DR MAXWELL ADEYEMI

A decubitus ulcer is also known as a pressure ulcer, pressure sore, or bed sore. It's an open wound that develops on the skin caused by a long period of constant pressure to a specific area of the body. Decreased blood flow to these areas leads to tissue damage and death.

People who are older and who have decreased mobility are more prone to bed sores, and if left untreated, infections can spread to the blood, heart, and bones and become life threatening.

For people who use wheelchairs, bed sores commonly occur on the tail bone or buttocks, shoulder blades and spine, as well as at the backs of the arms and legs where they rest against the chair. In patients who are bedridden, bed sores may occur on the back or sides of the head, shoulder blades, hip, lower back or tail bone, the heel, ankles and skin behind the knees.

Decubitus ulcers occur in stages. Each stage may require a different type of treatment and care.

Stage 1

The skin isn't broken, but it's discoloured. The area may appear red, blue or purple depending on the person's complexion. It may also feel warm to the touch, look swollen, be painful, itch, or burn.

Stage 2

A break in the skin reveals a shallow sore or cut that may leak pus. The sore may also look like a blister filled with fluid. It affects the first and possibly the second layers of skin. The ulcer hurts, and the surrounding skin may be discoloured.

Stage 3

The ulcer is much deeper within the skin, affecting the fat layer. Bones or tendons are not visible at this stage. The sore looks like a crater and may be foul smelling.

Stage 4

This ulcer is very deep and affects many tissue layers, possibly including the bone. There is a lot of dead tissue and pus. Infection is likely in this stage, and muscles, bones, tendons and joints may be visible.

Sometimes, it's not possible to measure the depth of a sore or the amount of tissue damage that has occurred, making it difficult to fully evaluate. This may be due to the presence of a hard plaque called an eschar inside the sore, which makes the sore look tan, brown or black. Ulcers can also contain discoloured debris known as slough that may appear, yellow, tan, green or brown. This my need surgical intervention to clean and remove dead tissues.

Symptoms

Each stage of a decubitus ulcer has different symptoms. Depending on the stage, you may have any of the following:

-skin discolouration

-pain, itching, or burning in the affected area

-open skin

-skin that doesn't lighten to the touch

-skin that's softer or firmer than the surrounding skin

-necrosis, or dead tissue that appears black

The sore may also be infected. Symptoms of infection include redness or discolouration surrounding the sore, pus or green-coloured drainage, a foul smell, fever.

Causes

Prolonged pressure is essentially the main cause of a decubitus ulcer. Lying on a certain part of the body for long periods causes the skin to break down. The areas around the hips, heels, and tail bone are es