Bed sores (pressure sores)

Bed sores are caused by the loss of blood supply to the skin due to continuous pressure on the affected parts. Over time, the skin and underlying tissues can die from the lack of blood flow.

Those who are most prone to bed sores include people who are bedridden (even for a short time), and those who use a wheelchair.

Older people are more vulnerable to bed sores than young people, as the skin becomes more delicate as we get older and the efficiency of wound healing declines. Additionally, older people are more likely to be underweight, reducing the amount of padding over their bones.

Other risk factors include:

• Needing a high level of care
• Being immobile, or being able to sit or lie in only limited positions
• Being unable to perceive pain
• Being in poor physical or mental health
• The skin being either too dry or too moist
• Being incontinent (because of the presence of moisture on the skin)

Having a poor diet is associated with more frequent bed sores, and increases both the likelihood they’ll become infected and the amount of time it takes them to heal. People with inadequate levels of protein, vitamin C or zinc are considered particularly vulnerable.

• The prevention and treatment of bed sores requires an ongoing management plan for the patient and any caregivers to follow. The following is intended as supportive therapy only, and is not intended to replace medical advice.
• Taking a multivitamin and mineral supplement may help to prevent nutritional deficiencies when dietary intake is inadequate. For older people, it may be particularly beneficial to choose a product that has been specially formulated to support the immune system and help support skin repair and wound healing.
• Vitamin C plays a role in collagen production, and consequently may support wound healing.
• Zinc is essential for the maintenance of healthy skin, and supports skin repair and wound healing. It also plays a role in healthy immune function.
• Grape seed may help protect against the breakdown of collagen and elastin in the skin, and may help to promote wound healing.

• The skin should be checked for redness or other changes at least once a day. Consult your healthcare professional if any changes are detected, and follow their advice for cleaning and treating the wound.
• Work with your healthcare team to develop a prevention plan against bed sores. The plan will likely include regular position changes, the use of supportive devices, a healthy diet, and a regular skin care regime.
• It is recommended that patients who are restricted to bed are moved every two hours throughout the day and night. For those in a wheelchair, movement should occur every 15 minutes.
• Avoid lying on your hip bones.
• Lying on soft pillows may help to relieve areas of pressure.
• Use moisturisers to keep skin supple.
• Follow good hygiene practices.
• Ensure that both the patient and their bedding are clean and dry, as damp skin is more vulnerable to damage. A light sprinkling of powder on the sheets may help to reduce friction.
• Stop smoking. It increases your risk of developing pressure sores, increases their severity, and delays their healing.
• Work with your healthcare team to ensure that any additional health problems that may affect your circulatory health are well managed (for example diabetes).
• Include some protein in your diet every day, as protein malnutrition is associated with an increased risk of bed sores.  Protein powders or liquids may be suitable for those with impaired digestion.
• Vitamin C and zinc are also particularly important for the prevention of bed sores. Vitamin C is present in a wide range of fresh fruit and vegetables, while the best sources of zinc are animal foods such as meat, eggs and seafood.

• Bed sores can be extremely serious. Check the skin for discolouration regularly, and discuss any concerns with your doctor or healthcare team as quickly as possible
• Don’t massage the bony parts of the body, as the skin in these regions is extremely delicate and prone to damage.