How Do Pressure Sores Develop, and What Are the Best Prevention Strategies?

Common Causes of Bedsores and Bedsore Treatment Options and Prevention

The elderly, people who are immobile or who have certain disabilities, and people who are bed-bound are at an increased risk of developing bedsores or pressure ulcers. Understanding the most common causes of bedsores and following pressure ulcer prevention tips can help you manage your health and wellness.

With proper care and vigilance, you and your care team can reduce your risk of pressure ulcers. If you develop pressure ulcers or bedsores, you can work with a certified wound care specialist to explore advanced bedsore treatment options in Portland, OR; Los Angeles, CA; Vancouver, WA; or Nashville, TN. Here is a look at the most common causes of bedsores, bedsore prevention, and bedsore treatment methods.

What Are Bedsores or Pressure Ulcers?

A bedsore, also called a pressure ulcer, is an injury or area of damaged skin that develops when the area is under constant or severe pressure. Pressure ulcers usually occur in bony areas of the body, like the elbows, shoulder blades, hips, heels, and lower back. You have an increased risk of developing pressure ulcers or bedsores if you are bed-bound, have limited mobility, spend a lot of time in bed or in a chair or wheelchair, or if you have partial or complete paralysis. Without treatment, bedsores can get bigger and can become infected. An infection can lead to other complications, such as gangrene, sepsis, and death.

Understanding the Most Common Causes of Bedsores

Bedsores can develop anywhere on the body, but they are most common on bony parts of the body, such as the:

• Hips
• Ankles
• Back
• Buttocks
• Elbows
• Heels
• Tailbone

You can also develop pressure ulcers in your mouth if you wear dentures, are intubated, or are on mechanical ventilation. You can develop pressure sores on your nose, behind your ears, or on the back of your head if you use oxygen therapy or wear a medical device that fits around your head.

Bedsores occur when consistent pressure reduces blood flow to the skin. A lack of blood flow can cause a pressure wound injury that can then be very slow to heal due to poor circulation. A bedsore or pressure ulcer can develop in just two hours, especially if it is caused by pressure combined with moisture from sweat, urine, or stool or from traction or friction between the skin and another object. The most common causes of bedsores or pressure ulcers are:

• Constant pressure when sitting or lying down, which hinders blood flow and/or creates wounds or trauma to the skin
• Immobility, or remaining in the same position for too long
• Poor circulation
• Friction and shear, or your skin rubbing against bedding, clothing, a wheelchair, or another object
• Pressure combined with moisture

Assessing Your Risk of Developing Bedsores

Certain health conditions and lifestyle factors can increase your risk of developing bedsores or pressure ulcers. By understanding your personal risk level, you and your healthcare providers can work together to create a plan that reduces your risk. You might have an increased risk of bedsores or pressure ulcers if you:

• Use a wheelchair
• Are bed-bound or spend a lot of time in bed
• Spend a lot of time in a chair
• Wear a cast or splint
• Use a prosthetic device
• Are in a coma or vegetative state
• Have a medical condition like paralysis, cerebral palsy, diabetes, heart failure, kidney failure, chronic venous insufficiency, peripheral artery disease, or a spinal cord injury
• Have malnutrition, diabetes, or dementia
• Are unable to care for yourself or get around easily and/or don’t have a caregiver or care team to help you
• Have a condition that reduces your ability to feel pain, discomfort, heat, or cold
• Are obese
• Have a neurological disorder
• Have poor hygiene
• Take certain medications like steroids
• Have thinner skin

Recognizing Symptoms of Pressure Ulcers

While pressure ulcers or bedsores may start as a minor skin irritation that feels tender or uncomfortable, they can quickly progress into a very painful condition. The best way to manage bedsores is to prevent them. You should be aware of the early warning signs of a pressure ulcer or bedsore so that you can seek treatment and develop a bedsore prevention plan. The earliest symptoms of bedsores or pressure ulcers are:

• Pain or tenderness
• Red or pink skin
• Skin that feels hard, warm, or cool to the touch
• Changes in the skin’s appearance or condition, such as red or purple skin, skin that is softer and thinner than surrounding skin, or skin that is dry, irritated, or mottled

Assessing Bedsore Stages

Bedsores can progress through several stages, becoming worse the longer you go without treatment. When you work with a certified wound care specialist, they will begin by assessing your risk for bedsores or evaluating existing bedsores to determine their severity. The stages of bedsores or pressure ulcers are:

• Stage One – Your skin will look irritated, dry, red, or pink and may feel warm or tender to the touch. You won’t see an open wound. This stage is often called a pressure injury.
• Stage Two – You will develop a shallow wound that is surrounded by a pink or red color. You may develop an abrasion or blister.
• Stage Three – Your wound will worsen and enter your skin’s fatty layer.
• Stage Four – Your wound will penetrate all three layers of skin and expose muscles, tendons, and bones.

Exploring Bedsore Treatment Options

When you work with a certified wound care specialist, they will assess your risk of bedsores, evaluate existing bedsores, and create a personalized bedsore treatment plan. The most effective bedsore treatment options are:

• Wound cleaning and irrigation
• Wound debridement
• Application of water-based gel, hydrocolloid, alginates, or a dry foam dressing or medical bandage to promote healing and prevent infection
• Administration of antibiotics
• Use of soothing balms or gels to relieve dry, itchy, tender, or inflamed skin
• Use of nonsteroidal anti-inflammatory drugs to relieve pain and inflammation
• Improve diet and nutrition and make key lifestyle changes to reduce the risk of complications
• Use vacuum-assisted wound closure or hyperbaric oxygen therapy to improve healing

Complications Associated With Bedsores and Pressure Ulcers

Without proper treatment and wound care, a bedsore or pressure ulcer can get worse or be slow to heal. This increases your risk of infection and other complications. The most common complications of bedsores are:

• Cellulitis – An infection of the skin and/or soft tissues that causes swelling, hardness, redness, warmth, itching, pain, and inflammation.
• Bone or Joint Infections – An infection caused by a bedsore or pressure ulcer can spread to your bones and joints, damaging your cartilage and tissue. You may develop aches and pains, stiffness, and limited range of motion in your limbs and joints.
• Sepsis – A life-threatening infection that occurs when an infection in a bedsore enters the bloodstream.
• Marjolin Ulcer – A chronic, non-healing ulcer or wound that can turn into squamous cell carcinoma.
• Necrotizing Fasciitis – A serious skin condition that causes tissue death and can be fatal.
• Gangrene – A serious infection of the tissue around the ulcer that can cause tissue death and require amputation.

You and your healthcare team must work together to reduce your risk of bedsores and properly treat and manage existing bedsores.

Pressure Ulcer Prevention Tips

If you are at risk of bedsores or pressure ulcers, you and your healthcare team can work together to reduce your risk. If you have certain health conditions or limitations, you may not be able to prevent bedsores on your own. You may need to work with a certified wound care specialist to address existing pressure ulcers and then work with a home caregiver to prevent future issues. Here are some effective pressure ulcer prevention tips:

• Change your position in bed every one or two hours to relieve pressure on bony areas
• If you are in a chair or wheelchair, change your position every hour
• Keep your skin clean and dry, and use a moisturizer to prevent flaky skin
• Use specialized mattresses and other support systems to redistribute the pressure on certain areas of your body
• Check your skin every day for signs of injury, trauma, broken skin, redness, warmth, or pressure ulcers
• Maintain a balanced diet and drink plenty of clear fluids to stay hydrated
• Quit smoking or using nicotine products
• Limit your consumption of alcohol
• Wear loose-fitting clothing without buttons or zippers
• Try to reduce friction when moving around in bed, transitioning from your bed to your wheelchair, or getting out of a bed or chair
• Wear adult diapers if you experience incontinence to prevent moisture from remaining on your skin for too long

Schedule a Consultation for Bedsore Treatment

At BH Wound Care, we provide bedsore treatment and personalized wound management services to patients at home or in care facilities. We help patients who are unable to care for wounds themselves or who want professional education and instruction in wound care. We specialize in treating bedsores, pressure ulcers, abrasions, lacerations, avulsions, puncture and incision wounds, diabetic foot wounds, and venous and arterial ulcers.

Our compassionate, experienced, certified wound care specialists are highly trained and educated and use modern wound care innovations and state-of-the-art technology to accelerate healing, promote recovery, and improve overall health and wellness. They will collaborate with your care team to create a highly personalized bedsore treatment plan that relieves discomfort, accelerates healing, and reduces your risk of complications. Call us now or contact us online to explore bedsore treatment options in Portland, OR; Los Angeles, CA; Vancouver, WA; or Nashville, TN.