Pressure Ulcers, also known as “bedsores” or Decubitus Ulcers, are the most common and well known wounds which develop in nursing homes. They are most often caused by pressure applied to soft tissue resulting in completely or partially obstructed blood flow to the soft tissue. Thus, they are often found on people who cannot freely move about such as those who are bedridden or confined to a wheelchair.
The Bedsore and Pressure Ulcer Attorneys at the Noll Law Office are experienced in all aspects of litigation related to bedsores in nursing homes abuse and neglect cases throughout the State of Illinois. If you or your loved one has been diagnosed with a bedsore, our lawyers can be contacted at (217) 414-8889 for a Free Initial Consultation.
On April 8 – 9, 2016, the National Pressure Ulcer Advisory Panel (“NPUAP”) redefined the term pressure injury as well as updated the staging definitions. Below, we will summarize the definition of a pressure injury as well as the staging definitions as determined by the NPUAP.
A pressure injury is localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device. The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, co-morbidities and condition of the soft tissue.
Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area. The area differs in characteristics such as thickness and temperature as compared to adjacent tissue. Stage 1 may be difficult to detect in individuals with dark skin tones. May indicate “at risk” persons (a heralding sign of risk).
Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister. Presents as a shiny or dry shallow ulcer without slough or bruising. This stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration or excoriation.
Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. The depth of a stage 3 pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have (adipose) subcutaneous tissue and stage 3 ulcers can be shallow. In contrast, areas of significant adiposity can develop extremely deep stage 3 pressure ulcers. Bone/tendon is not visible or directly palpable.
Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling. The depth of a stage 4 pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have (adipose) subcutaneous tissue and these ulcers can be shallow. Stage 4 ulcers extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteomyelitis likely to occur. Exposed bone/tendon is visible or directly palpable. In 2012, the NPUAP stated that pressure ulcers with exposed cartilage are also classified as a stage 4.
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According to the British Journal of Medicine, there are four main mechanisms which contribute to pressure ulcers.
There are various forms of treatment depending on the staging of the wound. They range from fairly conservative treatment upto and including surgery. Below, we will outline some forms of treatment as recommended by the Mayo Clinic.
The first step in treating a bedsore is reducing the pressure and friction that caused it. Strategies include:
Care for pressure ulcers depends on how deep the wound is. Generally, cleaning and dressing a wound includes the following:
To heal properly, wounds need to be free of damaged, dead or infected tissue. Removing this tissue (debridement) is accomplished with a number of methods, such as gently flushing the wound with water or cutting out damaged tissue.
Other interventions include:
A large pressure sore that fails to heal might require surgery. One method of surgical repair is to use a pad of your muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).
The Personal Injury Lawyers at the Noll Law Office represent clients throughout Illinois who have developed bedsores in nursing homes. Our pressure ulcer attorneys are happy to speak to concerned family members free of cost to investigate whether the nursing home is responsible for the development of the bedsore and to pursue coverage for the injured resident to cover their medical bills, future medical bills, and pain and suffering. Most bed sores are preventable with proper care. If your loved one has been injured, our Illinois Bedsore Attorneys can be reached at (217) 414-8889.
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If you have been injured due to the negligence of another, emotional stress compounds the physical injury. We understand. Whether your trauma resulted from a car accident, dog bite, nursing home abuse or work injury, we take the stress of dealing with the insurance companies off your shoulders so you can focus on getting better.
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