A decubitus ulcer is also known as a pressure ulcer, bedsore or pressure sore. It is a sore that is formed as a result of prolonged pressure of skin against a firm surface. Decubitus Ulcer Treatment depends on its severity.
It often develops on the part of the skin that covers bony areas in the body.
When prolonged pressure is exerted on the skin against a firm surface, the pressure cuts off blood supply to the skin and injures the tissue cells underneath the skin. The skin begins to look reddish. When the pressure is not relieved for a long time, the underlying tissues die and the skin begins to break down leading to open sore.
It is referred to as bedsore because it mostly affects people that lay on the bed or chair for a very long time due to their inability to change positions.
The parts of the body where decubitus ulcer is commonly formed are back, shoulder blades, buttocks, hip, ankles, elbows, heels and tailbone.
Causes of Decubitus Ulcer
Pressure of the skin against a hard or firm surface is the major cause of decubitus ulcer. Other related factors could also make the skin vulnerable, leading to decubitus ulcer.
Such related factors include:
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Friction
When the skin rubs against clothing or bedding for a long time, friction occurs, thus making the skin fragile and vulnerable.
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Shear
When you lie down is a sloppy position, you then to slide downwards. The skin over the bone will move further or away from its original position. This also causes vulnerability and makes the skin fragile.
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Putting on very tight shoes
When you put on very tight shoes, the skin of your toes presses against the shoe. This causes pain and vulnerability of the skin.
Risk factors of developing Decubitus Ulcer
People that are more at risk of developing decubitus ulcer are people that find it difficult to move or change positions. This could be as a result of one ailment or another.
Risk factors for developing decubitus ulcer include:
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Medical conditions
People that are limited to a particular position such as people with stroke or spinal cord injury are at risk of developing decubitus ulcer.
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Poor nutrition
If you don’t eat foods that are rich in protein, vitamins, zinc, and minerals, you are at risk of developing decubitus ulcer. Malnutrition causes the skin to easily break down.
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Diabetes and vascular diseases
Diabetes restricts blood circulation in the body. Lack of blood to skin tissues damages the tissues leading to decubitus ulcer.
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Loss of sensation
when you don’t feel sensations such as pain or discomfort, you will not be aware of the changes happening to your skin.
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Dehydration
When the skin is dehydrated, it lacks water and moisture. Dry skin also leads to increased friction. This causes the skin to easily crack which could lead to sores.
Symptoms of Decubitus Ulcer
The symptoms or signs of decubitus ulcer at its early stage are quite different from the symptoms at its advanced stages.
The symptoms that you may experience depending on the stage include:
- Skin discoloration
- Pain around the affected area
- Tenderness or hardened skin
- Inflammation or swelling of the skin
- Open skin or wound
- Infections
- Advanced stages of ulcer turn greenish or yellowish.
- Pus coming out from the wound
- Foul or bad smell emitting from the wound
Diagnosis of Decubitus Ulcer
Your doctor will first examine your skin to determine if you have decubitus ulcer or not. If it is observed that you have decubitus ulcer, the stage of the ulcer will be noted.
The stage of the ulcer will determine the treatment options that will be best. You may also need to undergo blood tests and other imaging scans.
Samples of the ulcer tissue and fluid to search for availability of bacteria or cancer. You may also undergo blood cultures to evaluate the actual condition of the ulcer.
All these tests and scans will help your doctor know the kind of tissues affected, the condition of the ulcer, and if there is any infection or not.
Treatment of Decubitus Ulcer
Treatment of decubitus ulcer depends on its severity. A non-infected ulcer can be easily treated by cleaning the wound and dressing it up. Infected ulcer needs more medical care and medications.
Below are the treatment options for decubitus ulcer:
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Reducing or relieving pressure
Relieving the pressure off the affected area is the first step to treating decubitus ulcer. You need to periodically change positions if you are lying down on a bed or sitting on a chair.
Try to take periodic walks and evenly distribute your weight to lower the pressure on some parts.
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Use support materials
Use materials that support your skin and prevent friction. You can lay down on a soft mattress or bed. Use pillows to support your head and other necessary areas. Don’t lay down on hard surfaces.
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Eat healthy diets
If your diet lacks some important nutrients such as zinc, protein, vitamins, and minerals, you are vulnerable to decubitus ulcer. Eat food that a highly nutritious especially in vitamins, protein, and minerals.
Treatment options for severe cases of decubitus ulcer require specialized medical care and treatments. They include:
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Clean and dress the ulcer
Remove all the damaged and dead tissues before thoroughly cleaning the wound. This process is known as debridement. Clean the wound with a gentle cleanser and gently dry it up.
You can apply some ointment or medicated creams and then bandage it up. The bandage keeps the wound moist and speeds up the healing process.
Change bandage periodically depending on how fast the ulcer is healing.
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Medications
You can take nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen sodium to reduce inflammation and pain.
Topical or oral antibiotics are also being taken in case there is an infection.
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Negative pressure therapy
Also known as vacuum-assisted closure is used to clean the ulcer.
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Surgery
Surgery is needed in extreme cases. When the wound is not healing after a very long time or getting worse, surgery might be the last option.
Your doctor might cut out a part of your skin or tissue from other parts of your body and use it to cover up the wound.
