Bedsores can be Responsible for Considerable Morbidity and Mortality

Bedsores can kill almost as many as the hospital superbug MRSA (Methicillin Resistant Staphylococcus Aureus) and cost a lot to the exchequer anywhere in the world.
Even when they don’t kill, they inflict terrible pain, discomfort; and rob the sufferer of their time and money.
Bedsores are pressure sores those develop at the pressure points of body of a bed ridden patient or when a patient cannot turn in the bed for a considerable period of time.
Circulation is impaired or stopped at the point of pressure, predisposing the tissue for death that can spread well up to the bone depth.

Image via Wikipedia; Bedsore

The elderly are particularly at risk — simply because they tend to suffer more with poor circulation and are less mobile. In some cases, bedsores can develop in as little as four hours.
Younger people can also suffer them.
The presence of any bedsore has been linked to a four-fold increased risk of death. Through the broken skin bacteria can gain access to the circulation in addition to the local growth and spread. When they multiply nicely in the blood stream can cause a condition called septicemia which becomes life threatening in many cases.
There are four grades of bedsores;

• Grade 1--Reddening or bruising of the skin.
• Grade 2--Broken skin and shallow ulceration.
• Grade 3—Large and/or deep ulceration.
• Grade 4--Ulcers are so deep that in many cases the skin and muscle has completely worn away, revealing bone, and sometimes internal organs.

It is mostly a preventable condition. The detailed care of a bed ridden patient can be accessed here.

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Care of Bed Ridden Patients

Bed sores are pressure point ulcers those may develop on a bed ridden patients. Many patients unable to move or even change their sides on a bed become the victim of pressure sores.
Bed Sores
Unconscious, paralytic, aged, fracture of hip or patients having neurological deficit remaining bed ridden are prone for it. These bed sores refuse to heal and go worse from day to day. Pressure sores develop because of less blood supply to the parts of body in constant pressure from bed. Associated diabetes, vascular disease or neurological disease add to the woe.
Bed sores usually develop over shoulder blade, hip bone, gluteal region, heel, knees and shoulder.

Best way tackle it is to prevent it than to treat it.
Some points are to be kept in mind while managing bed ridden patients;

• Bed should be soft and without any folds.
• A water bed is always better if can be affordable.
• Bed sheets should not be of rough type and there should not be any creases.
• Change of sides of patient at frequent intervals.
• The bed should not be soiled with water, urine or feces
• The patients should be cleaned daily and body sprayed with talc powder. Surgical spirit can be applied all over body; especially over the pressure points like; hip, gluteal region, shoulder blades, heels and back etc. two to three times a week.

All of the above will prevent development of bed sore.
But if develops, all of the above steps must be followed rigorously. A dressing is to be applied over the wound after cleaning with a mild antiseptic lotion.
Diabetic status is to be checked and if present will be controlled. Oral protein supplementation should be continued, if otherwise not contraindicated e.g. patients suffering from hepatic coma.
A short course of antibiotic coverage keeping an eye on anaerobic bacteria is to be added; but a culture and sensitivity test of the pus to choose an antibiotic is better than empirical choice.
Vitamin B, C and D supplement can be given to assist in healing. Sometimes blood and blood components may be required if there is anemia.
The gold standard is “Prevention is better than cure”.

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