The Basics of Bedsore Treatment

Bedsores are an unfortunate fact of life when it comes to treating and caring for bedridden and ill family members, and even family members who are in wheelchairs.

Regardless of the specifics of your family member or loved one, there are several steps you can take to minimize the risk of bedsores developing, to treat Stage 1 pressure ulcers at home and to help avoid them in the future.

Basics Of Bedsores (Pressure Ulcers)
Bedsores are simple. Pressure on a specific area of tissue diminishes blood flow, and this decreased blood flow leads to cell death, as the lack of blood flow deprives the tissue of oxygen

Risk factors include thin skin (or skin with reduced elasticity) bruises, scrapes or other surface injuries. These can all increase the risk of bedsores developing, making the elderly and infirm more at risk for these ulcers, especially when bedridden.

Basic Home Treatment Of Stage 1 Pressure Ulcers
A Stage 1 pressure ulcer typically presents in this manner: skin is discolored, but not broken, red and purple for light skin, white for dark skin—discolored and splotchy. No real tissue damage.

Stage 1 pressure ulcers are quite easy to treat, if they haven’t broken the skin, though consultation with a medical professional is recommended at first sign of a sore.

Remove Pressure With Frequent Repositioning
First, ensure that pressure is removed from the affected area immediately. This will help prevent the ulcer from progressing further and prevent skin breakage. One of the most dangerous complications from pressure ulcers is the risk of infection.

Stage 1 Bedsore

Constant repositioning helps ensure that no specific body part is under constant pressure, and has time to regain normal blood flow. When a loved one is in bed, they must (or you must help them) reposition themselves every one to two hours, at a minimum.

Bedside rails and other apparatuses can help your loved ones do this themselves. Consider installing one if they are going to be bedridden for a long time.

Adjusting the height and elevation of the bed can also be helpful, but elevations of 45 degrees or more put too much pressure on the tailbone—a high-risk area for pressure ulcers—and should be avoided.

You can also look into using an alternating pressure mattress pad that can lie on top of the mattress. These devices pump individual areas full of air and then release them, causing passive weight distribution by the body and helping to avoid pressure ulcers.

Keep the Area Clean
Once pressure has been removed, you will want to go over the area with a mild soap and water rinse, then clean and dry it completely.

After that, you can consider moisturization, but should consult a doctor for recommended products.

Prevent Further Injury and Progression
Pressure ulcers create areas of very sensitive skin that are prone to shearing with very little force. Ensure that steps are taken to minimize friction on your loved one’s bed, such as powdering the sheets, and prevent unnecessary exposure to pressure.

Clothing must always be kept clean, as well as bedsheets. These are best made of a 100 percent cotton jersey, which is breathable and absorbent.

This also includes managing incontinence. The liquids and bacteria present in urine and fecal matter are very dangerous to open pressure ulcers and risk infection.

Further Stages Of Bedsores
If not given the proper treatment bedsores can progress to later stages, each becoming more threatening and difficult to treat.

Stage 2: The skin has broken, and there may be some dead skin. There could also be a blistered area in the middle of some reddish-pink skin.
Stage 3: The pressure ulcer takes on a cratered appearance, and may reach into the fat layer. There may also be some pus or other drainage.
Stage 4: This stage of bedsore is extremely progressed and dangerous. It can involve muscles, tendons, and possibly bones and joints. A substance known as eschar—dead, sloughing skin that contains necrotic tissue—may slough off of the sore.
Unstageable: While it’s rare in any patient being actively monitored, bedsores can can progress past Stage 4, resulting in a full-thickness tissue loss where the injured area is completely covered with sloughed, dead skin and eschar, all the way down to the bone bed. These pressure ulcers will always require surgical excision and are not always treatable.

When to See a Medical Professional
If your loved one is suffering from an illness serious enough for them to be bedridden, you should already have a medical professional whom you are consulting about most of your care decisions, whether done personally or with a staff.

Specifically for pressure ulcers, medical professionals should be contacted if the ulcer ever breaks the skin; however, it is best practice to inform your doctor know at the very first sign of development. They may recommend simple at-home measures, but should always be informed of the state of your loved one, so that more drastic measures can be taken, if necessary.

When in doubt, call your medical professional. After all, this is the life of a loved one you are dealing with. You may care for them quite a bit, but you don’t have the depth of knowledge (even with internet resources such as this article) to make medical decisions for your loved one.