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?
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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.