Bed Sores Treatment [Ultimate Guide]

This article has been approved by Tiffany Rubin, R.N. BSN
Nursenextdoordelaware.com

Bed sores are, unfortunately, one of the most common ailments resulting from mobility issues. It's important to begin bed sore treatment at the first sign of any symptoms.  Pressure ulcers are much easier to deal with when they're caught early.  Even better, if you understand a risk is present you can take precautions to reduce the likelihood of occurrence.

6 Crucial Tips for Successful Bed Sores Treatment

Your healthcare provider will want to examine the affected area or areas when diagnosing suspected bed sores. Surgery is usually not recommended as long as you have not progressed into later bed sore stages.

Here are simple tips to try that you can discuss with your healthcare provider:

1. Frequent Repositioning

If you are in a chair, wheelchair or bed for a long period of time you need to vary your position - This will help to facilitate blood flow and reduce pressure on your boney areas so you are less likely to get a bed sore. It is important to be regularly repositioned so the pressure is dispersed throughout the body.

Wheelchair Repositioning

• Try shifting your weight by yourself every 15 minutes or so.  Go from left to right side of your buttock as well as shifting your position further forward or backward in your chair.

• Consider a wheelchair or seat cushion to help re-distribute pressure across your bottom (high-risk area). Avoid donut shaped cushions as they reduce blood flow to bottom increasing risk.

• Consider a tilting, specialty wheelchair. These are expensive, but depending on your budget and access to a caregiver they can be worth it.

2. Proper Dressings and Wound Care

Proper dressing and cleaning of the pressure ulcer is essential.  Open wounds are particularly prone to infection. Appropriate care and use of dressings will promote healing and shield bacteria.

(Always avoid using hydrogen peroxide as it can further damage the skin.)

Proper care for bed sores is determined by the stage of the pressure sore:

• Stage 1:
  

  If the skin of infected area is still intact the most important thing you can do is offload pressure immediately. Gently wash area with mild soap and water and consider asking your doctor about recommended moisturizers.

• Stage 2:

  Be sure that area is kept clean and dry. Use a saline rinse to rid of loose and dead tissue surrounding the bed sore.

• Stage 3 & 4:

  Pressure sores that reach these stages are typically monitored and cared for by your health provider who will provide specific instructions for at-home care.

**Special treatment gels, foams, and dressings are available but discuss with your doctor which would be best for the condition of your bed sore.

3. Proper Nutrition

Making good food choices will help facilitate healing and help prevent future bed sores. Foods rich in vitamins A, C and E are ideal. Consider oranges, strawberries, tomatoes, broccoli, cauliflower, nuts, olives (and olive oil for cooking) as a good starting point.

Nutritional drinks, such as Juven,, support wound healing and can be incorporated into your bed sore treatment. Vitamin C, Zinc, and Omega-3s are also great supplements to include in your diet for tissue repair. (These supplements are available OTC, but remember to discuss with your doctor before starting your own regimen.)

Maintaining a healthy weight is is frequently overlooked. In many cases, bedridden patients lose bodyweight.  This means less protection between skin and bone.  Conversely, with excess weight there will be more pressure on the body creating a higher risk. Do you best to monitor your weight and make sure you are maintaining a healthy balance.

Advanced pressure ulcers can possibly be treated directly or orally with antibiotics - this would be something that your healthcare provider would discuss with you if he or she feels it's necessary.

4. Prevent Further Injury or Shearing

Pressure ulcers and sensitive skin are susceptible to further injury with very minor force. You are at increased risk of damage from friction during repositioning or other basic movements.

Make sure to apply powder to your sheets to reduce friction. Do not engage in unnecessary exposure to pressure in sore areas.  Keep your skin as moisturized as possible by staying hydrated and get the ok from your doctor to utilize over the counter barrier cream.

5. Incontinence Management

Limited mobility combined with incontinence makes for a heightened risk of infection, particularly with open wounds. Diapers and bed incontinence pads need to be used to reduce bacteria exposure to skin. Protective lotions can also be used to shield the skin. In severe cases catheters or rectal tubes may be necessary, please consult with your healthcare provider for details.

6. Change Bedding and Clothing Frequently

A fresh set of clothes and sheets makes everyone feel better. A clean environment is especially important when bed sores or a risk of bed sores are present. During daily checks of the skin, make sure to change clothes and sheets to limit the ability for bacteria to spread. Try to time body inspection with clothing and sheet changes to avoid exposure to additional shearing or friction.

**Sheets and clothes should be made of cotton or breathable fabric. Some flannel or jersey materials are too dense, restricting airflow, and in turn, inhibit healing.

Avoiding Pressure Ulcers in Wheelchair

Dealing with the risk of pressure ulcers for wheelchair bound patients requires a slight variation in care and there are a few specifics you NEED to know.

1. Is your wheelchair the proper size and fit?

Factors to consider:

• Amount of mobility
• posture
• discomfort level
• inhibiting conditions

(please consult with your primary care physician before making your final selection)

2. Check for proper fit at leats twice a year

The patient may gain or lose weight over the course of time which can compromise the proper fit. Take note of any painful areas, and let your doctor know immediately!

3. Repositioning 

Shift weight to take pressure off of certain areas and promote blood flow.  Leaning forward and side to side are the easiest movements

Caregivers must assist with shift weight every 15-20 mins.  We realize that this can be very overwhelming to manage and almost unrealistic

So consider the use of medical aids. Just like bed sores, treatment for pressure ulcers from a wheelchair can be enhanced with the use of alternating pressure pads or cushions.  

What are Bed Sores?

A bed sore is an area on your skin that is irritated and painful due to prolonged pressure.

One of the very beginning signs of a developing bed sore is sore skin. Light skin tones will show that area is red, discolored, or darkening; while darker skin tones present purple, blueish, or shiny areas.  If untreated, these spots generally turn hard and warm to touch as they progress into stage 2 ulcers. Pressure ulcers are categorized in stages from 1 to 4, stage 1 being least severe and stage 4 being most severe.

Stages of Pressure Ulcers

Pressure sores are categorized in one of four ways:

Stage One

Your skin is discolored, but not broken. If you have a light complexion, the pressure ulcer may appear red or could look blue or purple. If you have a dark complexion, it may look white.

Stage Two

Your skin has a break in it and there may be some dead skin around the wound. You may also notice a reddish-pink area in the center, which could also involve a blistered area.

Stage Three

The pressure ulcer takes on the appearance of a crater and may go into your fat layer. The pressure sore may also have some pus or drainage.

Stage Four

A bed sore that is this deep involves your muscle, bone and possibly tendons and joints. Your healthcare provider may also notice a substance referred to as eschar.

In extreme cases, a bed sore may actually be unstageable , but this is rare if you're seeking treatment. In this particular case, the tissue layers involved would need to be surgically removed.

Risk Factors

People who have the highest risk for bed sores are typically:

• Bedridden
• Spend most of their day in a wheelchair
• Incontinent
• The elderly (due to decrease skin elasticity)
• Diabetic
• Have fragile skin

If you are at risk for bed sores it is important you implement a prevention plan. Movement is the best way to avoid bed sores. Make sure you stay as active as possible, try to schedule fixed times for position changes and exercise into your daily routine.

It's also important to make sure that you eat properly and drink plenty of water. Poor nutrition can increase your chances of getting pressure sores, especially if you aren't getting enough vitamin C, protein and zinc.

Those who smoke are also at a higher risk for bed sores. Nicotine will hinder your circulation and slow your healing process.

Bed Sore Causes

When there is too much pressure on your skin for an extended period of time, it diminishes the blood flow to that area. This increases your chances of developing a pressure ulcer. A couple of other causes are:

If you have frail, thin skin, a bruise or a scrape can lead to a pressure sore.  

The friction to your skin that can come from a wheelchair that is an improper fit, or the head of your bed raised too high.

Bed - Most vulnerable parts of body for pressure ulcers (with pictures)

• Tailbone
• Back of Head
• Buttocks
• Shoulders
• Heels
• Backs of arms or legs
• Spine
• Ankle
• Knee

Wheelchair - Most vulnerable parts of body for pressure ulcers

• Shoulder Blade
• Buttocks
• Heel
• Ball of Foot

Complications

Ignored or improperly treated bed sores can lead to some very scary complications.

• Pressure ulcers that advance to stage 3 & 4 can become life threatening and require attention immediately.

• Lack of treatment may lead to amputations of affected areas

• Infections can spread to other areas of the body such as your blood, heart, and bones

What's next?

STICK TO THE PLAN!

It's important to follow a routine bed sore treatment plan.Take the time to consistently apply the regimen you and your healthcare provider have put together using our treatment tips and recommended bed sore treatment products. Remember, knowing how to treat bed sores will help to prevent future ones. This will be your best line of defense for bringing about the quickest recovery and return to your best quality of life.

This article has been approved by Tiffany Rubin, R.N. BSN
Nursenextdoordelaware.com