A bed sore is a localized injury to the skin or underlying tissue, as a result of unrelieved pressure. Prevention includes identifying at-risk persons and implementing specific prevention measures, such as following a patient repositioning schedule; keeping the head of the bed at the lowest safe elevation; using pressure-reducing surfaces; and assessing nutrition if needed.
When pressure ulcers, or bedsores occur, detailed documentation of each ulcer and the appropriate staging (I through IV) are an essential part to the wound assessment.
Treatment of bedsores involve management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery. Debridement is indicated when necrotic tissue is present. Urgent sharp debridement should be performed if advancing cellulitis or sepsis occurs. Wound cleansing is a mainstay of treatment for clean ulcers and after debridement. Bacterial load can be managed with cleansing. Topical antibiotics should be considered if there is no improvement in healing after 14 days. Systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection.