SCRIPT NUMBER 134
PRESSURE SORES / BEDSORES - 2
(TWO SPEAKERS)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: PRESSURE SORES / BEDSORES - 2
PROGRAM NUMBER: 134
SUBJECT: CAUSES, SYMPTOMS, TREATMENT, PREVENTION OF
PRESSURE SORES OR BEDSORES
KEY WORDS: ULCERATION, BED REST, FORCEFUL IRRIGATION
DATE OF SCRIPT: OCTOBER 18, 2013
AUTHOR: RICHARD YUKL, MD, FACS
SPEAKER 1:
Have you ever known someone who required a long period
of bed rest because of an illness, or perhaps someone who had to sit in a
wheelchair many hours every day because of a physical disability? Because they
were not able to move about normally, they developed sores on the skin of their
back, their hips or their feet that took a long time to heal and required seemingly
endless treatment and care.
SPEAKER 2:
These sores are known as pressure sores or bedsores, and
they are the result of skin and underlying tissues being damaged by pressure
that is applied to an area of the skin for a prolonged period of time. Today, we
want to talk about pressure sores and how they can be prevented.
SPEAKER 1:
What is the mechanism that causes pressure sores?
SPEAKER 2:
The mechanism is straightforward. Skin and its underlying
tissues are nourished by oxygen in blood that is delivered through small blood
vessels located just under the skin’s surface. Pressure can squeeze these
vessels closed when the skin is trapped between a body part and a hard surface
such as a bed or a wheelchair. Then, oxygen can no longer be delivered to the
tissues, the cells suffer damage, and they begin to die. Pressure sores most
often develop in skin that covers the bony body parts of people who have a
limited ability to move because of a medical condition. The sores can develop
quickly. They are often difficult to treat, and they can take a long time to heal.
SPEAKER 1:
Describe some medical conditions that are risk factors for
developing pressure sores.
SPEAKER 2:
Any condition that limits a person’s movement is a risk factor
for the development of a pressure sore, and while confinement to bed or the
need to use a wheelchair create the greatest risks, other risk factors include
medical conditions such as being weak because of poor health or a prolonged
loss of consciousness due to a brain injury. Injuries that cause a loss of
sensation are risk factors because the person cannot feel pressure being applied
to skin that is numb. Aging is yet another risk factor. Older adults have thinning
skin, and new skin cells are generated more slowly than in the young. Having
poor nutrition is a risk factor because the skin thins, and the person lacks the
calories and proteins needed to maintaining good skin health. Anyone who has a
risk factor for developing pressure sores increases that risk by smoking. Their
pressure sores will not only be more severe, they will also be slower to heal
because the nicotine in tobacco decreases blood flow, and it reduces the amount
of oxygen the blood can carry.
SPEAKER 1:
What kind of complications can pressure sores cause?
SPEAKER 2:
Complications can be life threatening. The damaged skin of
a pressure sore can die and be shed, leaving an ulcer that can then become
infected. This allows bacteria to enter the bloodstream, spreading infection
throughout the entire body. The infection can also spread directly to the bones
and joints deep to the ulcer, reducing their function and causing damage that
sometimes cannot be repaired.
SPEAKER 1:
How should I treat a pressure sore? Can I help it heal?
SPEAKER 2:
If it is treated early and adequately, it will often heal in
several weeks to months. On the other hand, a neglected pressure sore is much
harder to treat, and healing may prove difficult. Open ulcers may even require
surgical repair. The first step in treatment is to relieve the pressure that caused
the problem. People who are not mobile need to be repositioned at regular
intervals. The person who is capable of movement needs to change their position
approximately every 15 minutes, and people at complete bed rest should change
positions at least every two hours, even if they need the help of a caregiver to do
so.
SPEAKER 1:
So, step one is to relieve pressure from the damaged area.
How do I treat an actual ulcer if one has developed?
SPEAKER 2:
Once the continuing pressure is relieved, the wound needs
to be cleansed of damaged, infected or dead tissue. Dressings placed over an
ulcer will absorb moist debris from the base of the wound, allowing the debris to
be lifted from the depths of the wound as the dressing is removed. Sometimes,
dead tissue can be removed by forceful irrigation using water in a pressure
syringe or a whirlpool bath. At other times, a doctor may need to cut away dead
tissue to clean the ulcer. Whatever means is used to clean the wound, once it is
clean, it must be kept clean using wound dressings changed on a regular basis.
God created us with a wonderful built-in mechanism that will heal a clean
pressure sore, but we must make the environment right for the healing to occur.
SPEAKER 1:
It sounds as though pressure sores are easier to prevent
than they are to treat.
SPEAKER 2:
Absolutely. It is easier to prevent this unfortunate condition
than it is to treat it. When caring for someone with physical limitations, remember
that their inability to move about normally increases their risk of developing
pressure sores. Paying attention to details is the key to preventing pressure
sores from forming. Various cushions and pads can help to relieve pressure
points, protecting the bony areas of the body, but despite that, at risk people
need to change positions frequently, even if they need assistance to do so.
Taking the proper precautions will allow the body to repair tissues that are
beginning to be injured and prevent ulcers from forming.
SPEAKER 1:
Health Nuggets is written by Dr. Richard Yukl, a medical
doctor working in the United States. The medical views expressed in this
program are his and may differ for your particular health needs. If you need
medical advice, please consult a medical professional in your area.