Bedsores: A Result Of Prolonged Pressure On Skin – OpEd |
Bedsores are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. They commonly develop on areas of the body where bone is close to the skin (e.g., hips, heels, elbows, tailbone). Bedsores form when continuous pressure cuts off blood supply to parts of the body, especially over bony areas. Without blood flow, the skin and tissues don’t get oxygen and nutrients, leading to tissue damage and death over time. They typically occur in people who are bedridden, use a wheelchair, or are unable to change position frequently, such as during hospitalization or long-term illness.
Common causes of the bedsores include: a. Prolonged pressure: Especially on bony areas like heels, hips, sacrum (lower back), and shoulders. Shear: When the skin moves in one direction and the bone in another (e.g., sliding down a bed). Friction: Skin rubbing against bedding or clothing. Moisture: From sweat, urine, or feces — increases skin vulnerability. Poor nutrition and hydration: Slows down skin repair and immune function. Medical conditions: Diabetes, vascular diseases, or paralysis can increase risk. b. Symptoms by Stage: Bedsores are categorized into four stages: Stage 1 (Mild): Skin is red or discolored. May be painful, warm, or itchy. Skin is intact (not broken). Stage 2: Skin breaks open, wears away, or forms a shallow sore. Looks like an abrasion or blister. Painful and tender. Stage 3: Deeper wound that extends into the fat layer. May appear like a crater. Risk of infection increases. Stage 4 (Severe): Deep wound exposing muscle, bone, or tendons. Often infected and may have dead tissue (eschar). Healing is difficult and slow. c. Complications: Infection (cellulitis, sepsis, bone infection). Delayed healing or chronic ulcers, pain and discomfort, and amputation (in extreme cases)
Absolutely — diet and precautions are crucial in both preventing and healing bedsores. Proper nutrition is essential to support wound healing, maintain skin health, and strengthen immunity. a. Key Nutrients include: Protein – For tissue repair and muscle maintenance Sources: Eggs, dairy (paneer, curd), chicken, fish, tofu, dals, beans, nuts, seeds Tip: Include some protein with every meal/snack — it speeds up healing. Vitamin C – For collagen formation and fighting infection: Sources: Amla, citrus fruits (oranges, lemons), guava, tomatoes, bell peppers, kiwi. Tip: Amla juice or lemon water in the morning can help improve absorption of iron too. Zinc – Supports wound healing and immunity: Sources: Pumpkin seeds, whole grains, legumes, nuts, dairy, eggs. Tip: Avoid overuse of zinc supplements unless prescribed. Iron – For oxygen transport to tissues: Sources: Leafy greens (spinach), beets, jaggery, red meat, lentils. Tip: Combine iron-rich foods with vitamin C for better absorption. Healthy Fats – For skin repair and energy. Sources: Ghee in moderation, coconut oil, olive oil, nuts, seeds, avocados. Tip: Avoid hydrogenated oils or excessive fried foods. Fluids – To keep skin hydrated and flush toxins: Goal: At least 8–10 glasses of water daily. Include: Soups, coconut water, buttermilk, herbal teas. Calories – Adequate energy to prevent body from using protein for energy. Ensure regular meals and snacks — include whole grains (rice, roti, oats, poha) and fruits.
Precautions to prevent bedsores include many steps which are essential. Skin Care & Repositioning: Change position every 1–2 hours in bed or every 15–30 minutes in a wheelchair. Use soft cushions, water/air/foam mattresses to reduce pressure. Keep skin clean and dry — especially in areas prone to moisture (groin, armpits, buttocks). Use barrier creams or powders to protect from sweat, urine, or stool. Hygiene: Gently clean with mild soap and lukewarm water — pat dry (don’t rub). Avoid talcum powder in damp areas — can cause irritation or clumping. Mobility & Exercise (if possible): Even small movements or limb exercises (with help) improve blood circulation. Passive physiotherapy can help bedbound patients. Daily Monitoring: Check pressure points (heels, hips, buttocks, elbows, shoulders) for: Redness, warmth, skin changes or blisters, and catching early signs helps prevent worsening.
Recently, there have been several advancements in the treatment of bedsores (pressure ulcers). These combine modern technology with better medical understanding to promote faster healing, reduce infections, and minimize pain. a. Advanced Wound Dressings : Modern dressings are designed not just to cover but also to aid healing: Hydrocolloid dressings: Form a gel that maintains a moist environment. Foam dressings: Provide cushioning and absorb excess fluid. Hydrogel dressings: Keep the wound moist and cool. Alginate dressings (from seaweed): Ideal for wounds with heavy drainage. Antimicrobial dressings: Contain silver, honey, or iodine to prevent infection. b. Negative Pressure Wound Therapy (NPWT): Also known as a vacuum-assisted closure (VAC). A sealed dressing connected to a pump that gently sucks out fluids and infection, promoting tissue growth and blood flow. Very effective for deep or infected stage 3 or 4 ulcers. c. Bioengineered Skin & Tissue Grafts: Involves using synthetic skin substitutes or tissue from donors. Can help close large or deep wounds. Promotes faster healing when the body can’t regenerate skin on its own. d. Electrical Stimulation Therapy: Low-level electrical currents are applied to the wound. Stimulates cell repair and blood circulation. Often used in non-healing chronic ulcers. e. Growth Factors & Stem Cell Therapy: Growth factors like platelet-derived growth factor (PDGF) or epidermal growth factor (EGF) are applied to speed up healing. Stem cell therapy (still experimental in some places) aims to regenerate damaged tissues.
a. Medical Honey and Natural Alternatives: Manuka honey dressings show strong antimicrobial and healing properties. Natural but clinically proven – useful in mild to moderate ulcers. b. Smart Beds & Pressure Sensors: Pressure-relieving beds/mattresses automatically shift pressure points. Wearable sensors can alert caregivers to reposition patients or detect skin changes early. c. Topical Oxygen Therapy (TOT): Delivers concentrated oxygen directly to the wound through a small device. Oxygen boosts healing and fights infection — especially helpful for chronic wounds. In India, the treatment of bedsores (pressure ulcers) has advanced significantly, integrating modern medical practices with traditional remedies. This comprehensive approach ensures effective management and healing of bedsores across various healthcare settings. Leading hospitals, such as Apollo Hospitals, offer dedicated wound care units for the treatment of bedsores. These centers provide comprehensive care, including advanced dressings, surgical interventions, and preventive strategies.