Decubitus sores, more modernly defined by experts as “pressure lesions”, are injuries to the skin and underlying tissues that occur as a result of the continuous and prolonged compression of a soft tissue – skin, underskin or muscle – between an underlying bone protrusion and an external supporting surface.
“The cause of the formation of these lesions – explains Dr. Elena Maria Abati, head of the Vulnology (Wound Therapy) Outpatient Clinic at Humanitas Gavazzeni Bergamo – is the fact that pressure “crushes small vessels”, generating a lower flow of blood and nourishment to compressed tissues “.
The onset of a decubitus lesion has an increased risk for those who are forced to stay in bed for a long time or stay seated for hours every day without ever changing position. It is therefore typical of elderly people admitted to acute hospital wards, guests in health-care homes or nursing homes because they are no longer mobile. Young people/adults (even children) with severe disabilities (para-tetraplegia due to accidents or serious illnesses) are also at very high risk of developing this serious type of skin injury.
Better to prevent than treat
The “best prevention” rule really applies a lot when it comes to pressure injuries. Once the wounds have formed – warns the specialist – their treatment is very complicated, which requires the intervention of specialized surgery called volnological surgery (wound comes from “vulnus”). Treatment can lead to a complete healing, but requires long implementation times; however, this is not always the case if the condition is severe and correct treatment was not timely administered.
It is therefore better to try to ensure that lesions do not form completely, observing some simple but fundamental rules.
Treat your skin well
The first is a hygiene rule, as Dr. Abati points out: “It is necessary to check the skin every day, even several times a day, especially in correspondence with bone prominence, such as near the heels, neck, sacrum, spinal column and bones of the hips. The skin should be cleaned at regular intervals and in any case every time it becomes dirty, without friction and using pH balanced detergents.
It is also important that the skin is always well moisturized, because dryness facilitates the onset of injuries, adds the expert: “Hydration must be carried out using emollient products as well as through a diet and hydration that provide the right balance of nutrients favoring the correct nutrition and hydration for the skin.
Avoid prolonged pressure
In addition to the care of your skin, it is essential to ensure that it is not subjected to strong and prolonged pressure. We know that decubitus sores affect people forced to stay bed or in a wheelchair for a long part of the day,” says Humanitas Gavazzeni specialist. Those who are responsible for their care should therefore be concerned that the pressures are distributed each time on different parts of the body. This result can only be achieved with continuous, correct and constant handling, as well as through the use of “aids” that help to reduce compression such as anti-decubitus mattresses and cushions, articulated beds, heel boxes and deck lifts “.