Bed sores—also known as pressure ulcers or decubitus ulcers—are wounds that form when the skin and its underlying tissue are compressed between bones and a hard surface for a prolonged period of time. When this happens, blood flow to the area is cut off and the tissue begins to die.
Sounds terrible, right? There is nothing pleasant about bed sores, but there are steps that can be taken to prevent bed sores from developing in the first place, and if bed sores do occur, there are some at-home treatments that can help heal them.
What Are Bed Sores?
Bed sores, also known as pressure ulcers, are a wound- or ulcer-like type of injury that can occur when someone is confined to a bed or wheelchair.
The injury is caused by the constant pressure of the body against the surface, which cuts off the supply of blood to the area. This can cause the skin and tissue to break down, leading to an open wound. Bed sores can be very painful and difficult to heal, and unfortunately, are especially common in people who are elderly or have a chronic illness.
The Four Stages of Bed Sores
Like many medical conditions, bed sores are categorized in stages ranging from stage 1 to stage 4.
A bed sore in stage 1 is not yet an open wound, but the skin will be very red. If you aren’t sure if a bed sore is forming, press gently on the red spot. If the spot fails to lighten up, then it is likely blood is not reaching that area.
Symptoms of a stage 1 bed sores include itching, pain, or a burning sensation. The red spot itself may feel warmer or cooler, firmer or softer than the area around it.
In stage 2, the skin breaks open and forms a shallow crater. This could look like a shallow wound or a blister that has yet to pop. You may also notice some swelling or redness around the sore, indicating that this tissue is damaged or dying.
Symptoms of stage 2 bed sores include pain and pus at the site of the ulcer.
In stage 3, the bed sore deepens and creates a tunnel under the skin. The sore will look like a crater or hole, and you may even be able to see some fat tissue.
Other symptoms of a stage 3 bed sore include redness, the presence of pus or discolored discharge, and the foul odor of infection.
Stage 4 is the most serious. By now, the bed sore is a deep crater that goes through muscle and down to the bone, muscle, tendons, and/or ligaments. By the time a bed sore reaches stage 4, serious infection becomes likely.
Symptoms of a stage 4 bed sore include sharp and consistent pain, pus and other visible signs of infection, and the appearance of hard, dead tissue known as eschar.
Who Is Most Prone To Developing Bed Sores?
Bed sores can occur in any individual who is confined to the same place for a prolonged period of time. However, certain individuals are at a higher risk for developing bed sores, including those who are:
- suffering from a medical condition that impairs circulation
By understanding which individuals are most at risk for developing bed sores, healthcare providers can take steps to prevent them. For example, a doctor or other caregiver may recommend that patients perform frequent turning and positioning changes, use special support surfaces, and maintain good hygiene.
How To Prevent Bed Sores
If bedridden or confined to a wheelchair, then it is important to understand that bed sores could develop. Not only are bed sores extremely painful, but they can lead to serious infections. Therefore, it is important to know how to prevent bed sores before they can develop. Here are some tips:
1. Keep the skin clean and dry
Bed sores form when blood cannot reach a particular spot, but can be exacerbated by dirt and debris, or excessive moisture. Therefore, it is important to keep the skin of anyone who is confined to one place as clean and as dry as possible.
Use a damp cloth to wipe the skin down daily, paying special attention to those places like hips, feet, elbows, and anywhere else bone sits close to the skin. Check for redness, pressure points, and new sores, then report anything you see to your healthcare provider.
2. Move position often
When lying down, shift position every few hours to avoid sustained pressure on one area of the skin. If the confined person can’t change position on their own, then employ the use of pillows or foam wedges to prop up the body and relieve pressure.
3. Maintain a healthy diet and drink plenty of fluids
Keeping the skin healthy and pliable should be a priority during times of confinement. If health allows, maintain a balanced diet with plenty of water and other fluids.
4. Keep the skin moisturized
Use petroleum-free lotion regularly—especially on bony areas—to keep the skin pliable and moisturized.
5. Keep bedding clean and dry
To prevent excessive moisture and harmful bacteria, keep any bedding and clothing as clean and dry as possible. Change wet or soiled sheets and clothes right away.
Preventing bed sores is the best way to avoid the pain and complications associated with them.
How To Treat Bed Sores At Home
If you develop bed sores, it is important to reach out to a healthcare provider. The recommended treatment will depend on the stage of the bed sore; ulcers at stage 1 and 2 are most successfully treated at home, while sores at stage 3 and 4 will require more aggressive treatment—antibiotics at least, surgery in the worst cases.
After reaching out to your doctor or another medical professional, you will likely be told to:
1. Keep any bed sores clean
If you develop a bed sore, clean it with mild soap and water. Pat dry very gently. If the bed sore has yet to crater, monitor it closely and reach out to your doctor if it worsens or does not heal.
2. Add support and remove pressure
Bed sores develop because of pressure, friction, and shear force—that is, when the skin rubs against something repeatedly, like a bed sheet. If bed sores are beginning to develop, then rearrange any pressure points by adding pillows, propping up on a foam wedge, or removing extra sheets and blankets.
3. Keep the skin moisturized
Keep skin moisturized by using lotion regularly, especially on bony areas. Not only is moisturized skin less likely to break open, but the act of applying lotion will promote blood flow to the area. For the best results, avoid lotions that contain petroleum or other oils, as these can make the skin more likely to break down.
4. Apply dressings regularly
If the bed sore hasn’t yet opened or cratered, apply an antibiotic ointment after cleaning it thoroughly with soap and water. This could prevent infection from getting into the sore and worsening it.
When To See a Doctor For Bed Sores
You should reach out to your doctor or another healthcare professional any time you notice a bed sore beginning to develop. If the sore has not yet broken open, your doctor will likely tell you to change a few things and keep an eye on it to make sure it isn’t worsening.
If the bed sore has opened, then seeing a doctor is essential. Sores in stages 1 and 2 will likely require a prescription antibiotic, while sores at stages 3 and 4 may require more aggressive treatment, such as surgery.
People Also Ask
What are pressure ulcers?
Pressure ulcers—also known as bed sores—are sores that develop on certain parts of the body when a person lies or sits in the same position for long periods of time. The lack of movement causes the skin and underlying tissues to break down, resulting in an open wound.
Where do bed sores develop?
Though bed sores can develop anywhere on the body, they most commonly develop in places where bone is close to the skin—the hips, elbows, heels, and ankles, for example. Other places bed sores commonly develop include the back, shoulders, and back of the head.
Who gets bed sores?
People who are unable to move on their own are at greatest risk of developing bed sores, as they are more likely to experience prolonged periods of pressure on one area of their body. People with diabetes, poor circulation, obesity, and incontinence are also at increased risk, as are older adults who are bedridden or no longer able to move.
Should bed sores be covered?
Developing bed sores should be covered with a specific dressing provided by a doctor. The purpose of the dressing is to keep the sore moist and to protect against infection. For larger bed sores, a doctor may recommend covering the wound and dressing with gauze.
How long does it take to recover from bed sores?
Bed sores can take weeks or months to heal completely; generally speaking, the later the stage of bed sore, the longer the healing time. For some patients, chronic pain and scarring will continue even after the wound has healed.
Should you keep a bed sore dry or moist?
It is important to keep the wound of a bed sore moist, but the skin around it nice and dry. This can be done by covering the sore with a film, gel, or foam dressing, then covering the area with gauze.
How do you prevent bed sores from getting worse?
If you have just noticed a bed sore on either yourself or a loved one, it’s important to do what you can to ensure it doesn’t get worse. If the bed sore is still mild (stage 1), change position or add a pillow or foam mat to remove the offending pressure. If the bed sore has reached stage 2, then change position, add a pillow or foam mat, clean the wound with water, and cover it with a moist gauze.
Bed sores, or pressure ulcers, can be painful and lead to serious infections, so it is important to know how to prevent and treat them. Those who are bedridden or in a wheelchair can prevent bed sores by moving position often, keeping their skin clean and moisturized, and maintaining a healthy diet. If bed sores develop, it is best to seek medical advice. Bed sores in stages 1 and 2 can usually be treated at home with moist dressings and a slight change of habits, though sores in stages 3 and 4 could potentially require antibiotics and/or surgery.