A decubitis ulcer refers to bedsores or pressures ulcers that occur when pressure is placed upon the skin, muscle, soft tissue, and bone. When the weight of a person presses against a surface beneath them, skin can start to break down. Typically, a decubitis ulcer affects those who are in poor health, bed bound, incontinent, and elderly. In addition, individuals who cannot reposition themselves at least every two hours, are also at risk for a decubitis ulcer.
Typically, impaired mobility prevents a person from changing position as necessary, which increases the risk of skin breakdown. In addition, those patients who are neurologically impaired, have dementia, or are heavily sedated are especially at risk. People who have pre-existing conditions, such as diabetes, are prone to a decubitis ulcer, and having diabetes can further delay wound healing. Bedsores are generally categorized as being mild to severe. A severe, or stage IV decubitis ulcer can affect muscle and bone and cause gangrene. Treatment for a decubitis ulcer depends upon the stage of the wound and the overall physical and mental condition of the patient.
Wound healing generally cannot begin until pressure is taken off the decubitis ulcer. In addition, the the area of skin breakdown needs to be kept clean and free from irritating urine and feces. Stage I pressure ulcers, or mild bedsores, generally respond to topical preparations such as petroleum jelly or diaper rash cream. More severe cases might require more powerful preparations that have the potential to slough off dead skin, while regenerating new skin. Sometimes, in severe cases, surgical debridement will be necessary to remove dead tissue and prevent gangrene from developing. Also, oral or intravenous antibiotics are necessary when bedsores become infected.
A high-protein diet and increased consumption of vitamin C can promote wound healing in those suffering from pressure ulcers. Also, patients who are immobile need to be turned and repositioned at least every two hours in order to keep pressure off bony prominences such as the hips, ankles, and elbows. Specialty mattresses, such as air or water mattresses, are also beneficial for reducing pressure on the skin. Patients who are incontinent need to have their incontinence apparel changed every two hours and when they become soiled. When patients sit in urine and feces, skin becomes irritated, this exacerbates pressure ulcers.