The Fastest Way to Get Rid of Pressure (Bed) Sores

By Scihealthhub – October 3, 2024

This article aims to provide effective,  evidence-based strategies that can help one get rid of pressure (bed) sores as fast as possible. 

Pressure sores are one of the most common secondary health conditions affecting individuals with spinal cord injuries. 

About one-third or 30-40% of individuals with new spinal cord injuries develop pressure sores during their initial hospitalization (1).

Also, between 50% and 80% of individuals with spinal cord injuries develop a pressure sore at least once in their lives (2).

Pressure sores represents a huge burden to affected individuals, with significant complications. It has negative impacts on the psychological, physical, economic and social wellbeing of affected individuals. It is a major cause of repeated hospitalization, multiple surgeries and premature death. 

Studies have shown that individuals with pressure sores have a 4.5 times greater risk of death than persons with the same risk factors but without pressure sores (3).

Sepsis has been identified as the major cause of these deaths. Sepsis occurs when an infection originating from the wound site, enter the blood and spreads through out the body until it overwhelms the vital organs of the body and leads to death.

The good news is that 95% of pressure sores are preventable with the right measures and close monitoring (4). 

However, if one develops a pressure sore, early identification and fast treatment is essential for better outcome and to prevent complications which could be life-threatening. 

What are pressure sores and how do they develop?

Pressure sores, also known as pressure ulcers, bed sores or decubitus ulcers, are areas of damaged skin and underlying tissues primarily caused by prolonged pressure on the skin. 

These sores often develop in individuals who are bedridden or have limited mobility.

Usually, pressure sores develop in bony areas like the hips, heels, tailbone, elbows and buttocks. 

Here’s how pressure sores typically develop:

• Prolonged Pressure: When a person stays in one position for too long, especially in bony areas (mentioned above), the constant pressure compresses the blood vessels. Without adequate blood flow, the tissue begins to die, leading to the formation of sores.
• Friction: occurs when the skin rubs against clothing or bedding, causing the outer layer of skin to weaken or break down. This is common when someone shifts positions in bed or is moved without proper support.
• Shear: happens when the skin moves in one direction, but the underlying bone moves in another. For instance, if a person slides down in a bed or wheelchair, the skin can stretch and tear at a deeper level, making it more prone to ulcers.
• Moisture: Excess moisture from sweat, urine, or feces can soften the skin, making it more susceptible to breaking down.
• Poor nutrition and hydration: A lack of proper nutrients and hydration weakens the skin and underlying tissues, making them less resilient to pressure and more prone to damage. Protein, vitamins, and minerals are essential for maintaining healthy skin.

What are the 4 stages of pressure (bed) sores? 

Pressure sores typically develop in stages, starting with redness and progressing to open wounds.

We will briefly describe these stages because it will help us better understand the fastest way to get rid of pressure sores. 

There are four (4} stages of pressure sores, which are:

• Stage 1: This is the earliest stage of pressure sore and the easiest and fastest to treat. At this stage, there is a red, unbroken skin that doesn’t fade after pressure relief.
• Stage 2: there is partial skin loss with shallow open sores.
• Stage 3: full-thickness skin loss where fat may be exposed. 
• Stage 4: Severe tissue loss, with muscles, bones, or tendons exposed.

Early identification is crucial because the faster you recognize and treat the sore, the better the outcome.

Why is it important to get rid of pressure sores fast? 

It is crucial to get rid of pressure sores quickly because delaying treatment can lead to a range of severe complications that negatively impact both short-term recovery and long-term health. 

Here are the key reasons why fast intervention is essential:

• Prevent infection: As the sore progresses, bacteria can enter the open wound, leading to local infections or even systemic infections like cellulitis (infection of the skin), osteomyelitis (infection of the bone), sepsis (infection spreads via the blood throughout the body) 
• Prevent tissue necrosis: If left untreated, the skin and underlying tissues may die due to lack of blood flow, leading to necrosis (dead tissue). Necrotic tissue cannot heal and must be surgically removed, which further complicates recovery and may lead to long-term disability.
• Minimize pain and discomfort: Bed sores can be extremely painful, especially as they progress to more advanced stages. Severe discomfort from advanced pressure sores can make mobility, sitting, or lying down difficult.
• Speed up recovery time: Early treatment of pressure sores significantly speeds up the healing process. When sores are detected in their early stages (Stage 1 or 2), they can often be managed with basic care, such as pressure relief, wound cleaning, and dressings.
• Avoid surgical intervention: Early treatment can prevent the sores from getting to more advanced stages (Stage 3 or 4) where surgical interventions, such as debridement (removal of dead tissue) or even skin grafting may be needed to close the wound.
• Reduce risk of recurrence: When sores are addressed and treated quickly, the wound is more likely to heal properly with minimal damage to the underlying tissues and minimal scaring. This reduces the risk of developing new pressure sores in the same area in future. 
• Improve quality of life: Pressure sores can severely impact a person’s quality of life, causing pain, discomfort, and mobility issues.
• Lower healthcare costs: Treating pressure sores in the early stages is generally less expensive and less resource-intensive. Advanced bed sores require costly treatments like wound care specialists, hospital stays, surgical intervention, and long-term follow-up care.

The fastest methods to get rid of pressure sores: Step-by-step treatment 

A. Relieving Pressure

The first and most important step in healing bed sores is reducing the pressure on the affected areas. Prolonged pressure cuts off blood circulation, causing more tissue damage and worsening the sore. 

Here are a few ways to relieve pressure:

• Frequent repositioning: Individuals lying in bed should change positions every two hours, while those sitting in a wheelchair should perform pressure relief maneuvers every 15-20 minutes.
• Cushions and pillows: Use pillows or foam wedges to offload pressure from the area
• Pressure-relieving surfaces: Special surfaces, such as air or water-filled mattresses, alternating pressure mattresses and pressure relief cushions help distribute weight evenly and reduce pressure on affected areas.

B. Keeping the wound clean

Maintaining a clean environment for the wound is vital for quick healing and preventing infection:

I) Cleaning the sore

For stage 1, gently wash the area with mild soap and water to keep it free from bacteria. Then apply a moisturizer.

For stages 2 and above, the solution for wound cleaning will depend on whether the sore is infected or not.

When there is no evidence that the sore is infected, normal saline should be used to clean the sore.

But, if the wound is infected, chemical solutions like povidone iodine (dilution is recommended) or sodium hypochlorite (2.5%) should be used initially to kill germs, dissolve and remove dead tissues in the wound. After cleaning with these chemical solutions, normal saline should be used to rinse the wound. Once, the wound becomes clean and free from infection, stop using the chemical solution and use only normal saline to clean the wound. 

Meanwhile, the signs of an infected pressure sore include: fever, discharge from the sore, bad smelling sore, warmth or swelling around the sore.

II) Wound dressings: 

For stage 1, no wound dressing is needed. 

For stages 2 above, various good wound dressing options are available. The major ones include hydrocolloids, foams, gauzes, hydrogels, transparent films, collagen and alginate dressings. 

Each of these wound dressing types, when applied correctly, help maintain moisture balance, prevent infection and promote fast healing of the sore.

However, based on available evidence, hydrocolloid dressings and foam dressings are the most commonly recommended options for faster healing of pressure sores.

III) Change the wound dressing regularly 

The frequency of changing a wound dressing for pressure sores depends on the type of dressing, the amount of discharge, and the wound’s condition.

However, general guidelines are:

Hydrocolloid dressings – these dressings can stay on for 3-7 days unless they become saturated with discharge or show signs of infection. They form a gel-like layer that can be left in place longer, helping to speed up healing.

Foam dressings – typically, foam dressings need to be changed every 2-4 days, or sooner if they become saturated with fluid. If the wound is producing heavy discharge, more frequent changes may be necessary.

Hydrogel dressings – these are usually changed every 1-3 days, depending on how moist the wound is. Hydrogels may dry out, so more frequent changes are sometimes required.

Alginate dressings – these should be changed every 1-3 days, or more often if the wound is producing a lot of discharge.

Collagen dressings – typically changed every 1-3 days, depending on the amount of wound discharge and healing progress.

Gauze dressings – should typically be changed at least once daily. However, if the wound is heavily discharging, contaminated, or infected, more frequent changes (every 4-6 hours) may be necessary to prevent the gauze from drying out, sticking to the wound, or becoming a source of infection.

C. Topical antibiotics treatments for accelerating healing 

Antibiotic creams such as silver sulfadiazine may be applied to wounds to decrease bacterial load and make healing faster. Silver sulfadiazine is very effective in killing germs without damaging the granulation tissues (new, healthy tissue that forms when a wound is healing). 

D. Proper nutrition to speed up healing 

Nutrition plays a critical role in wound healing. A diet rich in essential nutrients can speed up the body’s repair processes:

I) Protein: boosts tissue repair and prevents muscle loss. Include sources like lean meat, fish, eggs, and legumes.

II) Vitamin C: helps with collagen production, which is necessary for tissue repair. Individuals with pressure sores can get vitamin C through dietary sources (fresh fruits and vegetables) and vitamin C supplements.

III) Zinc: Aids in skin repair and immune function. Zinc supplements or foods rich in zinc like nuts, seeds, and seafood can be beneficial.

IV) Hydration: Dehydration can slow healing, so one should aim to drink at least 8 glasses of water daily.

E. Managing moisture and incontinence

Excess moisture from sweat, urine, or feces can break down the skin and worsen pressure sores. Here’s how to manage moisture:

Absorbent pads or briefs: diapers can be used to wick away moisture from the skin and keep it dry. It’s important to check them regularly and change them when soiled. 

Barrier creams: apply moisture-barrier creams like zinc oxide to protect the skin from moisture damage.

Catheters: A bladder catheter or (in males) a condom catheter may be used to control urinary incontinence. 

F) smoking cessation 

It is important to avoid smoking, as it impairs circulation and delays wound healing.

G. Advanced treatment options for severe pressure sores 

For more advanced pressure sores (Stage 3 and Stage 4), home remedies may not be enough, and medical intervention may be required.

I) Debridement

Debridement is the process of removing dead or infected tissue from the sore to promote healing. This can be done in several ways:

Mechanical debridement: using saline and gauze to physically remove dead tissue. 

Enzymatic debridement: using chemical solutions like povidone iodine solution to dissolve dead tissue.

Surgical debridement: for more severe sores, a surgical intervention may be need to remove the dead tissues. 

II) Negative Pressure Wound Therapy (NPWT)

Also known as vacuum-assisted wound closure, NPWT refers to a type of wound dressing systems that continously or periodically decreases air pressure on the wound. 

It is believed that this system can make a pressure sore heal fast by gently sucking out fluid from the wound, reducing swelling, increasing blood flow and keeping the wound clean. 

NPWT systems consist of a foam or gauze dressing put directly on the wound, an adhesive cover, a fluid collection system, and a suction pump. 

III) Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a pressurized chamber. This therapy increases oxygen supply to the wound, helping speed up the healing of deep tissue damage.

IV) Surgical intervention 

In severe cases where tissue damage is extensive, surgery may be necessary to close the wound. 

The surgical procedures available for management of pressure injuries include direct closure, skin grafting, skin flaps, and musculocutaneous flaps.

H. When to seek medical help for pressure sores 

In some cases, pressure sores may not heal with home treatments, and medical attention is necessary. 

In such situation, it is advisable to consult a healthcare professional for advanced care, such as specialized wound dressings, antibiotics for infections, or surgical intervention. 

Signs that indicate the need to consult a healthcare professional include:

• The sore is not improving or is worsening despite treatment.
• Signs of infection like pus, foul odor, fever, or increasing redness around the sore.
• Severe pain or blackened skin, which could indicate tissue death.

In conclusion, to get rid of pressure sores quickly and to improve healing outcomes, it is important to act quickly and follow the steps in this article.

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