If you are caring for a patient or loved one who is bed-bound, one of the greatest risks imposed on them is that of decubitus ulcers, commonly referred to as bedsores or pressure ulcers.
Bedsores can be caused by a number of reasons - immobility, impaired sensory perception, decreased blood supply to the tissues, poor nutritional status, friction and shearing forces, increased moisture and being elderly.
One of the best ways to treat bedsores is to prevent them from happening in the first place. The following are some basic steps that you should follow:
1. Improve Mobility
The patient who lays in the bed or sits all day in the same position is bound for bedsores. Turning or repositioning a patient at least every two hours will help improve circulation and prevent injury to the tissues.
2. Increase Sensory Perception
Impaired sensory perception is often the result of paralysis or an altered level of consciousness. As caregiver, it is your job to inspect the skin at least daily for evidence of breakdown. When a patient is suffering from altered level of consciousness, increase their awareness by frequently reorienting them to their surroundings and encouraging self-care.
3. Improving Circulation
Exercise and frequent positional changes can help improve circulation by increasing blood flow to all tissues of the body. If your patient cannot perform exercises alone, assist them in completing them.
4. Improving Nutrition
When a patient is malnourished, they are at greater risk for skin breakdown. A diet rich in protein helps wounds heal quicker. If your patient has a poor appetite, try encouraging high protein meal supplements. A daily multi-vitamin and mineral supplement is also essential, especially if your patient is not getting the nutrients they need from their diet.
5. Reducing Shearing Forces
Pulling your patient up and down and all around in bed can increase friction and shearing forces which place them at higher risk for bedsores. Raising the head of the bed too high actually increases this risk. Unless contraindicated, avoid keeping your patient in a semi-reclining position. Keep your patient from sliding down in bed by placing pillows under the the knees. Use of a sheepskin pad under your patient’s back and buttocks is also recommended. You can purchase one online or at a medical supply company.
6. Minimizing Moisture
Allowing your patient to lie in urine, stool, perspiration or drainage can create a bedsore nightmare in a relatively short period of time. If your patient becomes soiled, you must cleanse the skin immediately with mild soap and water. Blot dry and then apply a moisture barrier cream to the affected area. Incontinence pads will help reduce moisture, but they should not replace proper cleansing.
7. Use Heel Protectors
Bedsores do not always appear on the backside of the patient. Other areas of risk include the heels and elbows. Try using heel protectors on both areas. And, to keep these areas soft and supple, apply A&D Ointment twice a day.
The first indication that a bedsore is about to occur is a small area of redness to the affected area. If you don’t take the necessary precautions, that little bit of redness may easily transform into something far more serious, like infection or death. Prevention is the best way to fight back against bedsores. Employ these methods on a daily basis, and your patient will remain happy, healthy and injury-free.