Treatment for Pressure Ulcers

Pressure ulcers, more commonly known as bed sores, develop on areas of a person's body where prolonged pressure cuts off circulation. They are most prevalent on the buttocks, hips and heels. Without sufficient blood flow, the tissue dies. Those most at risk include paralyzed people and anyone who is bedridden, uses a wheelchair or cannot change positions without assistance. Sores are classified into four stages, and your particular treatments will depend on which stage your wound falls under. A complete healing strategy usually combines a number of methods.

Pressure Ulcer Stages

• Bed sores first manifest as an area of reddened skin that itches and feels warm and spongy to the touch. These wounds have not penetrated deeper layers of the skin yet, and resolve themselves soon after the pressure is relieved. This is considered a stage one sore.

  A stage two sore is an open wound that resembles a blister or abrasion. Nearby tissue often looks red or purple. This type of sore causes skin loss down to the dermis, the deeper layer of your skin.

  A stage three sore has invaded tissue below your skin and manifests as a deep crater-like wound.

  A stage four sore is the most serious, with extensive skin loss. The damage usually spreads to your muscles, bones, tendons and joints.

Relieving Pressure

• Regardless of stage, the first thing you need to do is relieve pressure. You should change positions often. If you are in wheelchair, reposition yourself every 15 minutes; if you are bedridden, at least once every couple of hours. If you cannot do it yourself, get someone to help you.

  Cushions, pads, mattresses and beds specially made to relieve pressure on sores and protect your body from further breakdown also are beneficial. Take certain factors into account when determining the most appropriate support for you; these include the extent of your mobility, your body type and the severity of your wound.

Nonsurgical Treatments

• Keeping your wound clean is vital. Mild soap and water is sufficient for a stage one sore, but you need to clean any others with a saline solution each time you apply a new bandage. Do not use hydrogen peroxide or iodine. They can damage the tissue and slow down healing.

  Debridement is a technique that removes dead and damaged tissue; this is necessary for proper wound healing. Surgical debridement involves using a scalpel to remove the tissue. It can be painful and your doctor might opt for nonsurgical removal. Mechanical debridement uses a high-pressure irrigation device to remove the tissue. Autolytic debridement prompts your body's enzymes to break down the dead tissue. The last option is the application of topical enzymes to remove the tissue. Your doctor will determine the most appropriate treatment for you.

  Medicated dressings shield the wound from infection and encourage faster healing. The type of dressing will depend on the extent of the wound.

  A whirlpool bath keeps your skin clean and naturally gets rid of damaged tissue. You will need oral antibiotics if your wound is infected. Eating a diet rich in protein, vitamin C and zinc encourages healing as well.

Surgery

• If the above measures do not promote adequate healing, you will need surgery. The procedure aims to improve the appearance and hygiene of the sore, prevent future infections and address current ones, and reduce fluid loss through the sore.

  The most common procedure involves using muscle, skin or other tissue to cover the wound and cushion affected bones. In most cases, your physician will take the tissue from your own body.