Sabine Schrör is a freelance author of lifelikeinc.com. She studied Business Administration and Public Relations in Cologne. As a freelance editor, she has been at home in various industries for more than 15 years. Health is one of her favorite topics.More about the lifelikeinc.com expertsbedsore is the medical name for a pressure sore. Colloquially, one also speaks of bedsores. The cause is permanent, heavy pressure that can damage the skin and underlying tissue down to the bone. Bedridden people and wheelchair users are particularly prone to pressure ulcers. With a careful prophylaxis, the pressure ulcers can be avoided. Read all important information about the development, treatment, prophylaxis, diagnosis and course of pressure ulcers.
ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. L89ArtikelübersichtDekubitus
- Examinations and diagnosis
- Course and prognosis
- What is pressure ulcer? Pressure ulcer, which occurs especially in places where bones are close to the surface of the skin (buttocks, elbows, heels, ankles, etc.). Above all, those affected are largely unable to move, bedridden patients and wheelchair users.
- Reason: Persistent, strong pressure that squeezes the blood vessels. Affected tissue is poorly supplied with blood, acid metabolites are no longer transported away and gradually destroy skin, tissue and bones.
- Risk factors: Long, motionless sitting or lying, thin, less elastic skin, diabetes, reduced sensitivity to pain, low body fat, incontinence, certain medications, obesity, lack of care, malnutrition, existing skin diseases and irritations.
- Treatment: moist wound dressings and regular cleansing. Removal of dead tissue. If the pressure is high, surgery may be necessary. It is also important to eliminate the cause of the pressure ulcers, such as pressure-relieving aids (anti-decubitus mattresses or seat cushions), regular repositioning, etc.
- Possible complications: The wound can infect and then cause complications such as bone marrow and bone inflammation, pneumonia, bone abscesses or blood poisoning.
- Prophylaxis: Anti-decubitus aids (foam mattresses, gel or air cushions, sheepskin pads, special seat cushions for wheelchair users, etc.), regular transfer and mobilization of bedridden patients, frequent changes of clothing and bedding, skin care, balanced nutrition, adequate hydration etc.
- History and prognosis: Lengthy healing process even with optimal treatment. Increased risk of relapse after successfully treated bedsores. Therefore, physicians recommend a careful prophylaxis and the earliest possible treatment of pressure ulcers.
Pressure ulcers: description
A pressure ulcer (decubitus, decubitus ulcer) is a localized damage to the skin, the underlying tissue and in extreme cases, the bone. It shows up in the form of a different deep, permanently open wound (eg on the buttocks, tailbone or on the heels). Especially bedridden people are affected. Experts estimate that about every tenth to thirtieth patient in the hospital develops a pressure sore. In nursing homes, it is even 45 percent. Even wheelchair users have an increased pressure ulcer risk, especially in the buttocks area.
Pressure ulcers are very painful, In addition, they can infect, A first indication is one unpleasant foul odor from the wound, On the psychological well-being, the pressure sores can affect. Because they restrict the patients in their daily lives. The persistent, painful wounds can even lead to depression.
Pressure ulcers: graduation
A pressure ulcer changes the skin. Depending on how strong the changes are, there are different degrees of severity:
- Decubitus grade 1 (stage I): In the initial phase, the affected skin reddened and sharply separated from their surroundings. The redness persists even when the pressure subsides. The area may be hardened and warmer than the surrounding skin, but the skin is still intact.
- Decubitus grade 2 (stage II): In decubitus grade 2, blisters have formed on the skin. Sometimes the uppermost layer of skin is already detached. The result is an open wound, which is still superficial.
- Decubitus grade 3 (stage III): In pressure ulcer grade 3, the pressure ulcer extends to the muscles under the skin. You can see a deep, open ulcer. Beneath the healthy skin in the marginal area of the decubitus are sometimes "pockets" that emanate from the ulcer.
- Pressure ulcer grade 4 (stage IV): In a stage IV pressure ulcer, one looks at exposed bones. Skin, muscles, bones and other structures such as joints or tendons are destroyed.
Where decubitus is particularly easy to form
Some parts of the body are particularly sensitive to pressure, so that decubitus can develop quickly there. Endangered are areas where bony prominences are directly under the skin, without being protected by fat or muscle tissue. Examples of this are buttocks,the big rolling hills (trochanters) on the outside of the thighs,ankleandHeels.
In the supine position, decubitus most commonly occurs on the buttocks, over the coccyx and on the heels. In lateral position are usually affected the rolling hills of the thighs and ankles. Rarely, decubitus develops on the ears, back of the head, shoulder blades or toes.
Basically, pressure ulcers form less frequently in lateral or prone position. An exception is prolonged prone surgery, which can cause pressure sores on knees, on the face (forehead and chin), on the toes or in the pubic area.
Pressure ulcers: complications
If a pressure sore is not treated quickly, it spreads to deeper tissue layers. The tissue dies (Necrosis) and must be surgically removed. In addition, the wound can be infect, If the infected ulcer is already in the bone, the pathogens can also spread there. It can become one Bone inflammation (Ostitis) and Bone marrow inflammation (osteomyelitis) develop. If the germs spread further in the body, this can be one Pneumonia, bone abscesses or one Blood poisoning (sepsis) trigger.
Also deficiency These can be the result of decubitus if it spreads extensively on the skin. Because then the affected person permanently loses important minerals and proteins via the open wound.