Bed sores, also know as pressure ulcers or Decubitus ulcers, are areas of skin and tissue that have been injured or broken down. They form most often when a person is sitting or lying in one position too long without shifting their weight. The constant pressure against the skin causes the venules and arterioles to close. If the pressure is not relieved and circulation restored, tissue death can occur within an hour. The areas most often affected by bed sores are over bones that are close to the skin such as the elbow, heels, hips, ankles, shoulders, back, and the back of the head.
Factors that increase the risk of bedsores include: age, the elderly are more at risk; those with the inability to move certain parts of their body without assistance; malnourishment; being bedridden or in a wheelchair; any chronic condition, such as diabetes or artery disease, that prevents areas of the body from receiving proper blood flow and nutrition; urinary or bowel incontinence (moisture next to the skin for long periods of time can cause skin irritation that may lead to skin breakdown); fragile skin and mental disability from conditions, such as Alzheimer’s (some patients may not be capable of taking the proper steps toward prevention and may not seek appropriate treatment when an ulcer has formed).
The National Pressure Ulcer Advisory Panel (NPUAP) created a process for evaluating pressure sores based on a staging system from Stage I (earliest signs) to Stage IV (worst):
Stage I: A reddened area on the skin that, when pressed, is “non-blanchable” (does not turn white). This indicates that a pressure ulcer is starting to develop.
Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.
Stage III: The skin breakdown now looks like a crater where there is damage to the tissue below the skin.
Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes tendons and joints.
Once a bedsore has been identified one should find a way to relieve the pressure in the area. Pillows, special foam cushions and sheepskin can all be helpful in reducing the pressure. Treatment of the sore will depend on the stage. Care should be taken to avoid any further trauma or friction. Powdering the sheets lightly can help decrease friction in bed. In addition assess diet and any other underlying problems that may affect the healing process. As massage can cause tissue damage under the skin, do not massage the area of the bedsore.
Prevention methods include identifying individuals at high risk; ensuring that those who are immobile change their positions at least every two hours to relieve pressure; use items that can help to reduce pressure caused by bed sheets or wheelchairs; make sure that the diet is well balanced, healthy and nutritious; encourage daily exercise, including range-of-motion exercises for those who are immobile; ensure that the skin is well taken care of, keeping it clean and dry.
An Aromatic Approach
Aromatics can be used to help with the control of bed sores and the methods of application chosen will depend on the severity of the bed sore.
At Stage I, when the skin is red and sore but still intact, hydrosols can be used to soothe the skin and reduce surface heat. Spray affected areas directly with hydrosol or hydrosol blend.
At Stage II, when the skin is broken, a compress using undiluted hydrosols can be used.
At Stage III, the wound has deepened and in order to prevent the compress from sticking to the sides of the wound and increasing the trauma, use a mixture of carrier oil (or vegetable gel) and essential oils in the compress. Dilution of essential oil in the carrier 1 – 3% or 1 – 3 drops of essential oil blend in every 5 ml of carrier.
Carriers to be considered include: Calophyllum inaphyllum, palm kernel; Rosa rubignose, rosehip; Aloe vera gel.
Essential oils to be considered include: Lavendula angustifolia lavender;
Chamaemelum nobile Roman chamomile; Chamomilla matricaria German chamomile; Boswellia carteri frankincense; Commiphora molmol myrrh; Pelargonium graveolens geranium and Melaleuca alternifolia tea tree.
Infused herbal oils to be considered include: Echinacea purpurea echinacea;Hypericum perforatum St. John’s wort and Calendula officinaliscalendula.
Hydrosols/hydrolates to be considered include: Rosmarinus officinalis CT borneolrosemary; Myrtus communis myrtle; Sambucus nigra elderflower and Rosa damascene rose.
Jane Buckle, Clinical Aromatherapy in Nursing
Blends For Bed Sores
2 drops of Tea Tree2 drops of Patchouli2 drops of Tea Tree3 drops of Ravitsara
|Blend 1||Blend 2||Blend 3||Blend 4|
|2 drops of German Chamomile||2 drops of Frankincense||2 drops of Roman Chamomile||3 drops of Lavender|
|4 drops of Lavender||2 drops of Myrrh||3 drops of Geranium||2 drops of Manuka|
|2 drops of Myrrh||4 drops of Marjoram||3 drops of Lavender||2 drops of Patchouli|