On Thursday 18 November 2021, the International Day STOP Decubitus will take place. The aim is to raise awareness amongst the general public about the issue of decubitus, decubitus prevention, skin care, nutrition, treatment of decubitus including the selection of appropriate cover materials.
Definition of bedsores
A pressure sore (decubitus) is a localized injury to the skin or subcutaneous tissue, usually in the area above the skeletal process, caused either by pressure alone or by pressure combined with shearing force. A number of factors have been suggested as contributing to pressure ulcers, but the seriousness of such an involvement has not been investigated to date.
Prevention
1. Skin assessment/skin care - Skin examination must include an assessment of skin moisture and the presence of cracking, oedema, raised temperature, hardened or softened skin, eczema or rash.
2. Pressure relief/pressure distribution - The first preventive measure should be an evaluation of the mattress or seat cushion used by the person at increased risk of developing pressure ulcers. All persons at increased risk should have a prescribed pressure-distributing or pressure-relieving pad.
3. Activity - The body's natural defence against the development of pressure sores and other complications caused by bed rest is movement. People with reduced sensitivity, paralyzed, suffering from spasms, or unconscious do not respond to their own body's warning signals because of reduced or impaired reactivity or inability to feel pain or discomfort. It is therefore necessary to help these patients to change their body position regularly.
4. Nutrition - Patients who are overweight or malnourished, dehydrated or have a reduced food intake are at greater risk of developing pressure ulcers. They should be given breakfast, lunch, dinner and three snacks to ensure adequate energy intake. The type of food should be tailored to individual needs, for example by adjusting the consistency of the food, or giving food with a high protein and nutritional value.
Treatment of bedsores
Bedsores heal very slowly, normally for a whole year. Those treating pressure ulcers should be very familiar with pressure ulcer management, assessment, recording, treatment planning and the correct choice of dressing. The fewer people involved in the treatment of a single patient, the better.