Bedsores are the bane of the bedridden. People who get these skin ulcers, caused by poor circulation and inactivity, are usually in poor health or are immobilized in traction. Their conditions make treatment somewhat difficult but not impossible. The ulcers can open, close, and heal, but you can actually identify a trouble spot before it opens: The skin area of an unopened bedsore is dark pink, red, or blotchy.
Whether you have bedsores yourself or are caring for someone who has them, some basic procedures can help the healing go as quickly as possible.
A bedsore, or pressure ulcer, usually occurs over a bony prominence such as a hip or elbow. The sores are caused either by the weight of the body remaining in one position for a long time or by shearing action that exerts pressure on the tissues beneath the skin. Continually sliding down while in a wheelchair or in bed puts extra pressure on the skin and may set the stage for bedsores.
Cleanliness is essential to help prevent infection, says Kathy Foulser, N.D., a naturopathic doctor at the Ridgefield Center for Integrative Medicine in Connecticut, so change the bedclothes as often as possible. Because urine or feces contribute to the breakdown of the skin, it’s essential to keep the area around the sore dry and clean. To help promote healing, suggests Dr. Foulser, apply a poultice with a saline solution, which is simply a cloth dampened with a low-concentration, sterile salt solution like those made by Bausch and Lomb.
If you’re caring for someone who has bedsores, move the person every couple of hours so the pressure isn’t always on the same part of the body. In a hospital, someone on the nursing staff may gently flex and extend the patient’s legs and help her to sit up and lie down, says Dr. Foulser.
It helps to put some protective padding over any areas where the skin is thin and bony prominences press against the bed or chair. And keep all areas of the body clean and dry, Dr. Foulser says. "You can also gently massage the area to stimulate circulation. Anything that gets the blood moving can help," she suggests.
Get Your Vitamins
All of this requires a lot of attention from the caregiver. In addition, there are some supplements that may help, says Dr. Foulser.
Immediately after someone becomes bedridden, taking 500 milligrams of vitamin C four times a day is a good idea, she says. If a sore develops, she advises upping the doses to 3,000 to 4,000 milligrams four times a day. You’ll need to be alert to possible reactions from amounts of vitamin C higher than 1,200 milligrams a day, however, since such high doses can cause diarrhea in some people.
Vitamin C is a good antioxidant and immune system booster. It also helps prevent the breakdown of body tissues. Despite the protective qualities of this important vitamin, however, elderly people often don’t get enough of it. When there’s a deficiency of vitamin C, the skin may become thinner, the underlying capillaries may become more fragile, and bedsores may be more likely to develop.
Another antioxidant, vitamin E, is important for wound healing. It may help avert the breakdown of skin and underlying connective tissues that occurs with bedsores. Dr. Foulser recommends taking between 1,000 and 3,000 international units (IU) of vitamin E daily as a possible preventive. Start with 100 to 400 IU and work up slowly, after discussing the dosages with your doctor.
Vitamin E oil or gel from the herb aloe vera also makes a good poultice as a topical treatment. Place a thin layer of the oil or gel on a sterile gauze pad and place it directly on the sore for a couple of hours, suggests Dr. Foulser.
Minimize Infection
If a bedsore opens, there’s a high risk of infection. Dr. Foulser recommends taking 50 milligrams of zinc three times a day for a few weeks. This is a very important mineral for boosting the immune system and speeding the healing process. Consult your doctor before taking doses higher than 20 milligrams.
If someone is bedridden, her immune system probably isn’t very strong to begin with. When circulation is impeded, as it’s likely to be in someone who’s not moving much, the protective, infection-fighting white blood cells have difficulty reaching the wound, notes Dr. Foulser.
Whenever you take a zinc supplement, you also need a bit more copper, because zinc and copper work in opposition to one another, says Dr. Foulser. Taking zinc alone can cause a copper deficiency. "Usually, it’s enough that the patient is taking a multivitamin that contains about two milligrams of copper. That should keep everything in balance," she says.
Stimulate Skin Repair
Zinc also works well in combination with vitamin A in treating open, uninfected bedsores. Zinc is needed by the skin to produce new cells and grow new layers of skin, while vitamin A is critical in helping the body regenerate and heal tissue.
A multivitamin/mineral supplement that contains the recommended daily amounts of vitamin A and zinc is a good way to start. (If you’re taking a daily supplement, just check the label to see whether it provides 100 percent of the Daily Value.) Frequently, though, those amounts aren’t enough, especially for someone who has problems with absorption or has a poor diet, says Dr. Foulser. "I recommend 50 milligrams of zinc and no more than 12,000 IU of vitamin A," she says. Before taking more than 10,000 IU a day, though, you should talk to your doctor.
