Bed sores, also known as pressure ulcers, pressure sores or decubitus ulcers are skin lesions which can be caused by friction, humidity, temperature, continence, medication, shearing forces, age and unrelieved pressure. Any part of the body may be affected; bony or cartilaginous areas, such as the elbows, knees, ankles and sacrum are most commonly affected. The sacrum is a triangular bone at the base of the spine and the upper and back part of the pelvic cavity (like a wedge between the two hip bones).
If discovered early, bed sores are treatable. However, they may sometimes be fatal. According to health authorities in the UK and USA, bed sores are the second iatrogenic cause of death, after adverse drug reactions. Iatrogenic cause of death means unexpected death caused by medical treatment – death caused by the action of a physician or a therapy the doctor prescribed.
In the 1950s, Doreen Norton (1922-2007), a British nurse, used research to demonstrate that the best treatment and prevention of bedsores was removing the pressure by turning the patient every two hours. Norton is seen as instrumental in changing nursing practices to effectively treat pressure ulcers, which was a major killer of hospital patients.
According to Medilexicon’s medical dictionary:
- A decubitus ulcer is “a chronic ulcer that appears in pressure areas of skin overlying a bony prominence in debilitated patients confined to bed or otherwise immobilized, due to a circulatory defect.”An acute decubitus ulcer is ” a severe form of bedsore, of neurotrophic origin, occurring in hemiplegia or paraplegia.” (Hemiplegia = paralysis on one side of the body. Paraplegia = paralysis of the lower part of the body, including limbs.
Pressure ulcers (bed sores) develop when the skin and the tissue below it becomes damaged. In severe cases the muscle and the bone may be damaged too. Pressure ulcers are much more common among patients who are unable to move because of paralysis, illness or old age. Sustained pressure can cut off circulation to vulnerable parts of the body, especially the skin of the buttocks, hips and heels – the affected tissue dies if it does not receive an adequate flow of blood.
According to the National Health Service (NHS), UK, it is estimated that between 4% and 10% of all hospitalized patients develop at least one pressure ulcer. Up to 70% of UK elderly patients with mobility problems develop bed sores.
Experts say that even with excellent medical and nursing care, bed sores can be hard to prevent, especially among vulnerable patients. Anyone, not only those living with paralysis, can develop bed sores – any person who cannot change position without help can develop bedsores. The bedsores can develop and progress rapidly and are frequently difficult to heal. Doctors say that with proper preventive measures the skin’s integrity can more easily be maintained, resulting in better healing of bedsores.