What Causes Bed Sores & Pressure Ulcers?
As I discussed in my Pressure Ulcer Primer, the primary cause of bedsores (also known as pressure ulcers, decubitous ulcers, or pressure sores) is staying in one position for too long without shifting your weight. Just as the label suggests, PRESSURE is the critical factor causing these wounds. In a nursing home setting this equates to the home not having either not enough staff or poorly trained staff and does not turn/shift the patient to move the pressure around. The National Pressure Ulcer Advisory Panel says, and it is common sense to be sure, “prevention is the best solution to the pressure ulcer problem.” The panel also says, and this is very important in nursing home neglect cases, “most pressure ulcers are preventable.”
Risks
There are also several factors (i.e. negligence) which are usually associated with how bed sores develop. They are:
- Bowel & Urinary Incontinence - Everyone knows what happens when they stay in the bath or swimming pool too long. Your skin gets really soft. Skin softened by moisture, in this case urine or feces, can become susceptible to pressure or tearing. And once the pressure ulcer develops into an open wound you know what can happen when you put dirt into them - infection. The buttocks is one area that is especially susceptible to pressure ulcers and incontinence. In fact, a 1999 report put 70% of all bed sores in this area. Residents who cannot control their bladder or bowel will be sitting in filth at the same time the pressure of being bedridden is applied to their skin. That is why experts and nursing home attorneys will tell you bad bed sores are evidence of poor, negligent care. Nursing homes may be liable for not controlling reversible incontinence and/or for not using materials that will wick moisture away from the patient’s skin.
- Malnutrition - nutrition is important for maintaining healthy skin and tissue below the skin. As you read about in the Primer, pressure starves the skin of nutrients. Thus, you want to make sure the skin is getting all that it needs to stay intact. Proper nutrition makes the skin vulnerable to trauma and also delays wound healing.
- Diabetes or Vascular Disease - This is going to be what the defense attorney will say caused the bed sore or made in unpreventable. (I should know, I used to be one!). They will argue skin breakdown was caused by disease and not pressure. This is an extremely complicated medical issue and is one I will devote a whole separate article to at some point.
Posted by
David Brauns
on Apr 17th, 2009 and filed under
Bed Sores & Pressure Ulcers.
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