How to Prevent Bed Sores on a Bedridden Patient?

Families and doctors who work in long-term care facilities and hospitals have to be very careful about bedsores, also called “pressure ulcers.” It can happen if someone is bedridden, unable to move, or doesn’t feel pain. But the question is how to prevent bed sores on a bedridden patient? Here we will know the best way to prevent bedsores on a bedridden patient. Keep forwarding till the end!

What are bedsores?

When someone is in bed, in a wheelchair, or wears a cast for a long time, they can get bedsores. These are ulcers that form on parts of the skin under a lot of pressure.

Decubitus ulcers are another name for bedsores. They are also called pressure sores or pressure ulcers.

According to the National Pressure Injury Advisory Panel, about 2.5 million people get pressure ulcers each year, and 60,000 people die.

If you’re in a bed or chair for a long time and can’t move your body on your own, you could get hurt.

Having a small, irritated spot of skin doesn’t sound like a big deal to most people, but this minor annoyance can quickly become a significant health problem for old and weak people.

Bedsores can be a big problem for very old and weak people. They may be linked to how well the person is cared for.

If a person who is unable to move or is on a bed isn’t turned, positioned correctly, and gets good nutrition and skincare, bedsores can form.

People with diabetes, circulatory problems, and poor nutrition are more likely to get sick.

Fortunately, there have also some ways to prevent bed sores on a bedridden patient. We will discuss them also here!

What causes bed sores in the elderly?

When blood flow to the skin is cut off for more than 2 to 3 hours, a bedsore form. As the skin dies, bedsore first looks red and hurts. It then turns purple and looks like a wound. Skin can break open and become infected if it isn’t taken care of.

“When tissue is squeezed between two hard surfaces, like a bed or chair and a bone inside the body, this happens,” says Dr. Aronson, a doctor. As a result, it’s like having a heart attack or stroke; your skin: the blood supply to that area is cut off, and the deprived tissue dies.

Bedsores: Three things cause bed sores

Blood flow can be cut off, and the skin can get hurt because of:

  • Pressure from sitting or lying for too long without moving.
  • There can be friction or rubbing during transfers, like when the body is dragged over bedsheets, and there can be friction, too. 
  • This happens when one’s body moves in a chair or bed, and the skin pushes or pulls away from the tissues below it.

Dr. Aronson says that pressure is the most common reason people have a heart attack. So, “of course, it’s not quite that simple, or we’d all get these wounds from our everyday activities.” 

Some people are more at risk than others. “The skin of older people is much less likely to protect people from getting hurt than younger skin.”

People who are paralyzed or have a lot of mobility problems may not be able to move even a little bit to let more blood flow to areas that have been compressed. 

Elderly people are more at risk because their skin thins, loses elasticity, and becomes more fragile as they age. Family caregivers who look after elderly people who are bedridden or in a wheelchair must be extra careful not to get pressure ulcers.

Seniors with incontinence problems or who sweat when they have a fever can also have weaker skin that is more likely to get irritated. People who live a certain way and have long-term health problems that affect their circulation, mobility, and sense of touch can also be more likely to have this risk. 

Cancer, stroke, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, diabetes, malnutrition, chronic obstructive pulmonary disease (COPD), peripheral artery disease (PAD), heart failure, and hip fractures are the most common risk factors for heart disease and stroke. 

However, one study found that smoking, urinary incontinence, and bowel incontinence were a few of the most important things that led to pressure ulcers.

When a bedsore grows, it can be intense and painful. It can go into the muscle and bones, too. Bedsores can take a long time to heal. There are a lot of factors that can affect how long bedsores take to heal. 

These factors include how bad the bedsore is and how well the person is physically and if the person has other diseases, like diabetes. They may need surgery to help their body heal.

What is the beginning sign of a pressure sore?

There are bedsores/pressure ulcers that can happen to any part of the body put under stress. In general, they’re found on parts of the body made of bone, like the heel and elbow.

A few hours can be all it takes for them to start to form, but it’s not always the case.

Early signs

Early signs of a pressure ulcer:

  • People with pale skin get red patches, and dark skin gets purple or blue patches.
  • When you press on the patches, they don’t turn white.
  • A patch of skin that is warm, soft, or hard.
  • Pain or itching in the area that was hurt.

A doctor or nurse might call a pressure ulcer at this point a category one pressure ulcer, which is the first stage.

Later signs

This happens if the pressure ulcer gets worse: The skin can be broken at the start.

  • A category two pressure ulcer is when there is an open wound or blister.
  • A deep wound that goes down to the deeper layers of the skin – a pressure ulcer classified as a type 3.
  • An intense wound that may go all the way down to the muscle and bone – a pressure ulcer that is classified as a type 4.

What are the common sites of bed sores?

There are some sites where the bedsores mostly happen. Those are-

For people who are in a wheelchair, the most common places where pressure builds up are:

  • Spine, shoulder blades, or both
  • Buttocks or the backbone
  • The backs of your legs or arms while they rest against the chair.

How to Prevent Bed Sores on a Bedridden Patient

Pic Credit: HealthWise

For bedridden patients, these areas are:

  • The shoulder blades
  • The sides or back of the head
  • The tailbone, hip, and lower back are all parts of the body that move together

How to prevent bed sores on a bedridden patient?

As a Patient Care Technician, it’s your job to make sure that the people who come to you for help feel happy and safe. Bedridden people are more likely to get bed sores, so they need to be extra careful. 

As we told already before, Bed sores happen when pressure is put on a small skin area for a long time. This causes the skin to die and form painful and bothersome sores. In general, the parts of the body that have less muscle and fat are more likely to get bed sores. 

This includes the tailbone, hip, heel, and elbow. These wounds are painful, but they can also put your patient at risk of getting an infection from them.

While it may be hard to avoid bed sores with some patients, there are ways to prevent them. Here are five ways how to prevent bed sores on a bedridden patient.

Make sure their skin stays healthy

Proper hydration and nutrition are essential to keep bed sores from developing. When the inside of the body is taken care of, the skin will be less likely to get sores and infections. 

A healthy diet and more water help the skin be at its best when coping with bed rest. Taking care of the patient with a healthy diet and water intake can also help with our next tips.

Perform Work out/ Exercise regularly

While we understand that your patient might not be able to move on their while in bed, it’s essential to move as much as you can with them as this is one of the best ways to get air to all parts of their body. 

There are a lot of places where good nutrition and water could help your patient get enough energy to do some simple exercises. 

You can start with simple tasks like lifting an arm up for 10 seconds at a time, with help if needed. Then, work up to the full abilities of your patient.

Repositioning them once every two hours

The most important thing you can do to keep your patients from getting bed sores is to move them around often. Try to move them at least once every two hours, and pay attention to high pressure or risk areas. 

Check their skin often to make sure there isn’t any redness that could signify a sore coming on. You can help your patient a lot by getting them off their backs and on their side. 

Repositioning moves the weight of the patient’s body and distributes it more evenly over the day. It also lets air get to places that didn’t get it before. 

Airflow and fewer pressure points are two of the most important things you can do to keep your skin from getting sores. Repositioning often helps with both of these things.

Use extra Cushioning

Putting pillows under areas of high pressure, like the tailbone or shoulders, can help relieve some of the pressure put on the skin.

For people who aren’t very mobile, extra padding may help to alleviate pressure all over their bodies. Often, this type of padding comes in the form of a foam mattress topper for the bed. 

This reduces the pressure the patient’s body puts on the surface. 

Pillows are more specific, but overall, the padding makes it easier to move someone than carry extra pillows. This can be good for people who can’t move or help move.

Everything should be clean and dry

Bed sores and infections can happen if you don’t keep your patient’s skin and clothes clean and dry. Make sure your patients get baths often and that you clean all the hard-to-reach places, even if you need help. 

These are where you’ll get sores if you don’t clean very well. You need to make sure that your patient is completely dry before putting them back on the bed linens. 

Wet skin stuck against a bed won’t dry, so it will grow and become full of bacteria that can irritate the skin and make it more likely to get sores.

Make sure the skin is dry before moving on. It also applies to the patient’s pillows, sheets, and blankets, which follow the same rules. 

To keep your patient’s skin from getting sores, you need to cut down on how many harmful bacteria they come into contact with. 

It’s dangerous for your patient to be in an unsanitary environment. This could lead to health problems, such as skin sores and irritation.

Keep skin lubricated and free of extra moisture

With suitable lotions and creams, you can improve the skin’s resilience. Every time an adult brief is changed, a barrier cream should be applied to maintain the integrity of the skin.

Even though moisture is terrible, it’s important to remember that dry, cracked skin can also be problematic. When bathing or cleaning soiled areas, use mild soaps and warm water to prevent inflammation and infection.

When cleansing, drying off, and moisturizing a senior, avoid scrubbing and rubbing motions to avoid skin tears and other injuries.

Skin checks in high-risk areas should be performed frequently (at the very least, daily).

As we told in point number three, you have to reposition your patient once every two hours. And you also have to check the patient’s skin frequently or when you reposition your patient.

So those are the way to prevent bed sores on a bedridden patient. If you follow those steps carefully, you may avoid bed sores on your bedridden patient!

What are the risk factors for pressure ulcer development?

To avoid getting a pressure ulcer, you need to know your risk of getting one. Many things make some people more likely to get these painful injuries that cost a lot of money and require a lot of time in the hospital, and sometimes death.

Then, keep reading to determine how many of the following risks you already know and which you might not have thought of.

Poor mobility or immobility

People who can’t move on their own are more likely to get a pressure ulcer because they put pressure on boney prominences, which leads to less blood flow to the tissues and a lack of oxygen.

Poor nutritional status

Even though there aren’t many studies to back this up, it’s widely thought that people who aren’t getting enough nutrients are more likely to get pressure ulcers. Patients who aren’t getting enough nutrients may benefit from a dietary consultation.

Compromised blood flow

Whenever there is less blood flow to the tissues, there is a greater chance of getting a pressure ulcer. Blood flow might be slowed down for many different reasons. Peripheral arterial disease (PAD), venous insufficiency, and shock are the most common causes.

Neuropathy/impaired sense

If you can’t feel pain or pressure, you are more likely to get a pressure ulcer. People who fall into this group have spinal cord damage, strokes, MS, neuropathy, and other conditions that make it hard to feel pain and pressure.

Skin changes

People with darker skin pigmentation may be more likely to get pressure ulcers because health care professionals ignore the early signs of damage caused by pressure (i.e., blanching erythema). In addition, people who have skin conditions that make their skin look different are at high risk (e.g., patients with bruising, dermatitis, eczema, and other skin diseases).

Support surfaces

The surface on which the patient lies or sits can significantly impact how much pressure is put on their bones, as can lying or sitting in the same place for a long time. Support surfaces should be checked often and changed as needed.

Pain

Pain may keep people from moving even when they feel the pain of pressure. Too much pain medication can make people sleepy, so they don’t move around as much as they should. Patients should be checked to see if they can move around while still comfortable.

Age

At the very end of old age, patients may be more likely to get pressure ulcers because they can’t move or change positions independently. Many older people have health problems that make it hard for them to move, so they can’t change their positions on their own.

Mental status

Patients with dementia or other mental disorders may not understand instructions that could help prevent pressure injuries, or they may not be able to recognize the discomfort as a sign to move.

Incontinence

Incontinence can damage the skin, making it more likely that someone will get a pressure ulcer. Some health care workers may not be able to see the early signs of pressure ulcers because their skin is damaged by this (i.e., reddened areas of skin that blanch when light pressure is applied).

By correcting the risk factors of bed sores, you can prevent bed sores in a bedridden patient. So make sure you are sincere about the risk factors of a bed sore patient.

What is the quickest way to eliminate bedsores?

There isn’t a single thing you can do to get rid of bed sores. Though we have talked about the prevention of bed sores in a bedridden patient previously, we are going to tell you more about the fastest way to eliminate bed sores. The fastest way to get rid of bedsores and stop new ones from forming is to do a few or all of the following things simultaneously. 

Removing pressure from the affected area

Changing sides/positions frequently can aid in preventing persistent pressure on a single side. Walking should be encouraged for the patient daily. If they are bedridden, they can be moved around with the help of a wheelchair. They should refrain from using doughnut cushions. Using cushions or an exceptional mattress instead will help relieve pressure.

Keeping the wound clean

Cleansing the wound with sterile saline water and/or povidone-iodine solution every day helps to keep bedsores at bay.

Performing debridement

Debridement is the removal of infected or dead tissue. The doctor gently cleans the wound and scrapes the damaged tissue with sterile water.

Dressing the wound regularly

Medicated gauze or other special dressings can cover the wound as an infection barrier.

Following a healthy (nutritious) diet

A high-protein diet with plenty of vitamin C-rich fruits and vegetables promotes rapid wound healing.

Antibiotics

If doctors notice signs of infection (tenderness, pus discharge) in the wound, they will prescribe antibiotic pills to clear the infection.

Using negative pressure wound therapy (NPWT)

Doctors use negative pressure wound therapy (NPWT). This therapy employs a gentle vacuum pump to draw fluid from an infected wound to aid in its healing.

Using platelet-derived growth factors

Regranex (becaplermin) is a gel containing platelet-derived growth factors (substances extracted from the blood) (substances extracted from the blood). It has helped some diabetic ulcer patients. It may also benefit patients suffering from bedsores. The medication must be taken exactly as prescribed by the doctor.

Concurrent treatment of an underlying condition

Poor nutrition, diabetes, anemia, and fecal and/or urinary incontinence contribute to non-healing bedsores. As a result, the doctor will treat these conditions aggressively to promote the healing of bedsores.

Using home remedies

Local application of aloe vera gel has shown promising results in healing wounds, including bedsores. A study also demonstrated its beneficial role in preventing bedsores when applied daily to pressure points or areas most vulnerable to the development of bedsores.

Using leech therapy (hirudotherapy)

Leech therapy involves sucking blood from problematic areas, such as non-healing chronic wounds, using small worms known as leeches. Ayurvedic practitioners have been using this treatment, known as Jalaukavacharan, for decades with great success. They primarily use leech therapy to treat skin disorders, chronic or non-healing wounds (such as diabetic ulcers, varicose ulcers, and bedsores), and various other conditions.

Undergoing skin grafting

It’s a surgical procedure that removes healthy skin and transplants it to the area of skin that’s been damaged by disease or injury. Skin grafting can be used to heal bedsores quickly or provide additional protection (a thick flap) in the boney areas of patients at high risk (such as patients with paralysis).

Consult your doctor first before using any new cream, ointment, or alternative medicine.

Conclusion

Even with excellent nursing and medical care, preventing bedsores is difficult. However, while challenging, preventing them is more straightforward than treating them.

If the patient notices any signs of developing bedsore, he should contact his doctor or a healthcare professional. Consult a physical therapist to learn about the best positions to avoid bedsores.

Keyword

#how to prevent bed sores on a bedridden patient

Resources

  1. https://www.ncbi.nlm.nih.gov/books/NBK553107/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413488/
  3. https://pubmed.ncbi.nlm.nih.gov/30664906/
  4. https://pubmed.ncbi.nlm.nih.gov/8053799/
  5. https://pubmed.ncbi.nlm.nih.gov/25991879/

 

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