pressure ulcer ll decubitus ulcer ll bed sore
Introduction
• Bedsores — also called pressure ulcers and
decubitus ulcers — are injuries to skin and
underlying tissue resulting from prolonged
pressure on the skin. Bedsores most often
develop on skin that covers bony areas of the
body, such as the heels, ankles, hips and
tailbone.
• Causes
Bedsores are caused by pressure against the skin that limits blood
flow to the skin. Limited movement can make skin vulnerable to
damage and lead to development of bedsores.
Three primary contributing factors for bedsores are:
Pressure. Constant pressure on any part of your body can lessen the
blood flow to tissues. Blood flow is essential for delivering oxygen
and other nutrients to tissues. Without these essential nutrients, skin
and nearby tissues are damaged and might eventually die.
Friction. Friction occurs when the skin rubs against clothing or
bedding. It can make fragile skin more vulnerable to injury, especially if
the skin is also moist.
Shear. Shear occurs when two surfaces move in the opposite
direction. For example, when a bed is elevated at the head, you can
slide down in bed. As the tailbone moves down, the skin over the bone
might stay in place — essentially pulling in the opposite direction.
Risk factor
Immobility
Lack of sensory perception
Fracture patient
Dehydration
Traction long term
Poor nutrition
Medical conditions affecting blood flow.
• Common sites of pressure ulcers
For people who use wheelchairs, bedsores often occur on
skin over the following sites:
Tailbone or buttocks
Shoulder blades and spine
Backs of arms and legs where they rest against the chair
For people who need to stay in bed, bedsores may happen
on:
The back or sides of the head
The shoulder blades
The hip, lower back or tailbone
The heels, ankles and skin behind the knees
Stages of bed sore
• Stage 1. The area looks red and feels warm to
the touch. ...
Stage 2. The area looks more damaged and
may have an open sore, scrape, or blister. ...
Stage 3. The area has a crater-like appearance
due to damage below the skin's surface.
Stage 4. The area is severely damaged and a
large wound is present.
Sign and symptoms
Unusual changes in skin color or texture
Swelling
Pus-like draining
An area of skin that feels cooler or warmer to
the touch than other areas
Tender areas
Itching
Pain
Complications
Cellulitis
Sepsis
Treatment
- Moisturizer
- Hydrates and protects skin from damage.
- Barrier cream
- A cream that soothes and protects irritated skin.
- Negative-Pressure wound therapy
- Applying an airtight covering to a wound and then using a vacuum to
- remove fluid and other material. Done to promote healing.
- Relieve pressure on skin
- Improves blood flow to skin, allowing for faster healing.
- High-protein diet
- A diet high in meat, fish, chicken, dairy, soy and other protein sources.
- Consult a doctor for medical advice
- Nursing care
- Change frequently position every 2 hourly
- Clean the wound ns if pus present use h2o2
- antiseptic solution
- Provide high protien added diet
- To improve blood circulation give massage
- Provide oxygen if needed
- Provide iv fluid to treat dehydration
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