Bed sores - how to prevent them

How do bed sores occur?

Bed sores are likely to occur when an elderly patient has to spend a long time in bed, such as after a stroke or perhaps a spinal cord injury. These chronic sores are usually found over the lower parts of the back, and over the prominences of the legs and ankles.

First signs of trouble are increased redness of the skin, which may later turn darker owing to local blueness of the skin. Eventually the surface of the skin breaks down and an ulcer develops which tunnels through the skin and into the deeper tissues, such as muscles and even the bone. Once the skin is broken, infection sets in, and the ulcer may continue to spread and burrow under the skin in different directions.

How to prevent bed sores

Bedsores are easier to prevent than to cure. Therefore, one must take precautions to avoid injury to the skin. Turn the patient from side to side every hour to prevent long periods of pressure over the same area. Fluffed pillows and rolled blankets should be placed under the knees so that the pressure will come on the bottom of the heel instead of on the back of the heel where the ulcers are more likely to form.

The bed sheets should be tightly tucked in under the mattress. Remember that small hard particles may easily injure the skin. Crumbs should not be allowed to remain in the patient’s bed.

Apply rubbing alcohol to keep the skin surface hard. Finally use a dusting powder containing talcum or zinc stearate, or use a silicon spray to protect the skin. This is particularly important in those areas where pressure is likely to be felt. Remember, elderly patients do not always feel pain. Therefore, you must anticipate their needs and provide the best nursing care possible. When the patient is unable to control his urine, it may be well to consider using an indwelling catheter. Always change the dressings frequently and keep the patient dry.