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Bed Sores Causes & Solutions

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Bed Sore Causes and Solutions Being Bedridden Doesn't Mean Bedsores are Imminent

Are you bedridden and showing signs of skin breakdown? Does your body ache during the night because your mattress doesn't have much give to it? Do you constantly turn over at night in bed, trying to avoid the pain of bedsores?

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If you’ve experienced bedsores yourself, you know that these aren’t the only issues that bedridden patients have to deal with on a daily basis. Faced with open wounds that itch and hurt, many bedsore victims also often cringe at the thought of having dressings changed, or wonder when someone can become available to bathe them and apply some type of topical ointment for just a little bit of much-needed relief.

The Goal: Reverse Bed Sores Now and Prevent Them From Returning

By reading this article, you have the opportunity to stop feeling the frustration, disappointment, physical pain, and embarrassment of bedsores.

You can once again have smooth skin and feel the pleasure of warm sheets and a firm mattress on your skin. You’ll discover the latest developments in bedsore treatments right here and now. By combining several of them together into a strategy of attack on this condition, you can find its cure and never have to suffer from bedsores again!

With this goal in mind, there are four primary categories to consider for the elimination of bedsores and the rebuilding of the skin so that it won’t break down, no matter what environment you are exposed to.

The categories are listed below and in order of what takes the least amount of time to accomplish.
Bedding Choices: Aids From The Best of the Best Scientists

Bedridden patients haven’t been left out of healing. On the contrary, even NASA scientists have made progress that affects you in your current challenges. Their research has contributed greatly to the development of mattresses, such as memory foam, which totally eliminates the pressure of a mattress against the skin.

And if you have any soreness on any part of your body from sleeping on your current mattress, you’ll read about what these scientists have discovered about pressure on the skin causing bedsores.

The NASA scientists have already stayed up all night searching for solutions for this so you don’t have to! Their solutions were good enough for the astronauts and they’re good enough for you, too!

Nutrition: What You Eat Becomes Part of You!

The 21st century is the age of in-depth research from the science of nutrition. Because scientists already understand what each vitamin and mineral does in the body, and have a good comprehension of biochemistry, metabolism, healing, regenerative medicine, and skin physiology, now is the age of answers. It’s easier now than ever to simply read the research and create healing plans for any condition. The answers are there – and the research is fascinating.

Topical Ointments and Dressings: New Levels of Penetrability Bring Long-Lasting Relief

All the research on skin physiology has uncovered one major fact: we know how to make products that will be absorbed by the skin. No longer is the skin’s barrier to impermeable substances a problem if you want to heal bedsores.

Optional Treatments to Consider

The 21st century is the age of technological advancements, too. It’s possible that you may want to ask your doctor for referrals for some of these treatments.

Nutrition: What You Eat Does Become Part of You!

Bedsores, called pressure ulcers or decubiti, are a problem without boundaries. And worldwide, researchers are concluding that nutrition is a big key to overcoming bedsores.

Spanish and Brazilian Researchers Predict Who Gets Bedsores

In Spain, doctors at the Servicio de Medicina Interna Univeristy Hospital in Granada found that poor nutritional status was related to the development of bedsores, and was also related to higher mortality rates. In Brazil, university researchers studied their hospital records to determine who gets bedsores the most often.

Here’s what they found:
  • Those who were hospitalized 15 days or more
  • Those who couldn’t feel sensations on their skin
  • Those with very dry skin
  • Patients completely immobilized
  • Even those with adequate nutrition
  • Those with issues involving friction and shear forces in bed
Bedsores Are Graded According to Severity

Bedsores are graded in a level system that can assist health practitioners in their assessments of healing. Any level of bedsore is a cry of the body for help, but Grade III and IV pressure sores are the worst.

Table 1. Characteristics of Different Grades of Bedsores

Grade I Bedsore: Redness in the skin that is not relieved after pressure is removed. May be painful.
Grade II Bedsore: The sore looks like a blister or an abrasion.
Grade III Bedsore: The sore has progressed to include the subcutaneous layer of skin.
Grade IV Bedsore: The sore has become a deep wound, extending down to the level of tendons, muscles and bones.

It Takes Time to Show Healing So Don’t Give Up

Researchers in the Netherlands found that a high protein, arginine and micronutrient-enriched drink in addition to standard treatment for bedsores in 43 patients accelerated the healing dramatically within 8 weeks. Arginine is one of the amino acids necessary for rebuilding new tissues.

The patients in this study were healthy except for the open wounds. Researchers also discovered that drinking the supplement over the 8-week treatment time also benefited the caregivers because fewer dressings were required per week. Great news for family members and home health care providers, too!

Japanese researchers found that when a patient had bedsores, it wasn’t smart to hold back on their calorie levels. They concluded that nutrition intervention could directly enhance the healing process and it was especially important to eat at calorie levels 1.5 times that of basal metabolic rate. If the amount of calories your body needs to maintain normal functions is 1200 calories, then providing 1200 plus 600 calories or 1800 calories would be the minimum needed to keep bedsores away.

Protein Matters! Don’t Buy Into the Meat is Bad Attitude

Other Japanese researchers found that patients with bedsores had low levels of arginine and when they drank water supplemented with arginine, there was remarkable and significant improvement in the shrinking of the sores.

Canadian researchers took a more wholesome approach to the topic of nutrition and bedsores and examined patients’ levels of nutrient consumption for three days for 31 home care patients with bedsores.

Their results? Forty-one percent weren’t eating enough calories, 32% weren’t getting enough protein, and 55% weren’t getting enough zinc in their diets. Without any of these three nutrients, wounds of any kind won’t heal.

But that wasn’t all they found. Their diets didn’t contain the estimated average requirement for fiber, vitamin D, vitamin E, vitamin K, folate, calcium, magnesium and potassium. Those with bedsores that worsened had low consumption of foods high in vitamin A, K, magnesium and protein.

Korean scientists at the Sung Kyun Kwan University in Seoul re-discovered what smart dietitians have known for a long time about bedsores: they go away when the protein level is increased in the diets of the patients. The scientists concluded that providing supplements to keep serum albumin level greater than 2.8 g/dL is the solution.

How to Calculate Protein Needs for the Day

This means that when you have a bedsore, increasing the protein in the diet up to about a gram per pound body weight may be what’s needed to heal. Thus, a 150-lb. woman may need close to 150 grams of protein per day.

Since 7 grams protein is in 1 oz. protein from chicken, turkey, beef, pork, fish, buffalo, or lamb, the way to calculate the amount is to take the total amount needed and divide it by 7. A woman needing 150 grams protein a day will need the equivalent of about 21 ounces of protein per day.

This means small feedings of protein-rich foods are in order! Three small meals with 4 ounce protein from the meat category provides 12 of the 21 ounces. Two 8-oz. cups of milk or yogurt will add another 20 to 28 grams protein, or about 4 more ounces. With the meat and the milk products, you’re at 16 ounces for the day so far. Nut snacks and a few grains and legumes during the day will make up the rest of the needed protein.

Other Nutrients Matter, Too!

In Israel, hospital doctors discovered that omega 3 supplements, along with vitamin A, C, and E, as well as gamma-linolenic acid supplements, lowered the occurrence of new bedsores in critically ill patients who had lung disease.

And at the Prince Charles Hospital in Brisbane, doctors didn’t just do their research project and let the matter go. They initiated strategies based on what they found in their research and reduced the rate of bedsores from 13.78 to 5.15% in 2010, a reduction of 62%. In over half of those who still had bedsores, the decubiti were only rated Stage 1.

The Prince Charles Hospital approach included providing better nutrition to the patients, better continence care for bowel and bladder control of all patients, and better skin hygiene. This was their winning strategy.

What is it about malnutrition that creates the bedsores? Nutritional deficiencies interfere with the normal stages of wound healing. Any deficiency increases the chance for infection and delays healing of any wounds, which then become chronic, non-healing wounds. This type of wound is correlated with death and dying.

Topical Ointments and Dressings:
New Levels of Penetrability Bring Long-Lasting Relief

Science has come a long way in terms of creating different ways to get medicine into the body. In the last 20 years, a major breakthrough occurred: it was discovered that you could get medicines into the body via the skin. This finding opened up a whole new field of findings about what could get into the body through the skin and what couldn’t.

Now, we know that although most things will eventually penetrate the skin, optimum delivery of any substance into the body through the skin may require unique formulation of ingredients.

Topraicin is a patented, natural, safe, odor-free homeopathic cream that improves blood flow to the injured tissue and drains toxins and fluids that build up as well. Listed in the 2010 Physician’s Desk Reference, Topraicin is an FDA-regulated over-the-counter medicine created for pain control.

Topraicin is blended without heavy fats or lanolin that prevents active ingredients from penetration into the skin. According to Lou Paradise, developer of the cream, traditionally used fats and lanolin can actually interfere with the skin’s ability to detoxify itself and heal.

The use of this ointment could have potential beneficial effects on the pain associated with bedsores.

Herbal and vitamin ointments may also help getting important nutrients into the skin to facilitate better healing, quicker healing and greater reduction of risk of mortality because the skin is healed. Various ointments for skin healing include substances such as vitamin A, vitamin E, vitamin C, comfrey, and calendula.

Silver Mesh or Silver Cream? Which is Better?

Thailand researchers used silver mesh dressings, changed once every three days, in a study with 20 patients with Grade III or IV pressure ulcers. The silver mesh dressings saved them a considerable amount of money, close to $1500 over the cost of silver sulfadiazine cream, and were able to control infections and promote wound healing just as well as the cream.

Optional Treatments to Consider

Six other non-traditional types of treatments researched for their wound healing abilities include electrical stimulation therapy, water-filtered infrared A radiation, vacuum-assisted treatment, pulsed ultrasound, vitronectin growth factor complex, and hyperbaric oxygen treatments.

Canadian researchers in Toronto used electrical stimulation along with traditional treatment for patients who had spinal cord injuries and Grade III and IV pressure ulcers. The added treatment was associated with a cost savings of $224 over a year’s time period and helped stimulate healing.

Germans Use an Innovative and Creative Solution to Decubiti
German scientists found that water-filtered infrared A radiation created the following benefits for those with chronic venous stasis ulcers of the lower legs:
  • thermal and non-thermal effects
  • tissue temperature increases
  • increased oxygen partial pressure and perfusion

Treatments were 30 minutes long five times a week along with standard care treatments such as wound cleansing, compression therapy and nonadhesive wound dressings. The water-filtered infrared A radiation treatment continued for 9 weeks and resulted in faster reduction of the wound area in those using this experimental treatment.

Even though stasis ulcers are not exactly bedsores, both are non-healing wounds that utilize similar wound healing processes in the body. The study appeared in the British Association of Dermatology.

Vacuum Treatment Works in Israel

Another treatment used for diabetic foot ulcers but not yet bedsores is that of vacuum-assisted therapy. This is a localized controlled negative pressure environment; the V.A.C. therapy system was used. This type of treatment is used for a variety of wound types.

Internal medicine doctors from the Ziv Medical Center in Israel found that vacuum treatment resulted in complete ulcer closure for a great proportion of the 17 patients and decreased the rate of amputation. Granulation tissue was formed and the total healing time was reduced significantly.

Stimulating Wound Repair Appears to Be the Key

The next three treatments use various methods to achieve only one goal: stimulate the wound repair on a physiological level.

Pulsed ultrasound at 0.1 W/cm2 was found by Japanese researchers to increase the number of fibroblasts and protein in the skin within the first 24 hours.

Australian scientists used a clinical Good Manufacturing Practice-grade vitronectin growth factor complex as a topical healing agent on venous leg ulcers and found that it was safe and caused new skin growth in 29 of 30 patients in a pilot study.

Hyperbaric Oxygen Treatment: No Damage to the Body, Study Says

One type of treatment that is gaining popularity for diabetics with non-healing wounds, although not bedsores, is hyperbaric oxygen treatments. Doctors in Russia and Germany are more educated on this topic since they have been using this type of treatment for decades, with much success.

Some doctors are concerned with possible DNA damage to the body from this treatment because oxygen is a fairly reactive compound that could potentially induce oxidative stress in the body.

In one study completed at the Department of Occupational Medicine and Toxicology at the Comenius University Bratislava in Slovakia, scientists searched for DNA damage from the oxygen treatment.

The hyperbaric chamber was filled with 100% oxygen and the pressure increased to 2.5 or 3.0 atmospheres (ATA).

Because there were no significant changes in the DNA damage values during or after the treatment, doctors concluded that there was no significant risk associated with the treatment.

What Other Studies and Doctors Say about Hyperbaric Oxygen

Hyperbaric oxygen treatments are definitely a controversial topic in medicine today. Research studies show that hyperbaric oxygen treatment significantly reduced the risk of major amputation and may improve the chance of healing at one year.

In pooled data from three trials on stubborn diabetic foot ulcers with 118 patients, there was a reduction in the risk of amputation when doctors used the treatment. The treatment increases the microvasculature as well as speeds up the healing. If this is something that would benefit patients with decubiti, then perhaps hyperbaric oxygen treatment should be considered.

Some doctors believe that using hyperbaric oxygen treatment for non-healing bedsores is not justified while others. The experts in the field and those who treat patients with hyperbaric oxygen believe it has its place in modern medicine and needs to be integrated into medical practice.

Bedsores don’t have to lead to death and more disability. The answers have already been found.

Bedding Choices: Aids From The Best of the Best Scientists

There are many types of bedding choices you can make that will result in a decreased chance of developing bedsores. By changing the surface you are sleeping on and lying on during the day, you can start receiving benefit as soon as the first night of sleep after the mattress or bed arrives.

Memory Foam Mattresses On the Market Since 1980s

The harder the mattress, the less give it has upon the body that lies upon it. The harder a mattress is, the greater the chance for painful pressure sores to develop.

NASA scientists invented memory foam back in the 1970s. They wanted the astronauts to avoid developing pressure spots or bedsores while up in the spacecrafts. In the next decade, the memory foam was created into memory foam mattresses, which have been extremely useful for those with all types of ailments.

Memory foam adapts to your body, and slowly bounces back to its original shape when you aren’t in bed. This characteristic is called viscoelasticity. It means you can sink down into the memory foam mattress when you lie on the bed and feel totally supported, and view the shape of your body in the mattress when you arise. This type of mattress reduces the pressure on the body from the mattress all the way down to zero.

And by reducing the pressure, you can more easily recover from bedsores.

Latex Foam Mattresses Offer More Support

Latex foam mattresses are another good choice of mattress for those with bedsores because these mattresses also reduce the pressure on the body. The difference is that latex foam mattresses bounce back much quicker than the memory foam mattresses; they are more elastic in nature. Latex foam mattresses are created from rubber.

Many people are concerned about latex allergies and wonder if this is a problem with the mattresses. Latex foam mattresses are hypoallergenic, even to those who have latex allergies. Allergy reactions don’t occur unless you actually open the mattress and touch the latex. The proteins that cause the allergic reaction are washed away during the processing of the latex.

Who Wants a Regular Bed When You Can Have a Hospital Bed at Home?

For any patient who is bedridden, the idea of laying in a bed all day and all night in the same position is agonizing. Pillows really don’t work that well to prop up someone in bed. The use of a hospital bed in the home of a bedridden patient is now more and widely accepted.

An adjustable electric bed eliminates a great part of the struggle to get up and out of the bed just because it is adjustable; the patient can place his feet directly on the floor when sitting on the bed. The back of the bed can be lifted so that a patient can eat meals or read a book. Adjustable hospital beds make it easier on the patient and add a dimension of comfort and quality of life.

Hospital beds can be fully electric hospital beds, semi-electric or be operated manually. In one nine-hospital study of 658 people aged 65 and older that underwent surgery for hip fracture, Maryland researchers at the Department of Epidemiology and Public Health found no difference between decubiti in those on beds that were electric versus those that weren’t. Either one will make the patient’s life more comfortable, though.

Air fluidized therapy beds were reported to reduce the development of decubiti in a study reported in August 2011 in the journal, Critical Care Nurse. Doctors at the St. Joseph Health System in Lexington, Kentucky found only one Grade I ulcer develop in 27 patients when they used the bed for an average of 7.9 days, compared to 40 ulcers in 25 patients before the intervention.

The cost of these beds is quite pricey, but still, there was a cost-savings.

Give the bed you are sleeping on much consideration in the treatment of bedsores. It is the easiest thing to change and can definitely impact your healing.