Decubitus wounds

Decubitus ulcers, also called bedsores or pressure ulcers, are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin.

They appear most often on the skin that covers bony parts of the body, such as the heels, ankles, hips and tailbone.

People at highest risk of developing bedsores are those who have acquired medical conditions that limit their ability to change body positions, requiring them to use a wheelchair , to move around or spend too much time in bed.

Bedes sores develop quickly and are difficult to treat.

What are the symptoms?

I stage

• The surface of the skin is not compromised;
• It appears reddened in people with a lighter complexion, and when lightly pressed the affected area feels too soft;
• People with darker complexions experience discoloration and are also overly soft to the touch, creating a clammy feeling like trench disease;
• The affected area may also be tender, painful, hard, or soft, warm or colder than the surrounding.

II stage

• The outer layer of the skin /epidermis/ and part of the actual skin layer /dermis/ is damaged or completely missing;
• However, the wounds are usually superficial with a pink or red color;
• The wound can to look like a bubble filled with a clear liquid or to represent a ruptured vesicle;

III stage

In this phase, the ulcer represents a deep wound:

• Skin loss makes some subcutaneous fat directly visible;
• The ulcer resembles a crater;
• There may be yellowish dead tissue at the bottom of the wound;
• The lesion may spread and to cover the inner layers and healthy skin surrounding the wound.

IV stage

At this stage, the type of ulcer shows a great loss of tissue:

• Muscles, bones or tendons may be visible from the wound;
• The bottom of the wound will most likely contain dead tissue that is yellowish or dark in color and is crunchy to the touch.

Most common localizations of bedsores

In people who use a wheelchair, they most often occur in:

• The tailbone or hips;
• The shoulder blades and spine;
• The back of the arms and legs where they rest on the wheelchair;

The most characteristic locations of bedsores in people who are limited in their movement within a bed are:

• The back or sides of the head;
• The ends of the ears;
• The shoulders or shoulders;
• The flank, lower back or tailbone;
• The heels , the ankles and the skin behind the knees;

If you notice the first characteristic manifestations of bedsores, change your position to relieve pressure on the site of their possible appearance.

If you do not notice improvement within 24-48 hours, contact your doctor.

Seek immediate medical attention if you notice signs of infection, such as fever, fluid leaking or a foul smell from the wound or fever or redness of the surrounding skin.

Treatment of decubitus wounds

When the wounds are in stage I or II they usually heal within a few weeks to several months after their appearance with standard conservative care and by maintaining good general state of health.

But in phase III and IV bedsores become very difficult to treat, requiring the adoption of a multidisciplinary approach.

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