Sunday, March 13, 2011

Textbooks and Stethoscopes: Decubitus Ulcer

By: Sunny Hon

If you didn’t know what decubitus ulcer, or pressure sore, was, you ought to look it up.  It was one of the first things I came across in nursing clinical, and I promise, it would not disappoint.  Up until that moment, I was fairly oblivious to the subject.  I’ve heard the term “pressure sore” before, but I’ve never really connected all the dots.  Like all sobering realties, the lesson here was like cold rain in a summer day – the dots were quickly connected.   

Eight of us had spent the first eight weeks of our clinical in a nursing home.  Because most of the residents were immobile, decubitus ulcers were common sightings.  In a nutshell, decubitus ulcer is the breakdown of the skin and/ or its underlying tissues over boney prominences due to the shortage of blood supply over time.  How much time?  Not as much as you’d think.  For older adults with thinner skin, ulcer can develop quickly over a period of merely hours.  The classification of ulcer is broken down into stages with Stage I being the most superficial to Stage IV having necrosis extending into the muscle, tendon or even bone. 

There I was, standing no more than two feet behind the wound doctor watching the treatment procedure as he described it.  “You have to cut till it starts to bleed.  That’s when you know where the dead tissue ends.”  And bleed he did.  In order to treat decubitus ulcer, the dead tissues must be removed because of its susceptibility to infections.  Depending on the stage of ulcer one has, different methods are used to rid of said tissues.  A diet high in protein and Vitamin C is encouraged to help with the healing process.  Like any other ailments, prevention is the best treatment.  Making sure those immobile patients or loved ones, be turned or have their positions readjusted every two hours will prevent pressure sores from developing.  Trust me, it’s not a pretty sight.         

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