In just a few hours, bedsores, likewise referred to as pressure ulcers, are lesions that commonly form on bony regions of our bodies. With around 3 cases of pressure injuries per year, bedsores, or pressure ulcers, are the most significantly prevalent ulcer in Singapore. The prevalence of chronic wounds as a whole is growing among Singaporeans aged 80 or older.
According to studies, pressure sores may be more likely to form as people become older. Elderly people who have pressure ulcers are really four times more likely to die. The percentage of the elderly, or those 65 and over, in Singapore’s population, is expected to rise to 18.4% by 2030 due to the country’s fast-aging population. Also, a longer lifetime brought on by improvements in medical technology and treatment options could potentially result in an elevated risk.
It might be beneficial to learn about further pressure ulcers, their indications, and symptoms, treating pressure sores, and prevention because it is anticipated that the burden of wounds would increase as the general population ages.
What is a Pressure Ulcer or Pressure Sore?
Particularly on bony regions like the tailbone, the hips, ankles, and even heels, pressure ulcers or bedsores are injuries to the skin and underlying tissue that develops as a result of persistent pressure on the afflicted area.
Most often, those who acquire bedsores have medical issues that make movement difficult. As a tendency, individuals spend a lot of time sitting or laying in bed, which may restrict blood flow to specific parts of their bodies and cause the buildup of dead tissue on healthy skin.
Also, an elderly person is also more likely to develop bedsores, joint infections, or pressure injuries if they have to wear a cast for an extended period of time or if they have impaired pain perception, such as after a spinal cord injury.
It’s also necessary to keep in mind that not everyone gets bedsores over a period of days or even weeks. Likewise, some pressure sores heal partially while others do not, even though many people relieve pressure sores and improve them after receiving therapy.
What Are the 3 Causes of Pressure Ulcers?
Because of inadequate blood flow to the tissues under the afflicted skin and on top of it, pressure ulcers develop. Blood contains nutrients that maintain our cells healthy, including oxygen, therefore this is a problem. The tissues might suffer damage and finally pass away with reduced blood flow. In fact, bedsores are a result of three aspects, which are as follows:
Blood flow to any area of the body can be impeded by persistent, severe pressure. Consider the times you sat down for an extended period of time and experienced an electric or numbing feeling. The blood circulation was hampered by your lack of activity, which is what caused that sensation.
Bony regions or those not sufficiently cushioned by either fat or muscle, such as the rear or sides of the head, the outer edges of the ears, the shoulders, spine, tailbone, elbows, hips, ankles, backside, or sides of the knees, and heels, frequently develop bedsores in people with disorders that restrict their ability to move.
Friction is another aspect, the mechanical force created when our skin scrapes against clothing, bedding, or other materials. Although it doesn’t entail pressure, repetitive friction can make the skin and underlying tissues more prone to injury and skin damage, like darker skin, particularly if the region being exposed to friction is often wet.
Generally, we talk about the skin and bones as the two surfaces in pressure ulcers. Consider a person who is lying in bed with their head up. While the skeleton is being pulled down by gravity, the skin’s surface is still affixed to the bed due to friction. Blood flow is disrupted as a result of compression of the vessels that carry blood between the bones and skin.
Risk Factors for Bedsores
Seniors are more prone to bedsores considering their skin is less elastic and more delicate, but the following variables significantly raise a person’s chance of getting one:
Immobility: as in the case of those who have suffered from stroke-related paralysis.
Inability to feel pain: people with diabetes-related nerve damage may experience diminished capacity to perceive or react to pain.
Incontinence: skin that has been exposed to pee or feces because of incontinence is more prone to pressure sores.
Circulation issues: a person who has blood flow issues is also in danger.
Poor nutrition: malnutrition and obesity can increase the strain on the small blood veins in the skin, which reduces blood flow. The likelihood of getting bedsores rises when low body weight is combined with additional variables like immobility.
Smoking: in addition to reducing mobility and harming blood vessels, smoking increases the chance of developing pressure ulcers.
4 Stages of Pressure Ulcers & Interventions
Stages of pressure ulcers vary in their symptoms and treatments needed. The various pressure sore phases, associated symptoms, and recommended care are listed below.
Pressure ulcers in the early stages do not cause the skin to break, but the afflicted region may seem discolored, occasionally in shades of blue, red, or black. It’s also possible that the place has a distinct texture and warmth from the surroundings.
If you’ll observe a Stage 1 pressure ulcer, relieve the pressure by shifting positions, look for any other causes, wash with mild soap, apply moisture barrier creams, and pat dry. Additionally, keep yourself hydrated, make sure you’re getting the vitamins and minerals you need for a healthy diet, and keep checking the region twice a day. If the part of the skin does not begin to recover after two to three days, speak with your healthcare professional immediately away.
The epidermis, the forefront layer of skin, has already been damaged in stage 2 pressure ulcers, leaving an open pressure sore, scratch, or blister. There is discomfort, and the vicinity of the incision seems discolored.
Follow the instructions for treating stage 1 pressure ulcers, particularly the one about relieving pressure. Consult your healthcare professional immediately since an open wound can need special attention or certain treatment. Typically, to maintain moisture while maintaining the surrounding region dry, rinse the area of injury with a saline solution and wrap it with a bandage.
Dermis, the layer beneath the epidermis, is impacted by stage 3 pressure ulcers. Stage 3 bedsores frequently have a crater-like look, and the injury may or may not spread into the deeper layers. However, the bones and tendons remain unaffected at this point. Reach out to your medical professional straight soon to get guidance on how to treat the wounds in this situation. Look out for symptoms of infection such as fever, redness, smell, and discharge that is green or pus-filled.
Large, deep crater-shaped sores are frequently present in stage 4 bedsores. There may already be bone and joint infections due to the incision being deep enough to impact the tendons and bones. The possibility of necrosis or tissue death should also cause anxiety at this point.
Ease any pressure and call an emergency physician right once since stage 4 bedsores may need surgery to cover the sore with a pad made of muscle or tissues from another area of the body or wound debridement, which involves removing dead tissue.
Pressure Sore Prevention Tips for People with Aged Parents
The best way to avoid skin breakdown is to regularly check an elderly loved one’s skin health a regular basis as part of their skin care so that you will know when these items are required. Here are some steps you may take in preventing pressure ulcers:
Change positions periodically. Depending on the patient’s capacities, maintaining a rigid repositioning plan is essential while caring for elderly patients with limited mobility.
Provide pads or cushions for protection. A chair or wheelchair padded with cushions that have been shown to gradually reduce pressure can be extremely helpful, for instance, as can placing pillows between the leg, utilizing specific mattress overlays, or employing these techniques to pad a chair or bed.
Conduct routine skin examinations. Checking the skin frequently for indications of bedsores forming. The patient could also require an ostomy or the installation of a urinary catheter. The doctor may also recommend barrier lotions to protect the skin from substances like urine and feces.
Keep extra moisture off of your skin. The skin may be made more robust by using the proper lotions and creams in a gentle manner. To maintain skin integrity, moisture barrier creams need to be used often after each adult short change. To avoid irritation and illness, bathe or clean dirty areas with warm water and mild soap.
Maintain a healthy diet. Although there isn’t a single diet that works best to avoid bed sores, poor nutrition can hinder or even halt the healing and regeneration processes. Sustaining a healthy weight is essential for preventing skin breakdown since carrying more weight can place additional strain on the body’s own pressure points.
How to Treat Bed Sores
To establish an effective treatment plan if an elderly loved one sustains one of these wounds, it is critical to comprehend the severity of the damage. Based on how they occur, pressure ulcers are divided into four broad phases.
Bed Sores Staging and Treatment
- Stage 1: Changes in color, warmth, consistency, or feeling occur in intact skin.
- Stage 2: A shallow ulcer with just pink tissue within or a blister containing either clear fluid or blood is present.
- Stage 3: Contains a deeper ulcer that may reach the subcutaneous fat layer and has yellow flaking tissue or an extremely thin scab.
- Stage 4: Severe ulcer that penetrates the bone, muscle, or tendon.
- Unstageable Bed Sore: This classification refers to wounds that are not evident whether they are Stage 3 or Stage 4 due to the presence of eschar, which is often yellow, tan, green, or brown in color, as well as a scab covering the base. These are best handled by eliminating the dead tissues, dressing the area of injury, and then attending to it appropriately.
- Deep Tissue Injury: This frequently occurs in high-risk locations and manifests as purple or maroon skin discolorations along with variations in warmth, consistency, and feel. These symptoms suggest significant damage underneath the skin’s intact layer.
Additional operations could be required if bedsore has progressed to the point where there is considerable tissue loss. Reconstructive surgery can be necessary to close the incision if the harm caused is severe enough to reveal the bone.
In the end, prevention is preferable to treatment because most bedsores happen to patients who are confined to their homes, in a Singapore nursing home, or in community hospitals. Patients and caregivers should both be aware of the danger and take responsibility for their own health to eliminate the risk of developing pressure ulcers.
Having said that, our nurses at Retire Genie can assist your loved ones by visiting you at home and teaching you ways to lower your risk—or the danger of a member of your family—of acquiring decubitus ulcers. It is vital to speak with a healthcare expert if you observe symptoms of stage 2 pressure ulcers.