Bed Sores or Pressure Sores: Causes, Symptoms and Common Sites

What Are Bed Sores or Pressure Sores or Decubitus Ulcer?

Bedsores or pressure sores (known as Decubitus ulcer) are the localized injury to the skin and or underlying tissue that occurs in a bed-ridden patient over a bony prominence area due to as a result of prolonging unrelieved pressure, or pressure in combination with shear which hampered circulation.

Common sites of bed sores or pressure sores
Fig: Common sites of bedsores or pressure sores

Shear occurs when the when forces moving in opposite directions are applied to tissues in the body. This can happen when patient slide down in bed or transfer patient’s weight from one surface to another and skin is stuck to a surface, such as a bed, while gravity forces the body down on the bed.

The tissue of that part becomes gangrenous or dead and the skin breaks down causing an ulcer. Most often bed sores develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone.

Causes of Bed Sores or Pressure Sores:

There is two number of contributing factors that are associated with pressure ulcers. I have explained the significance of these factors below.

  • The direct or immediate cause,
  • Indirect or predisposing causes.

Direct or Immediate Causes of Bed Sores or Pressure Sores:

All the factors listed below as direct or immediate cause of Bedsores or pressure sores:

  1. Crumbs or creases in bed,
  2. Rough handling of linen and bedpan,
  3. Hard surfaces of plaster cast and splints,
  4. Dirty and wet clothing,
  5. Same position for a long time,
  6. A pressure of clothing and other things,
  7. Poor back care,
  8. Friction or rubbing of the skin,
  9. Moist skin – for example, due to sweating or incontinence,
  10. Use a wheelchair or stay in bed for a long time,
  11. Shearing forces,
  12. Excessive perspiration,
  13. Wound drainage.

Indirect or Predisposing Causes of Bed Sores or Pressure Sores:

Following those indirect or predisposing cause lead Bedsores or pressure sores:

  • Older adult,
  • Long lying patients( immobility),
  • Helpless and paralyzed patients( inactivity),
  • Unconscious patients,
  • Fecal or urinary Incontinent patients,
  • Very thin or very fatty patient,
  • Patients with edema,
  • Malnourished patients,
  • Lack of fluid (dehydration),
  • Immunodeficiency,
  • Diabetes or Vascular disease that affects blood flow,
  • Progressive neurologic disorders (Alzheimer disease, Parkinson disease, multiple sclerosis),
  • Have fragile or dry skin,
  • Smoking, alcoholism,
  • Corticosteroid use,
  • Cancer Malignancies,
  • Muscle atrophy,
  • Spinal cord injury,
  • Traumatic brain injury,
  • Fracture,
  • Poverty or lack of access to food,
  • Weak sense of smell or taste,
  • Depression or psychosis,
  • End-stage renal disease,
  • Dementia.

Signs and Symptoms of Bed Sores or Pressure Sores:

Various sign and symptoms of  pressure sores are listed below:

  1. Discoloration and redness,
  2. Heat, pain, and tenderness in the affected area,
  3. Burning and discomfort in the area,
  4. The area becomes cold to touch and insensitive,
  5. Local edema also present,
  6. Infection,
  7. Open skin(an open wound or blister),
  8. The affected area becomes softer or firmer than the surrounding skin,
  9. Changes in texture, such as rashes, dryness, or swelling,
  10. Cracks, scabs, and blisters,
  11. A difference in skin temperature from the surrounding.

Common Sites of Pressure Sores or Bed Sores:

When a person is bedridden, pressure sores can occur in several areas, Common pressure sores sites includes-

  • Rims of the ears,
  • Over the back or sides of the head (Occiput),
  • Over the shoulder blades and spine,
  • Scapula,
  • Elbow,
  • Ischial tuberosity,
  • Sacrococcygeal region,
  • Heels, ankles, and skin behind the knees,
  • Greater trochanter,
  • Pelvis.

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