bed sore mattresses sleep center

Bedsores, more properly known as pressure ulcers or decubitus ulcers, are lesions caused by many factors such as: unrelieved pressure; friction; humidity; shearing forces; temperature; age; continence and medication; to any part of the body, especially portions over bony or cartilaginous areas such as sacrum, elbows, knees, ankles etc. Although completely treatable if found early, without medical attention, bedsores can become life-threatening, and indeed fatal. Christopher Reeve died following sepsis originating from a pressure related ulcer

Bed Sore Classification

The definitions of the four pressure ulcer stages are revised periodically by the National Pressure Ulcer Advisory Panel (NPUAP) in the United States. Briefly, however, they are as follows:

	Stage I is the most superficial, indicated by non blanchable redness that does not subside after pressure is relieved. This stage is visually similar to reactive hyperemia (a technical term for excessive redness) seen in skin after prolonged application of pressure. Stage I pressure ulcers can be distinguished from reactive hyperemia in two ways: a) reactive hyperemia resolves itself within 3/4 of the time pressure was applied, and b) reactive hyperemia blanches when pressure is applied, whereas a Stage I pressure ulcer does not. The skin may be hotter or cooler than normal, have an odd texture, or perhaps be painful to the patient. Although easy to identify on a light-skinned patient, ulcers on darker-skinned individuals may show up as shades of purple or blue in comparison to lighter skin tones.
	Stage II is damage to the epidermis extending into, but no deeper than, the dermis. In this stage, the ulcer may be referred to as a blister or abrasion.
	Stage III involves the full thickness of the skin and may extend into the subcutaneous tissue layer. This layer has a relatively poor blood supply and can be difficult to heal. At this stage, there may be undermining damage that makes the wound much larger than it may seem on the surface.
	Stage IV pressure ulcer
	Stage IV is the deepest, extending into the muscle, tendon or even bone.
	Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so the depth cannot be determined.

With higher stages, healing time is prolonged. While about 75% of Stage II ulcers heal within eight weeks, only 62% of Stage IV pressure ulcers ever heal, and only 52% heal within one year.^[1] It is important to note that pressure ulcers do not regress in stage as they heal. A pressure ulcer that is becoming shallower with healing is described in terms of its original deepest depth (e.g., healing Stage II pressure ulcer).

Bed Sore Etiology

Bedsores are accepted to be caused by three different tissue forces:

Pressure, or the compression of tissues. In most cases, this compression is caused by the force of bone against a surface, as when a patient remains in a single decubitus position for a lengthy period. After an extended amount of time with decreased tissue perfusion, ischemia occurs and can lead to tissue necrosis if left untreated in an immunocompromised patient.

Shear force, or a force created when the skin of a patient stays in one place as the deep fascia and skeletal muscle slide down with gravity. This can also cause the pinching off of blood vessels which may lead to ischemia and tissue necrosis.

Friction, or a force resisting the shearing of skin. This may cause excess shedding through layers of epidermis.

Aggravating the situation may be other conditions such as excess moisture from incontinence, perspiration or exudate. Over time, this excess moisture may cause the bonds between epithelial cells to weaken thus resulting in the maceration of the epidermis. Other factors in the development of bedsores include age, nutrition, vascular disease, diabetes mellitus, and smoking, amongst others.

There are currently two major theories about the development of pressure ulcers. The first and most accepted is the deep tissue injury theory which claims that the ulcers begin at the deepest level, around the bone, and move outward until they reach the epidermis. The second, less popular theory is the top-to-bottom model which says that skin first begins to deteriorate at the surface and then proceeds inward.^[2]

Stage 4 decubitus displaying the Tuberosity of the ischium protruding through the tissue and possible onset of Osteomyelitis

Bed Sore Pathophysiology

Pressure ulcers may be caused by inadequate blood supply and resulting reperfusion injury when blood re-enters tissue. A simple example of a mild pressure sore may be experienced by healthy individuals while sitting in the same position for extended periods of time: the dull ache experienced is indicative of impeded blood flow to affected areas. Within hours, this shortage of blood supply, called ischemia, may lead to tissue damage and cell death. The sore will initially start as a red, painful area, which eventually turns purple. Left untreated, the skin may break open and become infected. Moist skin is more sensitive to tissue ischemia and necrosis and is also more likely to get infected.

Bed Sote Proper care

The most important care for a patient with bedsores is the relief of pressure. Once a bedsore is found, pressure should immediately be lifted from the area and the patient turned at least every two hours to avoid aggravating the wound. Nursing homes and hospitals usually set programs to avoid the development of bedsores in bedridden patients such as using a standing frame to reduce pressure and ensuring dry sheets by using catheters or impermeable dressings. For individuals with paralysis, pressure shifting on a regular basis and using a cushion featuring pressure relief components can help prevent pressure wounds.

Pressure-distributive mattresses are used to reduce high values of pressure on prominent or bony areas of the body. However, methods to evaluate the efficacy of these products have only been developed in recent years.^[7]

FULLY ELECTRIC 3 MOTOR HOSPITAL BED

A fully electric hospital bed has 3 motors that allows you to electrically adjust the whole bed up and down; 3 Motor: Head Up and Down; Foot Up and Down PLUS Whole Bed Goes Up and Down. The third motor (fully electric) is helpful if you need to transfer to a wheelchair (so the hospital bed can be at the same level of the wheelchair.) Also it can assist a caregiver to get you at the right height for the caregiver. If you are short, a low bed is helpful to help you get into bed. A low bed can also be helpful if you feel someone may ever fall out of bed. Low beds go as low as 7" to 9" without the mattress. 36" x 80" Standard some 84"

IF YOU ARE DISABLED

Although all hospital beds elevate and bend the legs to help with circulatory problems and low back pain, some doctors recommend trendellenburg and Cardio-Chair reclining functions.

Trendellenberg slants the whole body flat with the feet up and the back down; or reverse trendellenburg that does the opposite. Trendellenburg also helps a caregiver and the patient themselves to self-boost and re-adjust their body's position on the hospital bed.

Cardio-Chair Reclining features of theTransfer-Master Sleeper Lounge or Tri-Flex help maintain comfort, respiratory and circulatory functions. Cardio-Chair reclining positions are also used in pain avoidance positioning creating pressure relief that may also ultimately help to prevent decubitus ulcers. If someone is disabled, Cardio-Chair Reclining features are surely an added benefit.

BED SORES

If Bed Sores (Stages I-IV) are a concern, there are many advanced technology, special therapeutic support, alternating air and Lateral Rotation Therapy mattresses available. We would recommend, for one, the fine mattresses from Blue Chip. Mattresses Span-America Blue-Chip Sleep-Center Gendron

	Innerspring Adjustable Bed Mattresses
	Air Mattresses
	Latex Foam Mattress
	Memory Foam Mattresses by Tempur-pedic
	Sleep Center Medical Mattresses: Blue Chip, Span America, Volkner

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FULLY ELECTRIC 3 MOTOR HOSPITAL BED