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Bed Sores – Causes and Symptoms of Bed Sores

Bed Sores are ulcers that occur on those areas that are extended to extreme pressure for long periods of time. This pressure can be a result of lying in bed for a long period of time, sitting in the wheel chair or cast application for a prolonged period of time. This usually occurs when a person is unconscious, bedridden and is unable to sense pain or when the person is immobile. These sores are found in the hips, back, elbows, ankles and heels and they can spread deeper into the muscles.

Causes of Bedsores:
The causes of bed sores are:

  • Sustained Pressure: When the skin and the underlying tissues are in contact with a surface like bed or wheelchair, then blood flow gets restricted and this reduces the supply of oxygen and other nutrients that are required for the growth of the tissue. This leads to the death of the tissue.
  • In some cases, the pressure that stops the circulation comes from sources like rivets, crumbs in the bed, perspiration, wrinkled sheets or clothing. These can soften the skin  making it more susceptible to sores.
  • Friction: Friction is the rubbing of the skin with any material that is in close contact with it for a prolonged period of time. Frequent changing of the position is the main way to prevent bedsores.
  • Shear: This happens when the skin moves in one direction and the underlying bones move in another. Sliding in a chair, bed or elevating the head end more than 30 degrees causes shearing. This results in the tear of the tiny blood vessels and the cell walls. This affects the tailbone, where the skin is thin and fragile.

Other Causes of Bed Sores
The other causes for Bed Sores include:

  • Age: Older people have thinner skin, making them more susceptible to damage. Old people with serious problems like underweight, poor nutrition can be more prone to develop sores.
  • Nursing Homes: Old people who are being taken care of in nursing homes are more prone to pressure sores than those people who are hospitalized or those cared at home.
  • Lack of Pain perception: Injury to the spinal cord and other diseases that cause a loss of sensation can also be one of the cause for pressure sores. When there is no sensation, a person may not know when to change the position and this can result in sores.
  • Weight loss: When a person is sick or hospitalized, muscle wasting or atrophy is a common problem. This occurs in people with paralysis and this can cause loss of fat and muscle because fatty tissues act as a cushion for a normal person.
  • Malnutrition: Poor diet can result in pressure sores.
  • Urinary or Fecal Incontinence: Those people suffering from bladder problems can increase the risk of pressure sores as the skin is moist, which makes it more prone to break down. This causes severe infection and bacteria from fecal matter can lead to serious local infections and life-threatening complications like gangrene, sepsis and narcotizing fasciitis, which is an infection that spreads rapidly.
  • Medical Conditions: Some of the health problems like diabetes and diseases of the blood vessels can also increase the risk of damage to the tissues.
  • Smoking: People who smoke develop severe wounds and the healing process is very slow. It impairs the circulation that results in reduced blood supply to other parts of the body.
  • Decreased Mental Awareness: People who suffer from mental trauma or psychiatric illnesses are also more prone to pressure sores, but care can be taken to prevent these sores.

Signs and Symptoms
The signs and symptoms of bed sores depend upon the stages of bed sores. There are four stages. They include:

  • Stage-1: The sore begins as a reddened patch that can hurt and cause itching. When the area is touched, it is warm and spongy or sometimes very firm. The stage 1 wound is superficial and reduces once the pressure is relieved.
  • Stage-2: In this stage, the skin loss starts from the outermost layer and the dermis (the deeper layer of the skin). It is an open sore and looks like a blister or an abrasion. The surrounding area may show red or purplish color discoloration.
  • Stage-3: By this time, the damage has occurred to the tissue below the skin that creates a deep, crater-like wound.
  • Stage-5: This is the most advanced stage and loss of skin takes place along with damage to the underlying skin and to the supporting joints and tendons.

Site for Pressure sores:
The common site for bed sores include:

  • Shoulder blades and spine
  • Tailbone or buttocks
  • Back of your legs and arms

If bed ridden, pressure sores can occur in the following areas. They include:

  • The back of your head or sides
  • Rims of the ears
  • Hip bones
  • Backs or sides of the knees, ankles, heels and toes.

When to consult your Doctor?
Contact your doctor when you notice a sore that is in its first stage. Get medical care immediately before the bedsore gets complicated.

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