break open and the area can become infected. A pressure sore can become deep . It can extend into muscle and bone . Once a pressure sore develops, it is often very slow to heal .

Depending on the severity of the pressure sore, the person's physical condition, and the presence of other illnesses (such as diabetes), pressure sores can take days, months, or even years to heal . They may require surgery to facilitate the healing process.

Pressure sores often occur on:

- the buttocks region (on the coccyx or hips) `

- the heels of the feet

- the shoulder blades

- the back of the head

- the back and sides of the knees

3. What are the risk factors for pressure sores?

Being bedridden , unconscious , unable to feel pain, or immobile increases the risk of developing a pressure sore. The risk increases if the person is not turned, positioned correctly, or does not receive adequate nutrition and skin care. People with diabetes, circulation problems and malnutrition are at greater risk.

4. What are the symptoms of pressure sores?

Pressure sores are divided into 4 stages, from least serious to most serious.

These are :

- Stage 1 . The area is red and warm to the touch. If the skin is darker, the area may have a blue or purple tint. The person may also complain of burning, pain or itching.

- Stage 2 . The area looks more damaged and may have an open wound, scrape, or blister. The person complains of significant pain and the skin around the wound may be discolored.

- Stage 3 . The area looks like a crater due to damage below the surface of the skin.

- Stage 4. The area is severely damaged and a large wound is present. Muscles, tendons, bones and joints can be affected. The risk of infection is significant at this stage.

5. How are pressure sores diagnosed?

Doctors and nurses diagnose pressure sores by inspecting the skin of people at risk . They are classified according to their appearance according to the stages presented above.

6. How are pressure sores treated?

The specific treatment for a pressure sore is discussed between the patient, doctor, and healthcare team and is based on the severity of the condition .

Treatment may be more difficult once the skin is broken, and may include the following measures:

- Remove pressure on the affected area

- Protect the wound with medicated gauze or other special dressings.

- Keep the wound clean

- Ensure good nutrition

- Remove damaged, infected or dead tissue (debridement)

- Transplant healthy skin into the wound area (skin graft).

- Negative pressure wound treatment

- medicines (such as antibiotics to treat infections).

Healthcare professionals will carefully monitor the pressure sore. They record the size, depth and response to treatment .

7. What are the complications of pressure sores?

Once a pressure sore develops, it can take days, months, or even years to heal. It can also become infected and cause fever and chills . It can take a long time for an infected pressure ulcer to heal. As the infection spreads through the body, it can also cause mental confusion , rapid heartbeat , and generalized weakness


8. Can pressure sores be prevented and avoided?

Pressure sores can be prevented by inspecting the skin daily for areas of redness (the first sign of skin breakdown), paying particular attention to bony areas .

Other methods of preventing pressure sores and preventing existing wounds from getting worse include:

- Turn and reposition every 2 hours

- Sit upright and upright in a wheelchair, changing position every 15 minutes.

- Provide soft padding in wheelchairs and beds to reduce pressure.

- Take care of the skin by keeping it clean and dry.

- Ensure a good diet, because without sufficient calories, vitamins, minerals, fluids and proteins, bedsores cannot heal, regardless of the care given to the wound.

Special attention to the elderly

Almost all older people are at risk of pressure sores . These bedsores develop when pressure builds up in a specific area of ​​the body over time, and repeated exposure to pressure on the same area causes the integrity of the skin to break down, literally opening the skin to the infection.

Getting older people moving

Exercise , ambulation , and range-of-motion exercises promote circulation, and circulation helps prevent pressure sores from forming . It's not just about getting out of bed and into a wheelchair. Pressure sores can develop on the tailbone , hip , shoulders or heels with prolonged sitting in a wheelchair, so variety of movement is essential.

Use wheelchairs when necessary, but offer to help seniors into recliners or other more cushioned chairs . Also avoid leaving older people in the same position , regardless of location, for an extended period of time . This includes repositioning older adults who are lying down or awake during the day.

Old lady in a wheelchair with someone helping her

Check the skin often for signs of pressure sore development.

The skin should be examined frequently for signs of pressure sore development. A pressure sore can develop in less than a few hours .

For example, have you ever experienced increased pain and redness on your buttocks while driving for more than an hour or two?

If so, you have developed a stage I pressure ulcer, but your ability to move has allowed you to recognize the pain and adjust your position to prevent it from progressing.

For some older adults, it is you who should check for and recognize signs of pressure ulcer development during perineal care , showering , or other skin integrity assessments. All these checks must also be documented.

Use special bedding or materials to reduce pressure

Depending on the needs of each senior, special beds , such as water or air mattresses , or special padding, such as heel protectors , may be necessary to reduce pressure on sensitive parts of the body. These additional materials should not be limited to mattresses or shoe modifications.

Rather, keep your options open for what may or may not be most comfortable and beneficial to the needs of older adults.

For example, a memory foam pillow is great, but it doesn't do much good if it's always placed in the same position.

Alternatively, soft wedges , similar to pillows, can be used to help older adults stay on their side when lying in bed between repositioning periods. Some newer beds may suggest the use of an automatic rotation system .

However, these systems do not allow a person to be completely repositioned. Therefore, it is best to use these systems in conjunction with manual repositioning of a person.

Keep skin dry and clean

Incontinence is one of the main factors associated with the development of pressure ulcers. When stool or urine remains in contact with the skin, the acids and enzymes it contains begin to cause excoriation and breakdown of the skin more quickly than usual. Add to this a limited ability to reposition themselves , and an older person may more quickly develop a pressure sore in the perineal area.

If the area appears to turn red, the senior may have developed a stage 1 pressure sore . In this case, it is best to assume that the area has been subjected to more intense pressures and proceed with appropriate treatment, such as using a barrier cream to help prevent further excoriation from bodily substances .

However, using a barrier cream does not eliminate the need to continue to reposition and move to prevent the area from getting worse. The Antiscar liquid dressing is a cream that prevents the appearance of bedsores based on glycerol and honey. A new polymer-based technology promotes cell growth for better healing.

Encourage seniors to maintain a healthy diet

Seniors should strive for a healthy, balanced diet . In fact, optimizing the nutritional status of an elderly person suffering from pressure ulcers is essential to ensure successful treatment . For older adults with metabolic disorders , such as diabetes , a healthy diet can go far beyond simply preventing or encouraging the healing of pressure sores.

Effectively manage chronic health conditions

Chronic health conditions can also impact the risk of developing pressure sores . Any condition that affects the function of the cardiovascular system can lead to poor circulation and an increased risk of pressure sores.

Therefore, effective management of these conditions remains essential, in addition to all of the above measures, to prevent the development or worsening of pressure ulcers. This may include monitoring fluid intake in people with heart failure, following dietary restrictions in older adults with kidney failure, or ensuring that drug interactions do not lead to poor health . circulatory function .

9. Key points about pressure sores

- Bed sores are ulcers that occur on areas of the skin that are under pressure from lying in bed, sitting in a wheelchair and/or wearing a cast for a prolonged period of time.

- Pressure sores can occur when a person is bedridden, unconscious, unable to feel pain, or immobile .

- Bed sores can be avoided by inspecting the skin daily for areas of redness (first sign of skin breakdown), paying particular attention to bony areas.

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