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Bed Sores in Hospital

AuthorAlan Curtis
PublishedMay 31, 2022
Estimated reading time:
8 minutes

Introduction to bed sores

Bed sores in hospitals are an often overlooked condition that affects between 4% and 10% of people in hospitals in the UK. Yearly, around 186,617 develop one or more bed sores during a stay in Hospital.

Bed sores are not typically life-threatening, but they can significantly negatively impact the quality of your life and well-being while you are hospitalised. So what's the solution? Is there such thing as being completely free from developing a bed sore?

This article will discuss how a patient can develop and prevent bed sores in a hospital. I hope you find the information here helpful. Please leave any feedback in the comments below, and feel free to share examples of your bed sore stories with us.

What are bed sores?

A bed sore is a skin ulcer caused by someone lying in the same position for long periods.

Bed sores can take many different forms, ranging from small red spots on the skin to deep ulcers with exposed bone or tissue beneath them. Some people have only one or two localized areas where they experience discomfort; others may have multiple lesions spread across their body.

Bed sores are a common problem for people in hospitals or other long-term care facilities. They're also a risk factor for residents of nursing homes and assisted living facilities and people who are at home with family members who may not be able to help them as much as they need.

Common names for bed sores

There are many different terms commonly used for Decubitus Ulcers in the UK.

Decubitus ulcers

Decubitis Ulcer is the medical term for a bed sore. 'Decubitus' refers to the position someone lies while in bed. 'Ulcers' are sores that are slow to heal, can take many forms and occur on the skin or inside the body.

Bed sores

Bed sore is the most common term for Decubitus Ulcers in the UK. However, it's important to note that bed sores can also be caused by prolonged pressure from sitting in a chair or wheelchair.

Pressure sores

Pressure sore is another common term used to refer to Decubitus Ulcers in the UK.

Bedsores

You will sometimes see bed sores written as bedsores with no space.

Pressure ulcers

Again, a pressure ulcer is a common term used in the UK, but typically not as common as 'bed sore' or 'pressure sore'.

Pressure injuries

Probably the least commonly used term for a Decubitus Ulcer in the UK.

The four stages of bed sore development

Stage One

Skin reddened and may be warm to the touch and feel firmer or softer than the surrounding skin.

Stage one of a bed sore

Stage Two

Skin breaks open and exposes the epidermis or dermis. The lesion will be superficial and often resemble an abrasion or popped blister.

Stage two of a bed sore

Stage Three

The lesion extends into the dermis and spreads to the subcutaneous layer. At this stage, the lesion will form a small crater. Fat may begin to show in the open sore.

Stage three of a bed sore

Stage Four

The subcutaneous layer and underlying fascia are breached, exposing muscle and bone.

stage four of a bed sore

How might you develop bed sores in Hospital?

To get a bed sore, you need to be in a position where your weight is on one part of your body (usually your bottom or hips) for an extended period. Bed sores can happen if you stay in one position for too long, like if you're bedridden or sitting up all day with no breaks.

Some people have a higher risk of developing pressure ulcers. Age, diet, hydration and certain medical conditions can cause a greater risk of developing a bed sore. We'll talk more about specific risk factors later.

Hospitals and Care Homes have a duty of care for their patients and can be liable if their patients develop pressure ulcers while in their care. Typically, you can make a legal cliam if the pressure ulcer is stage three or higher.

Parts of the body that are most commonly affected

Certain areas on the body are more likely to develop pressure ulcers, so it is important to check them regularly when sitting or lying down for long periods.

It's typically a boney area that is most likely to develop a pressure sore, especially if it is supporting your weight. Here's a list of the most likely places for sores to develop:

  • Buttocks (tailbone)
  • Hips
  • Heels of feet
  • Shoulder blades
  • Backs and sides of knees
  • Back of the head

How serious are bed sores?

Bed sores can be severe if not treated promptly. The most significant risk factor of a pressure ulcer becoming life-threatening is infection. Thankfully, life-threatening complications from pressure ulcers are infrequent.

However, the tissue damage caused by pressure ulcers can be debilitating and can cause significant pain.

Pressure ulcers need to be treated promptly and professionally to ensure a healthy recovery and prevent the ulcer from developing further.

Top Tip: Make sure you take photos and keep a diary of the bed sore(s) development if you or a loved one develops a bed sore while under the care of a medical professional. This evidence will be vitally important if you make a legal claim.

Bed sore risk factors

Several factors increase the likelihood of developing a pressure sore. Knowing the risk factors enables you to assess your risk. If you believe you are at risk of developing pressure ulcers while in hospital, talk with your doctor or health care professional about minimising your risk.

Prolonged pressure

Prolonged pressure is the leading risk factor for developing pressure ulcers. When the skin has pressure applied over a long time, the blood supply gets cut off, allowing pressure sores to form. Keep reading to find out some more risk factors and ways you can prevent pressure sores from forming.

Poor nutrition

Poor nutrition can lead to bed sores. Patients who are malnourished and have a poor diet, or patients who have a poor diet because they're in the hospital, are at risk of developing pressure ulcers.

Bony areas

Bed sores are more likely to develop on bony body areas, such as the heels, ankles, hips, elbows, and shoulders. These areas don't have much fat to protect them from pressure. We recommend that you use pressure relief cushions for these areas whenever possible.

Elderly patients

Elderly patients are more likely than younger patients to develop bed sores because their skin is more fragile, and they have less body fat than younger patients (which means they're more likely to experience pressure). There's also an increased risk of infection in elderly patients due to weakened immune systems.

Body fat

The less body fat someone has (even if they're not underweight), the more likely they'll be to develop bed sores—that's because fat cushions against pressure on your skin which helps prevent damage from occurring underneath it.

Fragile skin

Fragile skin is another factor that makes it easier for bed sores to develop. If your skin is thin or damaged from an injury, it will take longer for wounds to heal and may become infected more easily.

Cold skin

Cold skin also increases your risk of developing pressure ulcers because it does not have enough warmth or moisture for healing tissue.

Diabetes

People with diabetes are particularly at risk for developing these painful wounds because of their decreased circulation and increased pain sensitivity. Diabetes can also impair the body's ability to heal from skin damage, so good aftercare is vital for minimising the risk of infection.

Preventing pressure ulcers

Let's take a look at some ways that you could avoid bed sores.

Change position

To prevent pressure sores, you should change your position every hour or two. This will help keep your skin healthy and moisturized. It also helps with circulation and prevents muscle aches and numbness.

Healthy diet

A healthy diet is another essential part of preventing pressure sores; eating well helps keep your skin healthy and supports your overall health. Eating healthily reduces the likelihood of fatigue or other symptoms that could make staying comfortable difficult (like nausea). Make sure you're eating plenty of fruits and vegetables and foods high in fibre.

Make sure your diet includes plenty of vitamin C and omega-3 fatty acids. These nutrients help keep your skin healthy and elastic.

Drink water

Water helps keep your body hydrated and healthy overall, reducing the risk of developing a pressure sore or similar problems associated with immobility like deep vein thrombosis (DVT). Dehydration can cause blood vessels to become constricted and lead to poor circulation.

You may want to try drinking an electrolyte-balanced beverage like Gatorade or coconut water for the extra mineral and hydration benefits!

Reduce pressure

Make sure you have enough padding under your body so that it doesn't rest directly on a hard surface. This includes pillows and mattresses with sufficient support for different parts of your body (such as hips/shoulders) while sleeping or sitting upright.

Use proper body positioning to help spread your weight and support your entire body. To learn more about doing this, ask your doctor or nurse practitioner to show you how!

Healthy skin

Wash daily with mild soap and warm water; pat your skin dry gently with a towel instead of rubbing vigorously. Clean skin will reduce the risk of infection and keep your skin hydrated.

It's essential to ensure you're getting plenty of vitamin D as this is one of the most important vitamins for healthy skin. Vitamins C, E and K also play a vital role.

Sleep

I know it seems a bit counterintuitive when you consider maintaining the same position for long periods can cause pressure ulcers. However, sleep is vital for our body's ability to heal. Ask your nurse to help you turn during the night to reduce your risk of developing sores.

Risk Assessment

If you're at risk of developing bed sores, your caregiver should provide you with a risk assessment with actionable steps to reduce your risk of developing a bed sore. The risk assessment should include instructions that hospital staff must follow to reduce the likelihood of you developing a pressure ulcer.

Check-in with your caregiver regularly to make sure they're checking for sores and changing any dressings as needed.

If you develop pressure sores while in hospital and your caregivers did not follow your risk assessment, you may be entitled to compensation. Make sure you keep records of the care you're being provided and when your bed sores develop.

Who is responsible for preventing pressure ulcers while in Hospital?

Preventing bed sores is a team effort; everyone is responsible. The primary responsibility lies with your care professionals, usually your nurses and doctors, while in a hospital.

However, you also have a responsibility to follow your caregiver's instructions and provide them with accurate information about your health. If you're unhappy with the care you're receiving while in hospital, contact your local GP and record your concerns.

Treating bed sores

If left untreated bed sores can become a very serious problem and even, in rare cases, lead to death (caused by the spread of infection). Here are some tips to help you treat mild bed sores - but make sure you also consult your doctor and follow their instructions.

Pressure sores are treated by protecting the skin from further damage and cleaning and dressing the wound. Pressure sores often take a long time to heal, which can be painful.

To treat a pressure sore, you should first check the skin for open wounds and pus. If there is any pus drainage, you should clean the skin with soap and water and apply antibiotic ointment to prevent infection. If there is any movement around the wound area, you should use a soft gauze bandage or other dressing.

Contact your doctor immediately if the sore is not healing, getting worse, or causing you pain. They can prescribe antibiotics and stronger pain medication. Sometimes further professional medical intervention may be necessary like the removal of dead tissue.

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Alan Curtis
Alan Curtis graduated with a Law degree from the University of Westminster in 1988. He passed the Solicitors final examination in London in 1989. After training in a central London practice, he qualified as a Solicitor in 1992. He then worked in Yateley, Surrey, in general litigation before moving to Cornwall and specialising in personal injuries and clinical negligence.
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