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Pressure ulcers (also known as bedsores or decubitis ulcers) is an area of skin and tissue that becomes injured or broken down. Pressure sores develop when the skin and underlying tissue is squeezed between a bone and an external surface, such as a bed or chair. The most common places for pressure ulcers are over bony prominences (bones close to the skin), such as the elbow, heels, hips, tailbone, ankles, shoulders, back, and the back of the head. Generally, pressure ulcers occur when a person is in a sitting or lying position for too long without shifting his or her weight. Thus, Anyone confined to a chair or bed is at risk. Incontinence and decreased sensory perception (due to a stroke, for example) also increase the likelihood of developing bedsores. The constant pressure against the skin squeezes the blood vessels that supply nutrients and oxygen to the skin and nearby tissue, causing a decreased blood supply to the area. Subsequently, the skin can no longer survive and dies. Left untreated, nearby tissue begins to die, eventually resulting in an ulcer that reaches the bone, leaving an open cavity with resulting secondary infections that can cause death.
Factors that increase the risk for pressure ulcers include:
Education of at-risk patients and their families is the most productive way to prevent pressure ulcers. Steps toward prevention include:
Bed-bound individuals should be moved at least every two hours. Chair-bound individuals should change positions every 15 minutes if possible. The patient or the caretaker should take care to wash the patient properly, especially if the patient is incontinent. Over-washing, and certain types of cleansers, can irritate the skin, and should be avoided.
A variety of pressure-reducing beds and cushions are available, as are lifting devices that help minimize friction when moving chair- or bed-bound individuals. These include lift sheets, belts, sliding boards and hydraulic lifts.
The National Pressure Ulcer Advisory Panel (NPUAP) created a process for evaluating pressure sores based on a system that spans from Stage I (earliest signs) to Stage IV (most advanced):
The protocol for treating a pressure ulcer is based upon the ulcer’s stage,. In the early stages (Stage 1 and 2), characterized by redness (Stage 1), and blistering and cracking (Stage 2), the area is generally kept exposed, free from pressure, and dry. Gentle massage may facilitate healing. By Stage 3, when the ulcer is a crater-like sore and bacterial infection may be present, treatment may focus on draining and dressing the wound, and using topical ointments to promote healing.
If you or someone you love have suffered from a stage 3 or stage 4 Bed Sore due to the neglect of a caregiver (such as a hospital, nursing home, or assisted living provider), you should immediately contact a competent attorney. The attorney will work with you to determine the legal options that may be available.
Law Office of Joseph A. Hernandez
858 Washington Street
Dedham, MA 02026
Phone: (781) 461-9400