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The definition of decubitus, causes of its development, prevention and treatment

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The definition of decubitus

Decubitus ulcer is also known as bedsore which is a skin tissue damage by permanent pressure, shear force, friction or a combination of this effects. Its symptoms appear in painful and difficult-to-heal wounds and ulcers, later the skin or even bone cells can die.

Causes of decubitus development

The development of pressure ulcers mainly occur among long-term bedridden patients who as a consequence of an accident, old age, after surgery, or other chronic illnesses are bedridden for a longer period of time due to their treatment and care. The biggest risk factor is the elderly, as the skin loses its elasticity as it ages, and it is easier to develop injuries that take longer to heal.

If a patient spends a lot of time in a certain lying or sitting position, pressure is put on the skin surface, resulting in a reduced blood supply to that area and besides in the layers of the skin anoxia (oxygen deficiency) and metabolic disorder occur. As a consequence of this bad blood-supply, body parts can more easily damaged and also difficult to regenerate, so when the patient is being moved to another position, being washed or being dressed by a caregiver, the skin stretches and injuries to the skin tissues occur which together develop decubitus.

Most often, the lower body parts are affected by bony elevations or areas with less muscle or adipose tissue. When lying on back it is more likely to have a bigger risk of getting bedsore to body parts like sacrum, heels, buttocks, elbows and scapula which are continuously exposed to pressure. When lying on side thigh, hip and ankles are at big risk of developing bedsore.

 Body parts where decubitus can develop

Preventing decubitus

Like most of the diseases it is necessary to pay attention to prevention. With attention and care, bedsores can be easily prevented. The most important viewpoint is to give professional information to the patients and their caregivers.

It is necessary to change the patients’s lying position, they should not just lie on their back, they should be moved regularly to the right or left as well, which shoul be secured with pillows or mattresses. The pressure can be reduced when they are lying on their side and it is recommended to place a a decubitus pillow under the heels and the sacrum. Bed linen must remain free of creases and dry in all cases, and sleepwears should be made of natural clothing materials.

Not only pay attention to general hygiene, but also to the temperature of the room, because if it is too hot in the room, due to sweating the skin is more exposed to friction and the development of infections. Adequate nutrition and vitamin intake, as well as regular meals and fluids also play a key role in prevention. The person should be washed once a day beginning from top to bottom and then thoroughly wiped dry. Then you can use the special skin care product in the endangered areas.

Many doctors and nurses recommend dermolex skin regenerating gel, which contains herbal ingredients (Aloe vera, Echinacea purpurea, and several others), significantly reduces the risk of developing bedsore and provides effective support for patients who are permanently bedridden.

Its carefully selected ingredients refresh and regenerate the skin exposed to long-term pressure. The gel formulation is rapidly absorbed and will not stain the clothes or the bed linen as it does not contain any colourings or fragrances.

The usage of this product is very easy, cleanse and dry the skin, then gently massage it into the skin, use it one or twice a day and significant results can be achieved. Dermolex gel can be purchased here.

Stages of decubitus

It is a fact established by medicine that the bigger pressure on the surface of the skin, the shorter time it can develop an ulcer. Only 3-4 hours can be enough for tissue damage. Its stages can be divided according to the depth of the wound.

Four stages of decubitus

The first stage of decubitus

There are no wounds on the skin surface, however, there is redness that does not turn white at the touch of a finger. The skin is warm to the touch, with weepy (watery) and painful swelling may also occur. The skin is sensitive, thinned and more easily to get damaged.

The second stage of decubitus

The skin begins scarring, partial erosion occurs of the epithelium on the surface which look like a bruise and small blisters appear.

The third stage of decubitus

The entire skin tissue is affected by the damage, then the entire layer of it dies, the ulcer is already deep, and it goes toward to the muscle tissue. The area becomes dry and cold and there is loss of sensation in skin. Firstly skin turns into dark blue, then brownish red, next gangrene affects the skin. Wet, secretory tissue death can also occur, in which case the wound is black and has an unpleasant odor. At this stage, the chances of recovery are low and very difficult to reverse.

The fourth stage of decubitus

In this stage ulcer may spread to the muscles and bones as well, the wound turns black and because of the bone tissues are being damaged osteomyelitis (infection of the bone) and tissue death can appear.

In some cases, the subsurface deeper layers of the skin are damaged even when the surface is still intact, so even after the onset of symptoms, the patient's condition may deteriorate even more rapidly, so it is important to emphasize on prevention.

Treatment of decubitus

The treatment of bedsore depends on the progress of the stages, as each must be treated accordingly. In all cases, a medical examination is required.

Wounds should be bandaged regularly, changed several times a day, with wet, intelligent bandages that can be ordered by a dermatologist, surgeon, or rehabilitation specialist. Home care services can help with wound care at home. When re-bandaging, the previous cover is rinsed with saline water then the dead skin parts are removed, afterwards it is covered with hydrochloride and gel to keep the bond wet and prevent the development of infections. In severe cases, dead tissue is surgically removed by a doctor.

Traditional home-made disinfectants and dusting powders should be avoided due to their allergenic effects, as they make wound healing more difficult. Antibiotic treatment may also be necessary at some time to avoid inflammation. Treatment should only be performed at home with medical instructions.


The development of decubitus is most common in long-term bedridden patients, including the elderly. Symptoms include wounds which can be difficult to heal and also painful and ulcers. In severe cases, it can even cause skin or bone tissues death.

The good new is that with proper care, it is possible to prevent decubitus in most cases. Furthermore if symptoms of its development become visible, a healthcare professional should be consulted and treatment initiated as soon as possible.

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