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Bed Sores and Pressure Sores

Bedsores, also known as pressure sores, decubitus ulcers and pressure ulcers, are one of the many signs of nursing home abuse, nursing home neglect, or medical malpractice in a hospital. Bedsores are caused when there is unrelieved pressure to the skin and can cause serious health problems like infections and other life-threatening injuries. They occur most frequently to areas of the body where bone and skin are very close in contact, such as the hips, back, elbow, ankles, and heels. Nursing home residents and people staying at a hospital are at high risk for bedsores because they often times remain sedentary in a bed or wheelchair.

According to the Centers for Disease Control (CDC), as many as 1 out of 10 residents in nursing homes currently suffer from bedsores. Although this is alarming to many, this isn’t a new problem. For several decades, bedsores have been a prevalent problem in nursing homes throughout the United States. In many instances, bedsores are caused primarily from lack of attention and improper medical care in nursing homes.

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Keep in mind that if you or your loved one has suffered from pressure sores because of the negligence of a nursing home, an experienced nursing home abuse attorney can help you.

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Bedsores are serious health concerns and once identified they need to be treated immediately. If a resident enters a nursing home with bedsores, it’s the responsibility of the nursing home to ensure the sores don’t get worse. Unfortunately, a good majority of residents who enter facility with bedsores don’t get the kind of quality medical attention needed. As a result, their bedsores increase and move on into the later stages of bedsores, which causes a whole new host of medical problems.

When patients, who are already suffering due to a disability or are elderly, develop bedsores, this is an extremely cruel complication for them to endure. These sores can cause them pain, disability and considerably increases the chance of patients acquiring dangerous complications including gangrene, osteomyelitis or sepsis, which can lead to wrongful death in a nursing home.

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Tips for Bedsore Prevention

Of course it is best to prevent bedsores before they start. Too often, however, bedsores are already at an advanced stage before being noticed, which in turn requires long and difficult treatments. It is said that the best treatment for a bedsore is prevention. In order to help prevent bedsores, a number of activities can be done to ensure the best possible chances.

Change positions regularly, every 15 minutes if you are in a wheelchair, and at least every two hours if you are in a bed. It also helps to avoid laying directly on your hip bones. Instead, try to lay at a 30 degree angle to reduce pressure to the hips. Avoid laying with a raised head of more than 30 degrees, as this encourages the body to slip down and raises the risk of friction injuries. Try using a pressure reducing mattress if you must remain in a bed every day.

Inspect skin daily. Inspecting the skin is a great prevention tool to incorporate into your daily routine. Also keep skin clean and dry. If you have bandages, it’s imperative to make sure they are changed daily. If you notice any skin damage, foul smell, infections, or tenderness, you should seek medical attention immediately.

Pay close attention to nutrition. Malnutrition can lead to bedsores as well as other diseases and illnesses. It is essential to get enough calories, protein, fat, vitamins, and minerals in your diet. Consult a dietitian to help come up with an eating plan that appeals to your food preferences while supplying the necessary nutrients.

Try to exercise every day. Exercising increases blood flow throughout the body, as well as promotes a positive mood and socialization; all three are important while in a nursing home. You should consult with a physical therapist for an exercise program that is most beneficial to you.

Stages of Bedsores

Hospitals and nursing homes use a scale to help determine and treat these bedsores. Bedsores are also known as decubitus ulcers and pressure sores or ulcers. By using this scale to categorize bedsores, according to their typical characteristics, some uniformity can be established. This assists medical facilities in the treatment of those suffering with bedsores.

Stage 1

At first, a pressure sore will appear as an area of skin that is red and it could possibly itch. This area may also feel firm or warm and spongy to the touch. People with darker skin may have an area with a purple or blue hue, rather than the aforementioned red. It could also look ashen or flaky. Stage I bedsores will heal once the pressure has been relieved.

Stage 2

Some skin loss has occurred at this point and can appear as an open wound. This loss can be in the epidermis, which is the outer layer of skin or in the dermis, which is the deeper layer of skin, or in both of these layers. The wound has become a sore that resembles an abrasion or blister. The tissues surrounding it may have a purple or red discoloration. If this bedsore is treated promptly, these sores can generally heal rather quickly.

Stage 3

Once the bedsore has reached this stage, all the layers of skin have been affected down to the muscle.  This process has now damaged or destroyed these tissues. The wound that has been created is a deep wound resembling a crater (known as slough). The open skin may show fat around the infected area.

Stage 4

This is the most advanced and serious stage. Damage has now been done to the bone, muscle and the joints and tendons, which are the supporting structures. Large amounts of skin have been destroyed and these wounds are very difficult to cure. At this stage, they can cause lethal infections.

On occasion, a bedsore will be categorized as ‘unstageable.’ These are generally extremely advanced wounds involving muscle, skin and bone.

Common Areas to Monitor for Bedsores

Depending upon the circumstances, pressure sores will manifest in different areas of the body. For example, a person who is confined to a wheelchair will have different areas of the body affected as opposed to someone who is confined to a bed.

Residents in Wheelchairs

  • The buttocks area and/or the tailbone
  • The back both the legs and arms, in the areas that these body parts rest for long periods of time against the wheelchair.
  • The spine and/or the shoulder blades

Residents Confined to Beds

  • Both sides and the back of the head
  • The outside areas of the ears, specifically on the rims
  • Shoulders and shoulder blades
  • Lower back and hips
  • Knees, heels, and ankles

Most pressure sores are caused by friction, shear, and sustained pressure. Residents, especially those confined to a wheelchair and bed should be inspected regularly even if their positions are moved frequently.

Medical Complications as a Result of Bedsores

As aforementioned, bedsores can lead to an array of other medical conditions if not monitored and treated in the early stages:

Cancer: Chronic pressure sores can develop into squamous cell carcinoma, a type of destructive type of cancer that almost always requires surgery.

Joint/Bone Infections: Bone and joint infections develop after burying themselves deep into pressure sores. Also known as infectious or septic arthritis, these types of infections can not only damage cartilage and tissues, but can also severely restrict joint functions.

Sepsis: Sepsis is defined as a bacterial infection of the bloodstream or body tissues. Sepsis can occur when bacteria enters into the victim’s bloodstream via the open pressure sores. Once this happens, bacteria can quickly spread throughout the body, resulting in life-threatening organ failure and other issues.

Cellulitis: Cellulitis, an inflammation of connective tissues, can also infect victims of bedsores. If cellulitis occurs, victims may develop meningitis, which affects the fluid that surrounds the spinal cord and brain.

Bed Sore Treatment

There are a few ways to treat bedsores which will depend upon the level of the wounds. For Stage I pressure sores, a combination of antibiotics and cleaning solutions are usually used. Victims should also be repositioned regularly. Supportive aids should always be available, such as specialized cushions, pillows, and mattresses.

For the advanced stages, victims may need to undergo surgery via mechanical, autolytic, or enzymatic debridement in order to successfully remove the damaged tissues. Afterwards, cleansing and bandaging the wounds is extremely imperative and must be done regularly. Pain medication and antibiotics are typically described as well, per the Mayo Clinic.

Along with pain medication and antibiotics, victims are encouraged to eat a balanced, healthy diet as nutrition and hydration will help the healing process. In addition, muscle relaxants may be prescribed as some victims experience muscle spasms.

Source:

http://www.mayoclinic.com/health/bedsores/DS00570

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