Pressure wounds, also known as pressure ulcers or decubitus ulcers, form when a person’s skin is kept under too much pressure to allow blood flow to the affected area. The first sign of this condition is a bedsore; when left untreated, it can progress into an open wound, leading to infection and damage to underlying bone, muscle, joints and tendons.
The CDC found that 11 percent of nursing home patients had a pressure wound in 2004, and some studies conclude that they occur in up to 28 percent of nursing home residents. Pressure wounds often affect the most vulnerable nursing home residents — those who are bed-bound or confined to wheelchairs, and rely on the assistance of staff to prevent these injuries. When they are allowed to manifest in the first place they are often signs of negligence in the nursing home, when they are allowed to progress without proper treatment they can be deadly.
Preventative Measures Against Bedsores
As people age, their skin becomes more brittle and susceptible to skin wounds. Bedsores are predictable occurrences in nursing homes, particularly for those with limited mobility. It is part of the duty of care that a nursing home is charged with to prevent these wounds through preventative measures and frequent checking.
Pressure wounds are most prevalent in the parts of the body that have less body fat or muscle between skin and bone, such as at the spine, tailbone, shoulder blades, hips, heels and elbows. The risk increases in those who are incontinent, had recent weight loss and are under age 65.
To prevent bedsores and pressure wounds, nursing home staff should regularly:
- Reposition immobile residents — at least every 2 hours if they already have bedsores
- Help residents to lie at a 30-degree angle, which reduces pressure on susceptible areas
- Use pressure-relieving devices such as pillows or foam padding
- Frequently check bedding and clothing, ensuring that they are dry
- Check on residents daily — more frequently for those at higher risk
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The Stages of Pressure Wounds
Pressure wounds are graded according to their severity — with the last two stages considered nursing home “never events,” meaning they should never be allowed to happen:
- Stage 1: The skin isn’t broken but stays red or discolored for at least 30 minutes after the pressure is removed
- Stage 2: The topmost layer of skin is broken, creating a shallow, open sore
- Stage 3: All layers of the skin are destroyed
- Stage 4: The wound has progressed into subcutaneous layers of muscle and bone, causing irreversible harm
What are the Consequences of Pressure Wounds?
Stage 3 and 4 pressure wounds aren’t easily treatable, and 35 percent of pressure wounds Stage 2 or higher require specialized wound care.
According the US Department of Health and Human Services, 60,000 die each year of complications resulting from pressure ulcers, and more than 17,000 negligence lawsuits concern them annually. They are the second most common claim after wrongful death.
Illustration of a pressure ulcer. Source: Wikipedia
Disallowing for worst-case scenarios, pressure wounds can cause many other complications:
- Necrotizing fasciitis
- Osteomyelitis (inflammation of bone or bone marrow)
- Septic arthritis
- Mental confusion
- Increased weakness
When Should a Nursing Home Be Held Accountable for Pressure Wounds?
Nursing home neglect contributing to pressure wounds can include:
- Leaving residents with limited mobility in the same position for too long
- Causing dehydration and malnutrition in residents, which can make them more vulnerable to skin breakdown, infections and sepsis
- Leaving soiled adult diapers or wet bed sheets on the resident too long, which can expose them to a higher risk of bedsores
- Not checking on those with bedsores or at risk of bedsores regularly
- Not notifying the resident’s family and physician upon development of sores, impeding proper treatment
When to Consult with an Experienced Malpractice Attorney
Pressure wounds are mostly preventable, and some may lead to serious injury. The best course of action if you feel that nursing home negligence has caused harm to a loved one is to consult with skilled attorneys like those at McEldrew Young Purtell as soon as possible. With 30 years of experience in medical malpractice, McEldrew Young Purtell is well suited to evaluate the situation and help determine if the injury suffered involved acts of negligence.