$Unique_ID{BRK00328} $Pretitle{} $Title{Bed Sores: Causes and Treatment} $Subject{bed sores nursing home treatment aging age aged elder elderly geriatric Skin decubitus ulcers bed ridden aloe vera gold leaf insulin sugar vitamins iodine ulcer pressure time friction turning necrotic silver sulfadiazine povidone-iodine surgeries operation operations surgery grafts} $Volume{L-20} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Bed Sores: Causes and Treatment ------------------------------------------------------------------------------ QUESTION: While fighting an ongoing battle with bed sores in our aged and ailing mother who is being cared for at home, we are constantly on the alert for a possible magical cure that can help her. What can you add to our understanding of this terrible condition, and do you have any secret potion to aid us? ------------------------------------------------------------------------------ ANSWER: I wish that I had the remedy that could rid all sufferers of their bed sores (or decubitus ulcers in medical jargon). Over the centuries there have probably been thousands of treatments suggested or tried to relieve bed ridden patients of these gaping sores. During the era of Hippocrates, a warm water wash, followed by a vinegar sponging, a surgical trimming of all dead tissue, and then a poultice of verdigris (copper acetate), flower copper (copper oxide), molybdaina (lead oxide), alum, myrrh, frankincense, gall nuts, vine flowers and wool grease; not a concoction I would recommend today. But even in our modern times, we use remedies without scientific data to prove their effectiveness, such as aloe vera, gold leaf, insulin, sugar vitamins and even iodine. There are three major factors which contribute to the development of skin ulcers. They are pressure, time and friction. Pressure upon the small capillaries which nourish the skin tissues compresses them, reducing the nourishing flow of blood to the cells, and leading to their death. The longer the patient remains in one position, the longer the blood flow is reduced, and the more the damage to the cells. When the patient is pulled across the wrinkled bed sheets, or the skin moves over the bony prominences of the body, friction results that may cause blisters or abrasions which may lead to the formation of pressure or "bed" sores. A sound program of treatment takes all these factors into consideration and consists of frequently turning or carefully changing the patient's position, keeping the wound free of infection and clean of dead or necrotic tissue, to aid natural wound healing. A wide variety of topical agents, applied directly to the skin, including silver sulfadiazine or povidone-iodine, are used. Newer, moisture retaining materials reduce the number of dressing changes needed and reduce the loss of newly developed epithelial cells that are the body's attempt to heal the wound. Maintaining good nutrition is a must, and surgery may be needed to clean or close the wound or place skin grafts in position. The care of these patients is indeed difficult, and you might consider studying the nursing literature, where many excellent articles about decubitus care may be found. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.