November, 1, 2004

Family  Health,

Pressure Ulcers - Serious Health Threat for Wheel Chair Bound and the Elderly

Glen Cove, NY - The serious problem of pressure ulcers also known as bedsores, recently came to light when Christopher Reeve developed a systemic infection resulting in heart failure that started with a bedsore.

Patients like Mr. Reeve who have limited movement as well as the elderly, and those suffering with diabetes, renal failure and other systemic conditions, are especially susceptible to these types of wounds, and must be checked thoroughly and often by health care professionals to prevent this problem.

Pressure ulcers often develop on the skin over bony areas where there is little cushioning between the bone and the skin. Such as the lower back, the tailbone, along the spine, the buttocks and  the heels. Other affected areas include the back of the head, the backs of the ears, shoulders, elbows and between the knees where the legs come together.

According to Dr. Tharakaram Ravishankar, an endocrinologist and the Director of Medicine at the Glen Cove Center for Nursing and Rehabilitation, ∏Pressure ulcers are on e of the most common ailments acquired during a long stay of inactivity. It∂s vitally important for health care professionals to recognize the signs of a pressure ulcer because they start out harmlessly, but can be deadly. At the first sign of redness, the skin must be examined and monitored, and the sitting or prone position of the patient must be altered to take the pressure off the offending area.

Caused by unrelieved pressure that impedes circulation, friction from being pulled across bedsheets, or shear from sliding down in a bed or chair, pressure ulcers range in severity from Stage 1 through Stage 4 with the following symptoms:

Stage 1: Skin may appear reddened or darker than normal or look like a bruise and feel warm to the touch. Sores can be painful and tender, but the skin is not broken or torn. When the sore is pressed and released, the skin does not return to normal color for more than 30 minutes. (With normal skin, color will return to normal within seconds after pressure is stopped.)

Stage 2: The outer layer of skin actually tears or breaks and forms a tender, painful abrasion or blister. The sore is now expanding in the deeper layers of the skin.

Stage 3: The sore worsens, widens and deepens into the tissue beneath the skin forming a small crater. Due to significant tissue death, there is little pain at this state, but the risk of infection becomes increasingly dangerous. At this stage, there may be some skin damage beyond repair or necrosis.

Stage 4: The pressure sore is very deep by this stage, killing additional tissue and reaching into muscle and bone causing additional damage. Without intervention, there is risk of serious complications, bone and systemic infection and death.

Dr. Ravishankar is available to discuss the problems and treatment of pressure ulcers and offers the following preventative measures:

* Inspect skin daily, especially around bony areas such as the lower back, the spine, the hip, the buttocks, elbows, knees, heels and the back of the head.

* Keep skin clean and free of sweat, bodily fluids and secretions, and wash body with a mild soap being careful not to rub too strenuously.

* Provide good nutrition through a health balanced diet.

* Alter the position in which a person is sitting or laying down frequently - every hour - and make a conscious effort to vary the time and intensity of pressure on various bony areas of the body.

* Utilize pressure relieving devices, cushions, foam rubber and sheepskin to reduce the incidence of pressure sores.

* Keep the incapacitated person as active as possible.

* Learn to recognize pressure sores when they appear, and contact a doctor or health care professional immediately upon discovery.