Bedsores

Bedsores

Abedsore, otherwise known as a pressure ulcer, starts as just a red spot on the skin. It occurs when you sit or lie in a single position for so long that the sheer weight of your body pinches off blood flow to a certain area.

Usually, the danger spots are bony areas of the body, especially the hips, buttocks, and heels. If blood flow is cut off long enough, the affected skin can blister, deteriorate, and die. Left untreated, the sore can break through the skin and then extend through fat, into muscle, and finally expose bone.

Anyone who is confined to a bed or wheelchair, especially someone who has suffered paralysis or a stroke, is in danger of developing a pressure ulcer, says Mitchell Kaminski Jr., M.D., staff surgeon at Thorek Hospital and Medical Center and clinical professor of surgery at the Finch University of Health Sciences/The Chicago Medical School. But you can minimize that danger.

Try This First

Get a good pressure-relieving mattress. Try to keep the person on a mattress or cushion that distributes his weight more evenly, such as an air mattress, says Dr. Kaminski. “There are many kinds available, but a regular air mattress that you use at a lake or the beach can be used to help support a person who is bedridden.” Be sure it’s thickly covered with an airy cotton blanket and sheets to prevent sweating. Sponge mattresses and water beds are also good choices.

Other experts recommend using cotton padding or wool to soften the mattress. The extra padding should be evenly distributed, however, to prevent it from bunching and increasing the likelihood of pinched blood vessels.

Other Wise Ways

Move around in bed. “You have to rotate the person’s body throughout the day,” says Dr. Kaminski. “The person should be shifted at least once an hour, just to relieve the pressure on any area of the body.” Not only is this an essential way to keep bedsores from worsening once they start but it’s also one of the best ways to prevent them. Be sure to reposition the person so that pressure is relieved from any reddened area on the body.

Maintain good nutrition. “In a scientific study of nursing home patients, we have never found a pressure ulcer in anyone who was well-nourished,” Dr. Kaminski said. “Along with pressure, malnutrition is the single biggest co-factor in the creation of bedsores.”

Keep that from happening by getting your loved one the minimum daily requirement for protein, which is two to three servings of meat, poultry, fish, or eggs a day. A serving is two to three ounces of meat, poultry, or fish (which is a piece that’s about the size of a deck of cards), or two or three eggs, says Dr. Kaminski.

In addition, doctors recommend that people eat 6 to 11 servings of unprocessed whole grains, 2 to 4 servings of fresh fruits, and 3 to 5 servings of vegetables a day.

Choose your oils wisely. If you’re preparing food for someone who is bedridden, be careful about the kinds of oils that may be in the foods, according to Dr. Kaminski.

“Omega-3 oils, which are found in fish, canola oil, and flaxseed oil, lower blood cholesterol and support good circulation,” Dr. Kaminski says. Avoid using corn or safflower oil in your cooking, because such oils can enhance inflammation, which decreases blood circulation and can increase bedsore risk, he adds.

Supplement against sores. Dr. Kaminski encourages people who are at risk for bedsores to take a multivitamin that contains vitamins C and E and beta-carotene. These are antioxidants that can speed healing.

Maximize blood flow to existing pressure ulcers. Make sure there is no pressure on any area where a pressure ulcer already exists, warns Mary Ruth Buchness, M.D., chief of dermatology at St. Vincent’s Hospital and Medical Center in New York City and associate professor of dermatology and medicine at New York Medical College in Valhalla. If an ulcer appears on the heel, suspend the heel by raising the lower leg with pillows or soft blankets, she recommends. Once pressure is relieved, blood will flow to the existing wound and aid healing.

Make the wound moist. To help speed healing, cover any existing sores with gauze bandages coated in petroleum jelly or similar moist, thick ointment. This encourages tissues to grow rapidly, says Dr. Buchness. There are special dressings such as Duoderm and Vigilon, which are available through your pharmacist, that dissolve into the wound and create a good environment for healing.

Keep the healthy skin dry. “Keep the wound moist and the surrounding skin dry,” suggests Dr. Kaminski. Healthy skin that is allowed to remain moist is more susceptible to developing a sore and an open wound. For patients who are incontinent, undergarments must be changed when needed in order to keep skin dry.

Keep the wounds clean. Pressure ulcers have to be kept clean in order to avoid infection and to heal properly. “Rinse the wound and surrounding skin with soap and water,” says Dr. Kaminski. Do not use cleansing solutions containing disinfectants, such as povidone-iodine. Disinfectants generally slow the healing process.