Most pressure sores affect patients over 70 years old who are bedridden in hospitals and long-term care facilities. Bedsores can develop in patients with just a few hours of constant pressure and range from mild reddening to severe craters that extend into the muscle and bone. They're quite a nuisance and often painful. Anyone who must remain in a bed, chair, or wheelchair for extended periods can develop these sores.
Bedsores are injuries caused by constant and unrelieved pressure that damages the skin and underlying tissue due to lack of mobility and blood circulation (i.e., being bedridden). If you must sit or lie for prolonged periods, the surface of your seat or bed puts excessive pressure on the bony prominence or pressure points in your body. Common pressure points on the body include the tail bone (sacrum), hip bone areas, and the ankle and heel. Less common sites include the elbows, spine, ribs, and back of the head.
When a pressure ulcer develops, nursing’s patient safety goal is to assist the health care team in closing the ulcer as quickly as possible. Nursing is also concerned with preventing further ulcer deterioration, keeping the ulcer clean and in moisture balance, preventing infections from developing, and keeping the patient free from pain.
Once the pressure ulcer develops, the ulcer should be cleaned with a nontoxic solution. Cleaning the ulcer removes debris and bacteria from the ulcer bed, factors that may delay ulcer healing.
The nurse should assess and stage the pressure ulcer at each dressing change. Experts believe that weekly assessments and staging of pressure ulcers will lead to earlier detection of wound infections as well as being a good parameter for gauging of wound healing.
Managing bacterial burden is an important consideration in pressure ulcer care. All pressure ulcers contain a variety of bacteria. Pressure ulcer bacterial contamination should not impair health. The use of oral antibiotics or topical sulfa silverdiazine has also been found to be effective in decreasing the bioburden in the ulcer bed. Ofcourse, nurses may only implement this prior to the physician's order.
The use of high-protein diets for patients with protein deficiency is essential to wound healing. Diet is often neglected as a part of the treatment plan, however, the nutritional intake of the patients greatly affects their healing and recovery.
In conclusion, bed sores are consequences of immobility and friction on some parts of the body, hence, we should always give attention especially to patients incapable of ambulating and of old age.
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