The number one complaint received by our office is with regards to bed sores also known as pressure ulcers or decubitus ulcers. Bed sores are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone. Bed sores are dangerous and can rapidly worsen in a matter of days. Left untreated, it can create irreversible damage to one’s health and even cause death.
Stage I, II, III and IV
Bed sores are categorized as Stage I, Stage II, Stage III and Stage IV:
- Stage I bedsore is identified by redness to the outer skin layer.
- Stage II bedsore is identified by breaking of the skin. Blistering or an open wound is often noticed.
- Stage III bedsore occurs when the next layer of skin, the fatty layer, has been compromised.
- Stage IV bedsore occurs when the tendons and or muscles become affected. Bed sores can develop past the tendons and muscles and become “unstageable.”
As soon as a bedsore is detected, care providers are required to properly document it’s progress and take all measures to stop its growth. Documenting requires taking photographs, measuring the wound, and dressing it with gauze. Some measures that may be taken to prevent its growth are as follows:
- Regular manual rotations;
- An air-fluidized bed;
- Regular cleaning to the area; and
- Proper nutrition.
It is important to regularly turn a patient, especially if their condition is such that their movement is limited. For example, if someone has undergone a surgical procedure or experienced a fall that leaves them bedridden, it is critical to reposition the patient on a regular basis. How regular? The answer may be every two hours. Another example of a patient whose movement is limited is someone who is unable to walk or someone who has behavioral issues and is placed on restraints. It is important to anticipate a bed sore in those patients whose blood flow has been compromised by other medical factors or medication they are taking.
An air-fluidized bed is one that is inflated with air. It allows for decreased pressure to the affected area. If a specialized bed as not been provided for you or your loved ones, you may want to demand one right away. These beds are costly but may be necessary to treat bed sores.
Proper hygiene is also an important preventative measure to prevent the growth and development of bacteria.
Lastly, nutrition can play a key role in the growth of a bed sore. Once a bed sore is identified, a protein-rich diet is essential to one’s healing process.
Bed Sore vs. Deep Tissue Injury
Bedsores can be prevented, however, a deep tissue injury may not. It may be helpful to think of a bedsore as an event starting from the skin and moving into the body. A Deep Tissue Injury or DTI is more like a volcano that begins from within and works itself outward. It is often difficult to diagnose or know how a DTI is formed. Once it forms, it will play itself out. Sometimes a DTI will develop into a bed sore. In such event, the same precautions are taken to treat the bed sore.
The Department of Public Health mandates that health care providers report bed sores which have are Stage III in nature. If you suspect a bed sore has developed, you can inquire into an investigation or initiate one yourself.