The term decubitus or decubitus ulcers became one of the most talked-about subjects when a public figure passed away after she had been involved in an accident and partially paralyzed. Decubitus ulcers are said to be the cause of her death. Decubitus is a perilous condition and can lead to complications if there is no adequate care to the wounds. However, chronic wounds that occur due to pressure sores cannot cause sudden death because there are several stages before it reaches the life-threatening stage of complications.
Decubitus and Its Causes
Decubitus ulcers are also known as bedsores or pressures sore. They refer to the skin and soft tissue wounds that occur as a result of constant and prolonged pressure on the skin. These wounds are often found in people with limited mobility, especially in the elderly or patients whose bodies are paralyzed. The limitation makes it difficult for them to change body position so the skin of certain parts of the body will experience pressure and friction over a long period of time on certain objects, such as mattress or wheelchair.
Patients with the following conditions are at risk for pressure sores:
- Neurological disease
- Cardiovascular disease
- Prolonged use of anesthesia
- Lack of nutrition
- Low blood pressure
Parts of the body that often experience pressure sores include:
- Buttocks and hip area
- Spine and shoulders
- Ankles, elbows, and heels
Wound care treatment of decubitus is imperative. If the chronic wounds are left without the required treatment, the more dangerous health risks may appear. Therefore, it is important to know the signs, prevention, and treatment of pressure sores. Decubitus ulcers are often triggered by the cessation of blood flow to the skin due to pressure from body weight. At first, the skin will look red. Over time, if left untreated, lesions will occur due to skin damage and tissue death.
Skin friction on clothing or bedding can also cause pressure sores if it continues to occur, especially when the skin is damp. With proper diagnosis and treatment of the wound, many people who develop pressure ulcers have a great chance to heal.
Why Preventing Decubitus Is Important
Treating pressure sores can take days to several months, even years, to heal. Chronic pressure sores can also be infected because of bacteria. As the infection spreads throughout the body, mental confusion, faster heartbeats, and a feeling of weakness may occur.
That is why it is so important to prevent pressure sores. In addition, a number of complications, some of which are life threatening, may also arise, including:
- Cellulitis: infection of the skin and soft tissues connected to the skin
- Bone and joint infection: infection that can damage cartilage and limit joint function
- Cancer: chronic wounds that do not heal can cause cancer cell carcinoma
- Sepsis: an excessive reaction of the immune system to an infection that can damage organs and tissues
Early Signs of Decubitus
If an individual is prone to pressure sores, efforts need to be made to know the early signs of the appearance of these sores. Examples of signs include:
- Changes in skin color to reddish or purplish blue
- Skin texture becomes softer or harder than the surroundings
- Skin is swelling and feels hot or cold
- Pain in the affected area
- Skin that doesn’t turn white when pressed
- Itchy skin
Degree of Decubitus Wounds and Difficulty in Treatment
Decubitus ulcers are classified into four stages based on severity and degree of difficulty in treatment. This classification is useful for the wound diagnosis and treatment:
Stage I: Skin color begins to change, no sores appear. If the skin is fair, the skin becomes reddish. Meanwhile, if the skin is dark, the color turns blue or purple. The skin may also feel itchy, sore, or burning.
Stage II: Open sores, scratches, or blisters begin to appear. The wounds are red or pink in color. The skin around the wounds may change color. Patients often begin to complain of more severe pain.
Stage III: The wounds are deeper in the skin and look like crater. Pus begins to appear.
Stage IV: The skin is severely damaged and large lesions appear. Muscles, bones, and joints are affected. There is black dead tissue called eschar in the wound.
In addition to the four stages, there are pressure sores that cannot be classified, especially when a lot of tissue is lost and the wound is yellow or green and has pus.
Should Decubitus Treatment Always Be in the Hospital?
It is better to treat decubitus ulcers in the hospital because there are medical personnel who have experience in treating the wounds, especially in stage III and IV. Oftentimes patients who suffer from pressure sores while hospitalized undergo treatment for the sores at the same time. However, treatment can also be done at home for stage I and II wounds.
The focus of decubitus wound care is to reduce skin pressure, control pain, prevent infection, and maintain good nutrition for the patients. The medical team tasked with the treatment usually consists of:
- Doctor in charge
- Nurses or wound care specialists
- Nurses who oversee the treatment of wounds and provide education about wound management
- Physiotherapists to help improve mobility
- Occupational therapist to help the patient positioning the body to relieve pressure
- Nutritionists who will monitor nutritional needs and recommend a healthy diet
Decubitus Wound Treatment at Home
Treatment of pressure sores that can be performed at home is only recommended for stage I and II wounds. The treatment must be really proper to prevent the wound from getting worse and having a dangerous infection. For stage I wounds, carefully and regularly clean the wound area with water and soap with a non-abrasive substance. If necessary, use a moisturizer according to the doctor’s recommendations.
For stage II wounds, use salt water to remove dead tissue that has fallen off. Your doctor may recommend a special cleanser in addition to salt water. Do not use hydrogen peroxide as it may damage the skin.
Cover the wound carefully and change the bandage regularly to prevent infection and keep it moist so it heals faster. The most important thing in treating pressure sores is to consult a doctor first. For a better chance of recovery, patients can be treated at home with the help of an experienced medical team from hospital.