Bedsores
Nourishing Skin under Pressure
You would think that a couple of thousand years would be enough time to find a way to beat an ailment as common as bedsores. Evidence of these painful lesions has been found in ancient Egyptian mummies, but today we're still struggling to prevent bedsores from forming on people who are confined to bed.
Clearly, the quality of mattresses has improved since the rule of King Tut. So why are bedsores still such a problem? Because bedsores, also known as pressure ulcers, have less to do with beds and lots to do with nutrition, say the experts. And that, sadly, is something that can still be pretty poor even in this day and age, especially among the elderly.
"The bottom line is that a malnourished person is predisposed to developing a pressure ulcer," explains Mitchell V. Kaminski, Jr., M.D., staff surgeon at Thorek Hospital and Medical Center in Chicago and clinical professor of surgery at the University of Health Sciences/Chicago Medical School. Dr. Kaminski has researched and written extensively on the nutrition-pressure ulcer connection. "In fact, the more malnourished a person is, the more severe the ulcer. I believe that malnutrition may be the most significant component in the development of the type of pressure ulcer commonly seen in Americans today," he says.
| Food Factors Though they're called bedsores, your nutrition--along with change of position--is more important than your mattress when it comes to avoiding these painful lesions. Here is what most experts recommend to keep your skin healthy and free of bedsores. Get protection from protein. "Protein is very, very important for healing skin," says Mitchell V. Kaminski, Jr., M.D., staff surgeon at Thorek Hospital and Medical Center and clinical professor of surgery at the University of Health Sciences/Chicago Medical School. "You really need to increase your protein intake when you're dealing with pressure ulcers." Researchers at the University of Maryland at College Park gave supplements containing either 14 or 24 percent protein to 28 people with pressure ulcers. The researchers found that those who received the higher-concentration supplements experienced significant decreases in the surface areas of their pressure ulcers, while those receiving only 14 percent experienced almost no changes. To prevent or treat bedsores, Dr. Kaminski recommends that people get about 0.68 gram of protein per pound of body weight. That's about double the amount of protein you would typically need. To get enough protein to prevent bedsores, a 140-pound woman who is at risk, for example, would need 95 grams of protein, or about the amount found in four three-ounce cans of tuna. "If it's too difficult to get that much protein from foods, liquid protein drinks work just as well," says Dr. Kaminski. These are available in your local pharmacy. |
Anatomy of a Bedsore
Essentially, a bedsore occurs as the result of skin being suffocated beneath the body's weight. When someone lies or sits in one position for a long time, as is the case with people who are bedridden with illness or who use wheelchairs, the skin over bony prominences such as the hips and tailbone is squeezed against hard surfaces. This squeezing cuts off the blood supply that delivers oxygen and nutrients to the tissues. Eventually the smaller blood vessels clot, and a sore red patch appears, which, left unchecked, can crack open and develop into a crater-like, painful wound. In worst-case scenarios, the tissues can erode deeply, exposing muscle or bone.
One of the best ways to avoid bedsores is by continually changing positions. Doctors recommend moving every 15 minutes, if possible, or at least every two hours if you're in a bed or every hour if you're in a chair. It doesn't take much time for a bedsore to develop, especially when skin is thin and frail, when wound healing is slower and when movement is limited, as is the case with many elderly people.
That's why good nutrition is essential. The healthier and thicker your skin is, the better it can withstand the weight of your body and the less likely you are to get a bedsore.
Note: Though nutritional supplementation may expedite healing, it's very important that any bedsore that develops be treated under a doctor's supervision. And anyone who has diabetes must be especially alert for this condition. Bedsores can get worse very, very quickly.
Multivitamin Protection
Some doctors recommend A multivitamin/mineral supplement is especially important for older people who are confined to bed or to wheelchairs. They are frequently deficient in a wide array of vitamins, notes Dr. Kaminski.
| Prescriptions for Healing Research shows that strong skin and physical activity are your best defenses in the fight against bedsores. Here's what many experts recommend to toughen up and heal your skin. Nutrient Daily Amount
Vitamin C 1,000 milligrams Zinc 15 milligrams Plus a multivitamin/mineral supplement
MEDICAL ALERT: It's important that any bedsore be treated under a doctor's supervision. |
Vitamin C Plays a Major Role
One of the most common single vitamin deficiencies among the elderly is vitamin C. Too little of this vitamin opens the door to thinning skin, capillary fragility and, consequently, bedsores.
Some studies even indicate that vitamin C deficiency may be the key nutritional factor in bedsore development. Researchers studying 21 elderly people with hip fractures at St. James's University Hospital in England reported that of the 10 who eventually developed bedsores, all had vitamin C deficiencies. In fact, their vitamin C levels were just half of those of the people in the study who did not develop sores, even though other vitamin levels were similar.
"Vitamin C deficiency can double your healing time," says Dr. Kaminski. "I routinely put my patients who are being treated for or who are at risk for pressure ulcers on 1,000 milligrams of vitamin C a day. Vitamin C won't help if there is no deficiency, but the extra vitamin won't hurt, either."
Zinc Speeds Healing
Like vitamin C, zinc has been linked in studies to preventing bedsores and helping them to heal.
"If there is a zinc deficiency, healing time is retarded by 50 percent," says Dr. Kaminski. "Like vitamin C, supplemental zinc won't do any good if there is no deficiency. But zinc deficiency is so common that I routinely supplement it as well."
The Daily Value for zinc is 15 milligrams, an amount that you can get from either foods or supplements. To add some superior food sources of zinc to your diet, try eating more seafood and shellfish, wheat germ and whole-grain breads and cereals.
