Bedsores are localized injuries to skin or underlying tissues that affect people who spend a lot of time in one position due to various conditions like paralysis, old age etc.
The sores usually occur in the bony areas of the body like as a result of pressure and fiction. The most common sites are the areas around the coccyx, heels, hips, elbows, knees, ankles, and back of shoulders.
In Ayurveda, bedsores can be correlated to a condition called Shaya Vrana. Shayya means lying down while Vrana means wounds.
Causes of Bed Sore
Bedsores occur when pressure is applied to soft tissues that completely or partially obstruct blood flow to the soft tissues. This obstruction to blood flow may occur due to various reasons:
External Pressure: Pressure applied over any area of the body, specially the bony areas, can result in obstruction of blood flow. This deprives the tissues of oxygen and nutrients leading to formation of ulcers.
Friction: Friction occurs when the skin rubs against the bedding or clothing. It damages the superficial blood vessels directly under the skin.
Shearing: Shear happens when two surfaces move in opposite directions. For example, when a person is sitting on a bed, his skin might be sticking on to it. When the bed is elevated at the head, the body slides down, while the skin stays in place, causing shear. This separates the skin from underlying tissues, resulting in ulcers.
Signs and Symptoms
The symptoms of bedsores include:
1. Unusual change in skin color and swelling
2. Pus like discharge
3. Appearance of blisters
4. Tender areas
The risk factors of bedsores include:
1. Immobility: People who have difficulty moving owing to poor health, spinal cord injury or other causes, are at a higher risk of developing bedsores.
2. Reduced sensation: Patients with long-term spinal cord injuries or neuropathic conditions may suffer from loss of sensation. Thus, they may not be able to feel or sense a bedsore developing which might worsen the condition.
3. Old Age: Due to aging, the skin gets thinner and becomes more susceptible to bedsores.
4. Poor blood circulation: Conditions such as diabetes, vascular diseases, smoking, and compression can lead to poor blood circulation and result in development of ulcers.
The Punarva protocol is based on the simple premise that the Physician must diagnose and treat only based on sufficient evidence. This evidence should be ‘patient or rogi based’ in addition to being ‘disease or roga based’ in accordance with the fundamental principles of Ayurveda.
How is this made possible?
A thorough and complete recording of the patient’s medical history, capturing every minute aspect of his/her lifestyle.
A thorough head-to-toe clinical examination, uncovering health risk factors that the patient is unaware of, directly connected or unrelated with his presenting medical complaint(s).
This process of detailed history recording and clinical examination- which includes the classical Srotha-Vikrti pariksha – leads to an accurate understanding of the Dosha status of the individual and lays the foundation for an accurate differential diagnosis and medical management.
Further, the patient is entitled to be clearly informed about the diagnosis arrived at, as also understand the medical management proposed for him. The Physician shall proceed only with the patient’s informed concurrence.