Bedsores, known also as pressure sores or ulcers, occur most frequently on a person's heels, buttocks and hips, according to the Mayo Clinic. Those with the greatest risk include those living with paralysis, however anyone unable to change position on their own in bed, or who uses a wheelchair also presents a risk.
Blood Flow Reduction
As Merck explains, when blood flow is cut off for more than one or two hours, the skin begins to die, beginning with the outer layer. An open sore or ulcer forms as the dead skin breaks down.
Many people can change position on their own constantly without a second thought, even during sleep. For those who are extremely weak or in a coma, moving on a regular basis to prevent bedsores from occurring is not possible without assistance. In addition, these people do not feel pain or discomfort, signs that a change of position proves necessary. Therefore loss of circulation occurs, depriving the tissue of the oxygen and nutrients necessary to remain healthy. Ultimately a pressure sore forms.
Constant Friction
While a regular change in position remains necessary to prevent a bed sore from occurring, or to assist in the healing of an existing ulcer, the friction from moving from one side to another can contribute to skin breakdown.
As a person is rolled or slid across a bed regularly--generally every two hours--the top layer of skin layers of their skin pays the price and can begin to wear away, as Merck explains. Having one person on either side of the bed gently lifting and moving the patient with the use of the sheet under him reduces this friction.
Shearing
Shearing occurs when a person's skin moves in the opposite direction of the bone it covers--the tailbone for instance, which is a fragile area. The Mayo Clinic explains that shearing proves more likely to happen with patient's who slide down in their beds or chairs, or whose head of the bed is raised more than 30 degrees.
When caring for a patient who is unable to prevent themselves from sliding, provide them with a form of support under their buttocks, such as a folded blanket or pillow. If placing them in a chair, be sure it has a support in the center between their legs to stop any sliding from occurring.
Long Term Moisture Exposure
Those who use wheelchairs or become bed bound need consistent monitoring to ensure their skin does not come into contact with urine or feces for a long period of time. Those who cannot speak for themselves require monitoring a minimum of every two hours. If left unattended for long periods, this moisture not only increases skin friction, but also weakens and damages the outer layer of the skin.
Poor Nutrition
Lack of proper nutrition not only increases a person's chances of developing new bedsores, it also slows the healing process of existing pressure sores. Those who lack enough protein, zinc and vitamin C present more of a risk of developing bedsores.
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