Pressure sores from immobility
Decubitus ulcers also known as pressure sores are caused by constant pressure being exerted on the same part of the body. A lack of blood circulation gives rise to rashes and sores that initially only affect the skin. If pressure sores are left untreated, they can spread as far as the bones. Most at risk are quadriplegics, as they cannot feel pain in the paralyzed part of their bodies.
What are decubitus ulcers?
Decubitus ulcers are pressure sores caused mainly by continuous lying or sitting. The neuralgic points are the bottom, back, arms, knees and feet. Pressure sores are caused by poor circulation due to constant pressure being exerted on the affected area of the body. This causes the tissue to die. Initially this is indicated by a reddening of the skin or small lumps or dark spots, which at first sight appear harmless. However, decubitus ulcers can degenerate very quickly. If the pressure sore is left untreated, it quickly reaches the subcutaneous tissue. After that it affects the tendons and muscles. In extreme cases the damage can even enter the bones.
Who is at greatest risk from decubitus ulcers?
Most at risk are older people who suffer from poor circulation. The blood circulation in the skin is also affected by diet, over-consumption of alcohol, and smoking. The overweight are also at risk, as are the very underweight. Diabetes affects wound healing and increases the risk of small injuries turning into pressure sores. Likewise, varicose veins and other vein disorders increase the risk of decubitus ulcers. Some drugs can also affect skin blood circulation and wound healing. However, the greatest risk of disease is immobility.
How can decubitus ulcers be prevented?
Quadriplegics are particularly affected by pressure sores. Because they can no longer feel pain in the paralyzed parts of their bodies, unlike healthy people they do not intuitively know that they need to change their sitting or lying position. Because quadriplegics often spend the whole day sitting down, the buttocks are most at risk. Special cushions and bed supports are not sufficient to prevent pressure points developing. Quadriplegics must learn in the rehabilitation clinic how to reduce the risk of decubitus ulcers themselves. One important measure is for them to get used to regularly changing their sitting position, for example by lifting up their body using their arms. Other prevention measures including ensuring that clothing, and especially shoes, do not pinch anywhere. It is very important to check the skin regularly, something the patient can do themselves with a mirror.
What is the treatment for decubitus ulcers?
If a quadriplegic notices a seemingly harmless-looking injury or reddening to the skin, it is essential that they seek treatment fast, as pressure sores can spread extremely quickly. The affected skin area must be given immediate relief. Often the only way to do this is for the patient to lie down for a long time - usually on their stomach. The wounds caused by the decubitus ulcer must be treated carefully by expert medical staff. With surface wounds it is sufficient to cleanse the affected skin and apply special dressings. If the wound has gone deeper, it has to be surgically cleaned. A special bandage that stimulates the blood circulation and encourages the reconstruction of blood vessels can help to heal the wound. This can take several weeks. Unfortunately, the scarring caused by the wound healing creates the risk of another pressure sore appearing in the same place.
Author: Silvia Minder
Edited and translated by PmcC - MyH