Bedsores, pressure ulcers & wound therapy

Among the problems that negative pressure wound therapy is regularly used to treat, bedsores are one of the most common.  But what are bedsores? How do they develop, how are they treated and how and why is NPWT used to heal them?

In this article, we’ll take a brief look at these injuries, explain how they develop, explore possible complications, and discuss how and why wound vacs are used in healing them.
 

What are bedsores?

Bedsores – also known as pressure ulcers, pressure sores, pressure injuries or decubitus ulcers – are essentially skin, soft tissue and bone injuries that develop due to prolonged pressure on an area of the body. They’re called “bedsores” because they’re often seen in patients who have limited mobility and are confined for long periods of time to a bed or a chair.

Pressure ulcers can also evolve due to friction – for instance, if a patient is lying in bed and the skin has become fragile and moist, it can be rubbed and damaged by sheets or other fabric.

Pressure ulcers can develop quickly, and they appear most often in places where the bone is near the surface of the skin, such as:

  • On the lower back or at the base of the spine (tailbone)
  • Around the heels or ankles
  • On the elbows
  • On the hip
  • Around shoulder blades
  • On the back of the skull

Unfortunately, pressure sores may look small on the surface, but the damage beneath the skin is often much worse. The blood vessels next to the bone get squeezed, so the muscles and the tissues near the bone usually suffer the most. 

Bedsores are common, especially in hospitals and nursing homes, where patients remain in bed for extended periods of time.  In fact, according to a recent report by the National Pressure Ulcer Advisory Panel (NPUAP), approximately 2.5 million patients develop pressure injuries each year, leading to 60,000 deaths per year due to these injuries and related complications.
 

Early warning signs and complications

One of the first signs of bedsores is a change in skin color.  The skin in the affected area usually starts to look red, purple or blue, and then develops an open sore as the wound develops through the skin and tissue below.

As the sore worsens, dead tissue can lead to drainage and fluid leakage, as well as strong odors, and the patient may develop fever. In the worst cases, deep tissue injury, muscle and bone infection, necrosis and even sepsis can result if sores are left untreated.
 

Treatment options

During early stages, it’s important to move the patient and release pressure from the affected area. The infected area should be kept clean and dry, and patients should increase their intake of water and protein to help with blood flow and healing.

Dead tissue must be removed (this process is called debridement) and regular inspection of the area must be completed. Antibiotics – either topical or oral – are often used to help treat infection while the wound is healing, and dressings should be applied and regularly changed.

Treatment of more serious injuries is challenging. If treated quickly and properly with a process such as negative pressure wound therapy, bedsores can heal within a few weeks, but more serious wounds can require surgery.
 

Negative pressure wound therapy (NPWT) and bedsores

The use of negative pressure wound therapy (NPWT) with a wound “vac” (or vacuum-assisted therapy) has proven to be a highly effective option for the treatment of pressure ulcers. During this process, a suction tube is attached over the wound, along with dressings, to:

  •  Release pressure
  •  Draw away moisture and remove drainage
  •  Help close the wound
  •  Reduce the risk of infection

In short, after the removal of dead tissue, this process takes care of all the necessary requirements for helping the wound heal.

When used properly, negative pressure helps wounds heal within 4-6 weeks at half the cost of surgery. In addition, it removes all surgical risks and potential complications, which is especially important given that nursing home and hospital patients are often poor candidates for pressure injury reconstruction surgeries in the first place.

Have more questions about healing bedsores with wound vacs or NPWT? Contact us today.