Overview

Bed sores are wounds that affect areas of skin and underlying soft tissue that have had pressure put on them for long periods of time. The sores typically form on bony parts of the body, such as the elbows, knees, heels and tailbone. They develop when a person remains in the same position for a prolonged duration of time. Bed sores, clinically referred to as pressure ulcers, are wounds that arise on the skin and the underlying soft tissue due to prolonged pressure on specific areas of the body. These sores predominantly occur on bony prominences, such as the elbows, knees, heels, and tailbone. The development of these ulcers is typically associated with remaining in a static position for an extended duration, which may be due to reduced mobility or sedation resulting from surgical procedures.

The following outlines the common sites for bed sores based on various sustained body positions:

1. Resting Position: When individuals remain in a resting position for prolonged periods, bed sores may develop in the following regions:

   - Head (where it contacts the pillow)

   - Shoulder blades

   - Hips

   - Tailbone and buttocks

   - Back of the knees

   - Ankles

   - Heels

2. Prolonged Wheelchair Use: In instances of extended wheelchair use, pressure ulcers are often found in the following areas:

   - Shoulder blades

   - Spine

   - Arms or legs (where they come into contact with the chair)

Implementing preventive measures is essential in minimising the risk of developing bed sores, thereby ensuring the maintenance of skin integrity and overall patient comfort. Use of having decreased mobility or having been sedated for surgeries.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Examples of sites of bed sores in various positions of the body when maintained for a long time: Resting position for a long time-Head (where it rests against the pillow), Shoulder blades, Hips, Tailbone and butt, Back of the knees, Ankles, Heels.

Prolonged wheelchair use, sites are-Shoulder blades, Spine, Arms or legs (where they touch the chair)

Causes

Common Causes of Pressure Ulcers:

1. Unrelieved Pressure: Prolonged pressure on a specific area of the skin can result in the formation of pressure ulcers.

2. Friction:  The skin can sustain damage when it rubs against clothing or bedding, leading to the potential development of sores.

3. Moisture:  Exposure to moisture from sweat, urine, or stool can soften the skin, rendering it more vulnerable to injury.

4. Inadequate Nutrition and Hydration:  Insufficient intake of essential nutrients compromises the skin's natural defences and can impede the healing process.

5. Application of Medical Devices:  Medical items, such as oxygen tubing or immobilisation casts, may create pressure on the skin if they are not adequately cushioned, thereby contributing to the formation of sores.sores

Symptoms

Symptoms of pressure ulcers, commonly referred to as bedsores, are outlined as follows:

- Redness: A persistent erythematous area on the skin that does not blanch, or turn white, when pressure is applied.

- Pain or Discomfort: The presence of the sore is often accompanied by significant pain or discomfort.- Blisters: The odour development of fluid-filled blisters may occur as the integrity of the skin begins to deteriorate.

- Open Wounds: The formation of ulcers can result, leading to the exposure of deeper tissues that are at a heightened risk of infection.

- Foul Odour: When bedsores become infected, they may emit a foul odour due to the presence of necrotic tissue or underlying infection.         

Ayurvedic View

Dushta vruna -Due to aggravation of vatadi dosha, namely vata, pitta and kapha, but predominantly pitta dosha does dushti of twak (skin),rakta (blood tissue) and lasika (lymph )forms a chronic and deep-seated vruna (wound -forms ulcer), this is bed sores. Ayurveda treatment corrects the dosha imbalance and helps in the healing of the ulcer.