Pressure sores - Causes and Symptoms

Definition

Decubitus sores are lesions with necrotic evolution that appear in hypomobiles or forced to prolonged immobilization in bed, especially when their general conditions are poor.

The ulcers are formed in the parts of the body subjected in a persistent way to a pressure, a condition that causes a sort of impediment to the normal circulation of the local blood, with progressive alteration of the skin and underlying tissues. In the early stages, intact skin reddens and is painful (fixed erythema that does not disappear with digito-compression); other signs indicating the imminent onset of the pressure sores may be swelling, discoloration or heat at the affected area.

Subsequently, a bladder or partial thickness wound appears, which involves the epidermis and / or the dermis. Finally, the lesion tears and becomes, therefore, gradually deeper, until it also involves the underlying muscles and bones.

The appearance of pressure sores is more likely in patients suffering from serious diseases or cognitive deficits, undernourished, paralyzed or in bed in patients for long periods of time. Immobility, due to reduced spontaneous motility (for example, due to sedation or stroke) or due to the difficulty in varying the position frequently due to severe weakness, is one of the most important predisposing factors.

Other conditions that can favor the onset of pressure sores include the continuous rubbing of the skin against rough clothing or sheets (this mechanical stress tends to de-epithelialize the area) and maceration due to heavy sweating or the loss of urine or feces.

Predisposing factors also include malnutrition, mental disorders, systemic infections and some diseases that affect blood circulation, such as diabetes, chronic arteriopathy and venous insufficiency.

The areas most exposed to the development of pressure sores are those adjacent to a bone protrusion and, more often, are the lower back, hips, buttocks, heels and ankles.

Once established, the decubitus sore should be medicated with particular care, choosing products capable of favoring repair.

Prevention is possible both by preventing the patient from maintaining the same position for a long time (for this purpose, mattresses and other anti-decubitus devices are very useful), both carefully treating general and local hygiene. Waterproof materials such as rubber should not be allowed to breathe, and sheets should be soft and well laid out.

To counteract the formation of sores, it is good to change the position of the patient at least every two hours, keeping the skin clean and dry and guaranteeing a healthy and balanced diet.