Decubitus Ulcer

Decubitus ulcer is an impairment of skin integrity when staying in one position for too long without shifting weight. It is also called as bedsore or pressure ulcer. This case often happens when using wheelchair and bedridden. The common places for decubitus ulcer are over bony prominences such as the elbow, heels, hips, ankles, shoulders, back, and the back of the head.

The constant pressure against the skin can reduce the blood supply to that area and will affect tissue dies. It will start as reddened skin and will progressively worse to form a blister, open sore, and a crater. The important thing is to prevent of skin breakdown, particularly in caring or the bedridden or immobile patient.

There are factors that increase the risk for decubitus ulcer:

• elderly
• inability to move parts of body
• malnourishment
• bedridden or wheelchair patient
• chronic condition (diabetes or vascular disease)
• urinary or bowel incontinence
• fragile skin, and
• mental disability.

Stage of Decubitus Ulcers:

STAGE 1
Ulcer is a reddened area that returns to normal skin color after 15 to 20 minutes of pressure relief. The skin still intact and the red area does not blanch with external pressure.

STAGE 2
The top layer of skin is missing. The ulcer is shallow with a pink to red base and white or yellow eschar may be present.

STAGE 3
The ulcer extends into the dermis and subcutaneous tissues, white, gray or yellow eschar is present. Purulent drainage is common.

STAGE 4
The ulcer extends into muscle and bone, four smelling with brown or black eschar, and purulent drainage is common.

Care for Decubitus Ulcer:

• Prevent the position that promote pressure.
• Assess the nutritional status.
• Adequate nutritional intake to promote tissue integrity.
• Remove any pressure on the skin.
• Turn and preposition the bedridden patient every two hours or more if necessary.
• Active and passive exercises every 8 hours.
• Keep the skin clean and dry.
• Use moisture barrier if needed as prescribed.
• Use an alternating air pressure mattress or sheep skin padding.
• Wound dressing and medications as prescribed.