Pressure ulcers, commonly called bedsores, are a big problem in the United States. More than 2.5 million Americans develop pressure ulcers every year, and about 60,000 people die each year from pressure ulcer complications.
High-profile cases highlight how deadly they can be. Actor Christopher Reeves died from complications resulting from a pressure ulcer.
“This is not just a problem for patients and their families, but also health facilities,” said Joyce Black, an associate professor in the University of Nebraska Medical Center College of Nursing recognized as a national expert in pressure ulcers. “The government won’t reimburse for Medicare and Medicaid expenses if patients get pressure sores.”
Pressure ulcers can develop in as little as three hours as a result of sitting or lying too long in the same position, Black said. Those who are bedridden are most at risk, including those in hospitals and long-term care facilities like nursing homes. The problem can occur in the home, as well.
“Ulcers develop quickly depending on how hard the surface is that you’re on and how much fat padding a person has. Thin, frail individuals develop them more quickly,” Black said.
She said pressure ulcers develop due to pressure on the soft tissues when patients don’t move, or continuously slide down in a chair. The blood in the area stops and the tissue dies. Most problems with ulcers occur on the buttocks, tailbone and the heel of the foot.
Early symptoms include pain, redness or a purple color to the skin.
“Getting pressure off that part of the body is absolutely key,” Black said. “The sores result from lack of blood. Changing positions in bed and keeping the skin clean is the best way to prevent pressure ulcers.”
Some pressure ulcers advance into large wounds that develop deep in tissue. When the skin gets infected, a hole in the skin can develop and reach down to the bone. Surgeries to repair major wounds can cost up to $100,000.
The estimated cost of pressure ulcers is $11.5 billion per year in the United States, with cost for patient care ranging from $21,000 to $152,000.
The Journal of the American Geriatric Society estimates that an average 4 percent to 5 percent of patients develop pressure ulcers during a hospital stay, and the number is higher in long-term care facilities: 23 percent.
Black has these tips for preventing and treating minor pressure ulcers:
1. Sit or lie in different positions, and walk if you can.
2. Stay off the sore spot until the pain or color of red or purple goes away.
3. Put a pillow under the calf of the leg to keep the heel off of the bed.
4. Don’t rub the skin, as it may tear.
5. Keep skin clean. The healthier you can keep skin, the less chance of skin breakdown.
6. Make sure diapers get changed.
7. Turn bedridden individuals every three hours if they’re on a good mattress, or every two hours if mattress is thin, frayed or worn.
8. Cover wound with dressing or apply topical antibiotic to keep wound clean.
9. Ask what care facility staff is doing to reduce or prevent bed sores, and if you can help.
10. Ask how caregivers are turning your loved one to get them off their back (individual should be turned on their sides, and family members can help).
11. Ask what kind of mattress the patient is sleeping on. An old spring mattress with only an inch of padding is not adequate.