BEDSORES (DECUBITUS ULCERS)

In 1995 - A horse riding accident transformed Christopher Reed from an actor indelibly identified with SUPERMAN into a quadriplegic and an outspoken advocate for the disabled. Ten years later, Reeve's death from complications of a bedsore, called attention to one of the most serious problems facing people with disabilities. 

What Is It? - Each year, about one million people in the U.S. develop bedsores, (decubitus ulcers), simply from prolonged pressure on the skin, generally, resulting and ranging from mild inflammation to deep wounds that involve muscle and bone. This can deteriorate into life-threatening blood infections, destruction and fracture of bones. Some sources refer to it as one of the "Silent Killer Diseases."

Bedsore Facts:

• Pressure ulcers or bedsores are a frequent complication in bedridden patients.
• Pressure sores develop quickly, progress rapidly, and are often difficult to heal if allowed to progress, but can usually be cured with proper care.
• Key preventive measures can also encourage healing. 
• Patients transferred from a hospital to a nursing home are particularly vulnerable, with 10% to 35% having sores at the time they are admitted to the nursing home.
• Studies show that 50% of patients with pressure ulcers are over the age of 70 and among these elderly; bedsores means a fourfold increase in the rate of death.
• About 60,000 deaths a year are attributed to complications caused by bedsores. Incidence of bedsores varies among nursing homes anywhere between 12-26% in the U.S.A.
• Among those who are ulcer free at admission 13% develop stage 2 through 4 ulcers by one year and an alarming 21% by two years.
• Organs affected: buttocks, shoulder blades, elbows, heels, ankles, knees, lower back, spine, and hip.
• Bedsores can lead to other severe medical complications, infections, arthritis, and scar carcinoma.
• $2.57 million is spent on preventable decubitus ulcers yearly in the U.S. (2000-2).

Abuse-Neglect - "Nursing Home abuse and neglect is becoming one of the fastest growing industries in the legal system today secondary to the large increase in the elderly population." Some sources call abused seniors and dependant adults, the "silent victims." Experts estimate that at least 4% of all elders age 65 and over in the U.S. are abused. Bedsores are at the top of the list of elder abuse cited by the legal system, followed by falls, fixtures, malnutrition and dehydration.

Prevention :

• Relieve pressure on vulnerable areas of skin. 
• Inspect resident's skin at least once each day. 
• Reduce shear and friction.
• Minimize irritation from chemicals.
• Encourage resident to eat well. 
• Keep the skin clean and dry. 
• Exercise daily: bedridden can stretch, isometrics: walking.

Prognosis:

Timing - Firstly, aggressive, intensive treatment and wound management intervention by our fully licensed, experienced surgeons of Coast to Coast Wound Care is essential in assessing and caring for any signs of an ulceration in its earliest stages. Bedsores that are advanced and will not readily heal can require incision, drainage, skin flaps, skin grafts, and bone resection. Our surgeons can also provide conservative sharp bedside debridement of wounds, but wounds that are exceedingly progressed or unresponsive, may require plastic surgery. In later stages, also, deep craters may need skin grafting and other forms of reconstructive surgery.

Stages II, III, IV - In many cases, however, with skilled care, the prognosis for bedsores is good. Expertise bedside treatment can heal most Stage II bedsores within a few weeks or longer. If conservative methods fail to heal a Stage III or Stage IV bedsore, reconstructive surgery often can repair the damaged area. Without proper treatment, however, they can lead to: gangrene, osteomyelitis, fractures, sepsis, and other localized or systemic infections, increased cost of treatment, lengthen nursing home stays, or even cause death.

Obscure - In spite of this, forecast issues, or overall 'prognosis' of bedsores, by their nature are still unpredictable, because of the many and diverse outcome possibilities; duration, health, complication, recovery prospects, survival rates, death rates, and other issues.

Duration - Many factors influence the duration of bedsores. Healing can vary anywhere from one to six weeks, or from six weeks to three months, but often longer. Stage II to IV ulcers may take longer than six months to heal. Bedsores can be an ongoing problem. For the chronically ill group, the fight can be a long-term battle

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Aging | Chronic wounds | Bedsores | Wound types | Pain | Diet and healing | Risk factors