The word decubitus originated from Latin term decumbere, which means to lie down. Therefore in literary sense Decubitus ulcers are ulcerations that occur from prolonged period of lying down in the bed. Since such types of ulcers also occur with sitting for a long time or pressure generated on a particular part of the body, they are better referred as pressure ulcers or bedsores.
Pressure ulcers are injury to skin and the tissues underneath the skin that develop as a result of continuous pressure. They are usually seen on the skin surface that covers bony prominences.Hips, knees, heels, buttocks etc are normal areas where decubitus ulcer generally develops.
Decubitus ulcer develops in people whose medical condition prevents them from changing position frequently. Such patients are either confined to bed for a prolonged period of time, or those who use wheelchair and are unable to move. These ulcers are often seen in people who suffer from paralysis, person in coma, prolonged period of lying after major operation, in old and bed ridden people etc.
Stages And Symptoms Of Decubitus Ulcers
Constant pressure over the skin surface reduces the blood supply to that area.After some time the skin breaks down and an ulcer develops in that area. Pressure ulcers are more often seen on bony prominences where there is less subcutaneous tissue between the skin and bone.
They are often seen in lower body area such as the lower part of back, hips, heels, knees etc. They are also common in elbow, around the shoulder etc. They often progress with alarming rapidity in spite of every care and attention.
Decubitus ulcer or pressure sore can be categorized in four stages.
- Stage 1: It is the beginning stage of decubitous ulcer. The skin is not broken. It is red in color. It does not blanch when you press it. The area may become warm as compared to the surrounding skin. The skin is firm to touch than the nearby skin. The skin is tender to touch.
- Stage 2: The outer layer of skin breaks, even the deeper layer of skin is destroyed due to pressure. As the skin wears off, an ulcer is formed which is shallow and pink. Sometimes the lesion appears to be like a ruptured blister.
- Stage3: The ulcer expands and becomes deeper. It appears as a crater and extends in deeper areas. The base of ulcer has yellow dead tissue.
- Stage 4: The wound goes deeper down and extends into the muscles, tendons, and reaches the bone. The base becomes dark and crusty. It is a dead tissue.
Treatment Of Decubitus Ulcers
Decubitus ulcer is predisposed to five factors; pressure, moistures, anemia, malnutrition, injury. Prophylactic treatment is of prime importance.
- The pressure of bony prominences is counteracted by change in posture every two hours in a bed ridden patient. Stage 1 and 2 bed sores generally heal after a time by taking general care and hygiene of the patient.
- If the pressure sore further advances, water bed or air bed will help to some extent in relieving pressure.
- Homeopathic medicine calendula is known to be effective in treating bed sores or decubitus ulcer. Local application of calendula mother tincture is beneficial in many cases.
- However, decubitus ulcer of stage 3 and 4 may require surgical intervention and debridement of the dead tissue. This depends on the condition of the patient. Generally, stage 3 and 4 ulcers develop in people who are seriously sick.
- Cleaning and dressing the wound is an essential part of successful treatment when it comes to decubitus ulcer treatment. The health care giver should ensure that infection does not occur due to soiled clothes etc.
- Antibiotics, eating protein rich food, correcting malnutrition and anemia also help easy and fast recovery of decubitus ulcer.