Almost all besores are preventable. The occurrence of a bedsore is now a "never event"; that is, the treatment will not be covered by Medicare as it is considered a totally preventable occurrence. A bed sore, also known as a pressure sore, decubitus, or skin sore, is caused by reduced blood flow to an area of the skin which results in tissue death. The skin is the largest organ in the body, and maintenance of healthy skin during illness requires preventative measures. The biggest threat to maintenance of healthy skin is prolonged bed rest. In bed rest, the body weight is largely placed on bony prominences such as the sacrum, elbows, and heels. The prolonged pressure on the skin reduces blood supply and leads to tissue death. The first sign of a bedsore is redness of the skin, and the redness does not turn white when touched. If left untreated, the redness will lead to abrasion or blister, followed by an ulcer, and eventually, destruction of all soft tissue in the area.
Prevention includes: 1) daily inspection of the skin, especially the most vulnerable bony areas; 2) use of a sheepskin or air mattress to protect areas that are subject to too much pressure; 3) frequent change of position (at least every two hour in bed and weight shifts every 20 minutes when sitting); 4) maintaining clean and dry skin; 5) use of lotion and massage, especially to the bony prominence; 6) maintaining adequate hydration; 7) maintaining a healthy diet; 8) cessation of smoking; and 9) seeking prompt medical care at the beginning signs of ulcer formation.
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