What You Should Know About Bedsores

Bedsores, also known as pressure ulcers or decubitus ulcers, can have a devastating impact on individuals and their families. Bedsores are not just painful wounds – they often signify neglect or inadequate care in healthcare facilities, residential care facilities, or nursing homes.

How do bedsores develop?

Bedsores develop when there is prolonged pressure on the skin, typically over bony prominences such as the heels, hips, tailbone, shoulder blades, and elbows. The pressure restricts blood flow to the skin and underlying tissues, leading to tissue damage and eventually the formation of bedsores.

Several factors contribute to the development of bedsores, including:

• Pressure: Constant pressure on the skin from sitting or lying in one position for an extended period reduces blood flow to the area. This pressure can damage skin and tissues, especially in individuals who cannot change positions independently.
• Friction and shear: Friction occurs when the skin rubs against another surface, while shear happens when layers of skin slide over each other. Both friction and shear can exacerbate tissue damage, particularly in individuals who are moved or repositioned frequently.
• Moisture: Excessive moisture, such as from sweating or urinary or fecal incontinence, can soften the skin and make it more susceptible to damage. Moist skin is also more prone to friction injuries.
• Reduced mobility: People with limited mobility, such as those confined to a bed or wheelchair, are at higher risk of developing bedsores because they may not change positions frequently or shift their weight to relieve pressure on vulnerable areas.
• Poor nutrition and hydration: Malnutrition and dehydration can impair the body’s ability to repair damaged tissues and make the skin more susceptible to breakdown.
• Medical conditions: Certain medical conditions, such as diabetes, vascular disease, and neurological disorders, can compromise blood flow and sensation, increasing the risk of bedsores.

Who is at risk for bedsores?

Those with limited mobility are most at risk for bedsores. People who are bedridden, wheelchair-bound, or have difficulty changing positions independently are at high risk due to prolonged pressure on specific areas of the body.

What are the stages of bedsores?

As the Cleveland Clinic explains, doctors use a staging system to describe the severity of a bedsore. These stages are:

• Stage 1: The skin looks red or pink, but there is no open wound.
• Stage 2: A shallow wound, with a pink or red base. You may notice blisters or abrasions.
• Stage 3: The wound may extend into the hypodermis (the fatty layer of skin)
• Stage 4: The wound penetrates all layers of skin, showing muscles, tendons, and bones.

Medical personnel should intervene at the first signs of bedsores developing.

What are the symptoms of bedsores?

Bedsores can manifest with various symptoms depending on their severity and stage of development. The affected area may appear red, purple, or blue in individuals with lighter skin tones. For individuals with darker skin, the area may appear darker or lighter than the surrounding skin. Edema, or swelling, may occur around the affected area due to inflammation and fluid accumulation in the tissues.

People with bedsores may experience pain, tenderness, or discomfort in the affected area, particularly during movement or when pressure is applied. The skin over the affected area may feel warmer or cooler than the surrounding skin, or tender, firm, or spongy to the touch. In more severe cases, the skin may become shiny, taut, or blistered.

As bedsores progress, they may develop into open wounds, blisters, or ulcers with exposed tissue. These wounds may ooze fluid, pus, or blood.

Healthcare providers and caregivers should closely monitor patients, residents, and loved ones who are at risk of developing pressure ulcers.

What are the complications of bedsores?

Bedsores can lead to a variety of complications, especially if they are not promptly treated or if preventive measures are not implemented effectively. Cleveland Clinic notes that “Worldwide, bedsores lead to the deaths of more than 24,000 people each year.” Some complications associated with bedsores include:

• Infection: Bedsores provide an entry point for bacteria and other pathogens, increasing the risk of infection. Infection can lead to cellulitis (a bacterial skin infection), osteomyelitis (bone infection), or sepsis (a life-threatening systemic infection). Fever and chills are often the first sign of an infection.
• Delayed healing: Bedsores can impair the body’s ability to heal and regenerate damaged tissue, especially in individuals with underlying health conditions or compromised immune systems. Delayed healing can prolong recovery time and increase the risk of complications.
• Deep tissue injury: Bedsores can extend beyond the superficial layers of the skin, affecting deeper tissues such as muscles, tendons, and bones. Deep tissue injury may result in significant pain, impaired mobility, and increased risk of infection.
• Tissue necrosis: In severe cases, prolonged pressure on the skin and underlying tissues can cause tissue necrosis (tissue death). Necrotic tissue can become infected and impede wound healing, leading to further tissue damage and potential complications.
• Contractures: Prolonged immobility and pressure on specific areas of the body can lead to contractures, where the muscles and tendons become shortened and stiff, limiting mobility in the joints as well as range of motion.
• Chronic pain: Bedsores can cause significant pain and discomfort, especially in advanced stages or when complications such as infection or tissue necrosis occur. Chronic pain can impair quality of life and hinder rehabilitation efforts.

What is the treatment for bedsores?

Treatment for bedsores varies depending on the severity of the wound and any underlying health conditions. The primary goals of treatment are to relieve pressure on the affected area, promote wound healing, prevent infection, and address underlying factors contributing to the development of bedsores.

In milder cases, where the bedsores are in the early stages and have not yet broken through the skin, treatment may involve relieving pressure by repositioning the individual regularly, providing supportive cushions or mattresses, and maintaining good skin hygiene. Specialized dressings or creams may be applied to protect the skin and promote healing. Additionally, nutritional support with adequate protein, vitamins, and minerals is essential to support tissue repair and regeneration.

For more advanced bedsores that have broken through the skin and are at risk of infection, treatment may involve more intensive wound care. This may include cleaning the wound with saline solution or other cleansers to remove dead tissue, debris, and bacteria. Healthcare providers may debride the wound, removing necrotic or damaged tissue to promote healing and prevent infection. Sometimes, surgical intervention may be necessary to repair or reconstruct the affected area, particularly if there is extensive tissue damage or underlying bone involvement.

To prevent infection and promote healing, healthcare providers should prescribe antibiotics or antimicrobial dressings to combat bacterial growth and reduce the risk of complications. Pain management strategies, such as topical or oral analgesics, may also be used to alleviate discomfort and improve the person’s quality of life.

Throughout the treatment process, regular monitoring and reassessment of the bedsores are essential to track progress, identify any signs of infection or complications, and adjust the treatment plan as needed. Healthcare providers may collaborate with wound care specialists, physical therapists, nutritionists, and other members of the healthcare team to provide comprehensive care and support for those with bedsores.

Did your loved one’s bedsores happen because of elder abuse?

Pressure ulcers can indicate elder abuse or neglect when they develop due to substandard care or inadequate supervision. Where bedsores might justify a claim against a nursing home or residential care facility, our Seattle personal injury lawyers look at a variety of factors:

• Failure to implement preventive measures: Staff must assess residents’ risk for developing bedsores and implement preventive measures. If a facility fails to regularly reposition immobile residents, provide support for the body, maintain proper hygiene, or address nutritional needs, they may be held accountable for neglect.
• Delayed detection and treatment: Timely detection and treatment of bedsores is vital for preventing complications and promoting healing. If a nursing home or RCF fails to promptly identify and address the development of bedsores, allowing them to worsen or become infected, it may constitute negligence.
• Inadequate staffing and training: Nursing homes are responsible for ensuring that their staff members are adequately trained and supervised to provide quality care to residents. If a facility is understaffed or if staff members lack the necessary training or expertise to prevent and manage bedsores, it may contribute to instances of neglect, leading to pressure ulcers.
• Evidence of neglect or abuse: Signs of neglect or abuse may accompany the development of bedsores in elderly residents. These signs may include unexplained injuries, changes in behavior, poor hygiene, malnutrition, or dehydration. Documenting and reporting these signs to the appropriate authorities is essential for addressing concerns of abuse or neglect.

At Smith McBroom, our Seattle injury attorneys can assess the circumstances surrounding the development of your loved one’s bedsores, gather evidence, and advocate for their rights and well-being. We can help you seek justice for your loved one. To schedule a free consultation, call our offices or fill out our contact form today.