Also known as pressure sores, decubitus ulcers and pressure ulcers, bedsores are among the most common secondary medical conditions that you may experience as a quadriplegic. When you are confined to a wheelchair due to a spinal cord injury, your weight can put enough pressure on certain areas of your body to limit the flow of blood to the skin in these areas. The skin can become more fragile due to the lack of blood and more vulnerable to tearing due to shear and friction.
Left untreated, tearing of the skin can lead to a life-threatening infection. Therefore, it is important to be vigilant in watching for the signs of bedsores and obtaining prompt treatment if and when they do occur.
The appropriate treatment for a bedsore depends partly on its stage. Staging of bedsores is a measure of how deeply the ulcer penetrates into the skin. Stage 4 is the deepest, sometimes extending beyond the skin to affect the soft tissues underneath, like ligaments or muscles. Stage 1 is the most superficial and therefore the mildest.
Cleaning and dressing
If the ulcer is severe, this may involve debridement of the wound, i.e., removing dead tissue. Sometimes, though not always, this requires surgery. However, if the wound has not yet advanced very far, cleaning with saline solution or a gentle cleanser may be sufficient.
Dressing the wound is necessary once it is clean to promote healing and to prevent it from becoming worse. You may require a combination of dressings that may include gels, foams or gauzes.
Reducing pressure
Reducing pressure on the body not only helps an existing bedsore to heal but helps prevent new ones from forming. Special cushions added to your wheelchair can help to relieve the pressure. Repositioning is also helpful.
Surgery
It is sometimes necessary to perform surgery to close a bedsore that is large and/or resistant to other treatment methods.
Additional interventions that may help promote bedsore healing include good nutrition and negative pressure therapy with a vacuum-assisted closure device that uses suction to help clean and close the wound.