Bedsores (Decubitis Ulcers)
What Is It?
Bedsores, also known as decubitus ulcers or pressure ulcers, are skin lesions caused by prolonged pressure on different areas of the body (typically seen in invalids as a result of prolonged bed rest or inactivity). Although a bedsore begins as a skin lesion, it can ameliorate to affect large and deep areas of tissue, even reaching the bone. Bedsores are a serious medical condition and, if left untreated, can be fatal.
Causes
Bedsores are caused by pressure, shearing or friction forces that cut off blood circulation to parts of your body and the tissue in these areas. When blood flow is blocked there is an insufficient amount of nutrients and oxygen delivered to your cells. If this continues for extended periods of time, eventually your cells and tissue will die and a lesion can develop.
Types
Bedsores are not limited to a particular area of your body. However, bedsores most commonly form over bony areas and those with cartilage (cartilaginous) like your lower back, hip, tailbone, ankles and elbows.
Who Is at Risk
Bedsores are most common among individuals who remain in one position for long periods of time. People most at risk include the elderly, bed bound patients, patients with diabetes mellitus and people who are bound to wheelchairs.
Treatment Options
There are a few options for treating bedsores, including debridement and vacuum assisted closure, or VAC. Oral antibiotics are commonly used to prevent infection, and a healthy diet is recommended to prevent malnutrition and help guarantee intake of essential nutrients.
Treatment Procedures
Debridement can be performed in different ways and your doctor will choose the best approach based on the condition of your bedsore. Debridement is the removal of damaged and/or dead tissue present on bedsores. Dead tissue prevents healing and thus, needs to be removed to facilitate proper healing.
Sharp debridement is done by cutting off the dead tissue with a scalpel or scissors. Biological debridement is done by using maggots that eat the dead tissue from your bedsore without harming your healthy tissue. Autolytic debridement takes advantage of your body's own enzymes, and chemical debridement involves the use of topical enzymes that help in healing and removal of the dead tissue.
Vacuum assisted closure or negative pressure wound therapy is used to heal bedsores and other wounds. The procedure involves the use of a vacuum tube attached to the bedsore. The vacuum draws moisture from the ulcer and shortens the healing process, also reducing the risk of infection.
Prevention and Recovery
Good nutritional status is important for prevention or proper healing of bedsores. Poor nutrition can lead to slowed ability to repair damaged tissue. It is important to get vitamins A, B, C and E, and minerals like magnesium, magnase, selenium and zinc from a balanced diet. In addition, it is essential to eat proper amounts of protein on a daily basis.
The best way to prevent bedsores is by relieving the pressure that cuts off your blood circulation. This can be accomplished by turning and repositioning your body regularly to keep constant blood circulation to your tissues. If you have paralysis or are otherwise incapacitated, you may need assistance to turn and reposition your body on a daily basis. In hospitals, prevention of bedsores is done by turning patients every two hours.
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