Bedsores (decubitus ulcers) can be a serious condition for those confined to bed (either in the hospital or home), especially among the elderly with more fragile aging skin.
In a November 2010 issue of Dermatology Times, dermatologist and wound care expert Dr. Eliot Mostow, M.D., MPH states that dermatologists should be involved on multiple levels in the prevention and treatment of decubitus ulcers in the older patient,
“Dermatologists have a lot of expertise in thinking outside the box when it comes to the skin,” Dr. Mostow says. “It’s the dermatologist who would look at the pressure spot and know whether or not it’s a decubitus ulcer, a squamous cell carcinoma (skin cancer) or a deep fungal infection. Just because you see something on the buttocks doesn’t mean it’s a pressure ulcer, or just because it’s on the groin doesn’t mean it’s a fungal infection.
Sometimes, the dermatologist is the only one who can distinguish a pressure ulcer from something else”, says Dr. Eliot Mostow, dermatologist at Akron Dermatology and Associate Professor of Clinical Dermatology at Case Western Reserve University (CWRU) School of Medicine, Cleveland.
At highest risk for decubitus ulcers are those who are immobile and those who are malnourished. A recent study found the incidence of pressure ulcers in the nursing home environment ranges from 3 to 25 percent. Seniors admitted to acute care hospitals for nonelective procedures such as hip replacement and treatment of fractures were at even greater risk, with an incidence of 66 percent.
While bedsores can be healed, they can also be fatal if left untreated or diagnosed in a late stage. For this reason, Dr. Mostow encourages early and accurate diagnosis, preferably by a dermatologist.
Even non-hospitalized seniors are at risk for bedsores. The pressure from sitting or lying in one position for long periods of time may initially cause an area of redness of the skin. “Some clinicians may see this as just a red area, but a dermatologist might diagnose it as a stage I ulcer or a precursor to an ulcer,” Dr. Mostow says.
“It’s like hiking in a new pair of shoes, and you feel a hot spot,” he says. “If you don’t pay attention to that, it will likely end up as a blister. It’s the same analogy in people who get pressure ulcers. And oftentimes, elderly patients who have had strokes or spinal injury don’t have good sensation, so the hot spot goes unattended. We need to look first at preventing bedsores, and then caring for them when they occur,” Dr. Mostow says. “In prevention, we focus attention on pressure; in treatment, it’s pressure relief.
Some new products are helping in the treatment of bedsores that are listed at www.woundsource.com.