What Are The Causes of Bed Sores, Pressure Sores and Decubitus Ulcers?

A bedsore, also called a pressure ulcer, is an area of skin damaged after a two to three hour loss of blood supply, according to the University of Maryland Medical Center. The first sign is a reddened, painful area that later turns purple. Without treatment, the damaged skin breaks open and can become infected, eventually invading the deep tissue and muscle says San Deigo Nursing Home Abuse and Neglect Lawyer Steven Peck.

Patients who are unable to change position by themselves due to paralysis, loss of sensation, confusion, surgery, illness or advanced age are at highest risk for developing pressure ulcers indicates elder abuse attorney Peck.

Pressure

A healthy person unconsciously shifts her position many times during the day and night. Immobile patients, however, are unable to change position independently and may develop pressure ulcers at any point where the skin is trapped between bone and a surface such as a bed or wheelchair for two to three hours, elder law lawyer Peck. The pressure obstructs the blood flow to the skin in that area, causing damage to the skin and underlying tissue. Most commonly, this occurs at bony areas such as the hips, heels, elbows, shoulder blades, tailbone and spine, where there is less fat and muscle padding than in other areas of the body, according to MayoClinic.com.

Skin Trauma

Seemingly simple movements in bed or in a wheelchair can cause bedsores or make existing sores worse, according to Peck.. Moving a patient up in bed can create traction if the skin sticks to the bed linens. Turning the patient side to side or pulling him across the bed causes friction that wears away the top layers of the skin. When the patient slides down in bed, his skin moves in one direction and the underlying bone moves in another direction, causing a shearing force that damages the skin. Patients with circulatory problems, joint contractures or muscle spasms, as well as those who are elderly, are at highest risk for skin damage due to shearing, traction or friction.

Moisture

Prolonged exposure to moisture from urine, feces or perspiration increases the effects of friction and weakens the outer protective layer of skin, according to San Diego nursing home abuse and neglect attorney Steven Peck. The skin becomes macerated or softened and breaks down more easily. Enzymes in urine and feces promote the breakdown of tissue, and bacteria from fecal matter can cause serious infections in the wound as well as in the bloodstream.

Poor Nutrition

Poor nutrition is a common problem among the elderly and patients confined to bed rest. Since underweight patients lack the natural padding of body fat and muscle between the skin and bones that helps to prevent pressure ulcers, their risk of skin damage from even minor pressure is higher than for those of normal weights. A diet deficient in protein, zinc or vitamin C also increases the risk of developing pressure ulcers and prolongs wound healing.

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