Decubitus and Pressure Ulcers
From Holoprosencephaly
Decubitus ulcers (Pressure Ulcers)
A pressure ulcer is an injury usually caused by unrelieved pressure that damages the skin and underlying tissue. Pressure ulcers are also called decubitus ulcers or bed sores and range in severity from mild (minor skin reddening) to severe (deep craters down to muscle and bone).
Unrelieved pressure on the skin squeezes tiny blood vessels, which supply the skin with nutrients and oxygen. When skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms. The affected area may feel warmer than surrounding tissue. Skin reddening that disappears after pressure is removed is normal and not a pressure ulcer. The most common places for pressure ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head.
Symptoms
Pressure sores are categorized by severity, from Stage I (earliest signs) to Stage IV (worst):
- Stage I: A reddened area on the skin that, when pressed, is "non-blanchable" (does not turn white). This indicates that a pressure ulcer is starting to develop.
- Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.
- Stage III: The skin breakdown now looks like a crater where there is damage to the tissue below the skin.
- Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes tendons and joints.
Treatment
Once a pressure ulcer is identified, steps must be taken immediately. First alleviate stress from the area and ensure that it has appropriate blood flow. Do not pick at sores or massage affected area.
Follow-up with a health care provider for medications and skin care instructions. This is a serious condition that must be evaluated and treated by a physician to prevent permenant skin damage or long-term complications.
If the skin is bright red and inflammed around the edges or the sore has a foul odor, do not delay seeking medical treatment. These signs most likely indicate serious infection that may lead to sepsis.
Prevention
People who are bedridden or immobile should be checked for pressure sores every day. It is important to change position frequently, use pressure-reducing items, like pillows or sheepskin, perform isometric and isotonic exercises daily, if incontinent, keep area clean and dry and maintain optimal nutrition status
Sources: http://www.ahrq.gov/consumer/bodysys/edbody6.htm
Resources: Article- Home Alone with a Pressure Ulcer Article- Clinical Treatment of Pressure Sores with ROHO mattress
If you have any concerns, please don't hesitate to discuss your concerns with your child's doctor(s).
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