Saturday, April 14, 2012

BEDSORES
(DECUBITI)
Bedsores (decubiti) may occur when your patient is confined to bed for long periods of time.  These are caused by the blood supply being interrupted to part of the body, such as sleeping on one side all the time with the elbow on the sheets.  Usually the sores will appear in the skin areas over the body prominences of the body that come in contact with the bedclothes.  First the skin breaks down and a red spot will appear.  You must take care of these red spots before they become bedsores, which are very difficult to heal.
     Many factors can contribute to bedsores, including moisture, especially urine.  Even wrinkles in the bedclothes can irritate the skin sufficiently to create sores.  The skin is very delicate and care should be taken not to pull or tug on the skin, such as by removing the bedpan too fast.
     When you bathe your patient, you should watch for red spots that could turn into bedsores.  When you press on a red spot or pressure point, it will turn white and as you release your pressure it will return to red.  As it progresses to a bedsore, the skin turns a purplish red color and becomes rough, like a chapped area.  If not treated, the skin will break and become a sore.
     To prevent this from happening, a bedridden patient should be turned every two hours to a new position, so the pressure is changed to a different part of the body.  Gently rubbing the affected area with alcohol or lotion will help to stimulate circulation, thereby bringing needed nutrients to the affected area.  If your patient is large or obese, especially a woman with large breasts, special care should be given to these portions of the body.  When bathing the patient, be sure to get between the folds of skin and dry them carefully, then apply powder to relieve friction.
     It also helps to have an “egg-crate” mattress placed on the patient’s bed in ease pressure.  This is a piece of sponge rubber formed like an egg carton.  It keeps air in spots and doesn’t let the body settle completely onto the mattress.
     Sheepskin placed on the mattress also makes the patient more comfortable.  Anything soft and cushioned under the sore areas will relieve the pressure and assist the body to repair the damaged areas.
     A good back massage before retiring will also help with the circulation and relax the patient for a more comfortable sleep.  Be sure to report any red areas to the doctor, so  he can check them before they go too far.

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