Bed sores, also known as pressure ulcers, are areas of damaged skin and underlying tissue. They occur due to prolonged pressure, which restricts blood flow to the affected area. This article explores creams used in bed sore management.
Understanding Bed Sore Stages and Cream Relevance
Bed sores are categorized into stages based on their severity, influencing the appropriate care approach.
A Stage 1 pressure injury presents as intact skin with persistent redness or discoloration. At this initial stage, creams focused on protection and moisture are often considered.
A Stage 2 pressure injury involves partial thickness skin loss, appearing as a shallow open sore with a pink or red wound bed, or an intact or ruptured blister. For this stage, creams that support a healing environment and gentle protection are used. Stage 3 bed sores show full thickness tissue loss where subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed.
Stage 4 pressure injuries involve full thickness tissue loss with exposed bone, tendon, or muscle, often with slough or eschar present. Additionally, unstageable pressure injuries have full thickness tissue loss where the base of the sore is obscured by slough or eschar, making the true depth unknown. Deep tissue pressure injuries involve intact or non-intact skin with localized purple or maroon discoloration, indicating damage to underlying soft tissue. The progression through these stages dictates specialized care, including the type of cream or topical agent used.
Key Cream Categories and Their Benefits
Different categories of creams serve specific purposes in bed sore management.
Barrier creams are designed to protect the skin from moisture and friction, which can exacerbate existing sores or contribute to new ones. These creams often contain ingredients such as zinc oxide or dimethicone, forming a protective layer over the skin. They are commonly used for prevention or in the early stages of pressure injury development to shield vulnerable skin from irritants like urine and stool.
Antiseptic and antibiotic creams are employed when there is a risk of infection or an existing infection in open sores. Antiseptic creams, like those containing povidone iodine or cadexomer-iodine, work by killing or slowing the growth of microorganisms. Antibiotic creams, such as silver sulfadiazine or mupirocin, are typically prescribed for specific bacterial infections and are used under medical supervision to treat infected wounds. These specialized creams address microbial load, which can hinder the healing process.
Moisturizing creams and emollients help maintain skin integrity and prevent dryness, particularly around the bed sore or on fragile skin. Ingredients like lanolin and beeswax can lock in existing moisture and attract additional hydration from the air. Regular application helps keep the skin supple and resilient, supporting the overall health of the surrounding tissue. These creams are generally suitable for skin that is dry but not broken.
Some specialized creams are formulated to aid in wound healing or debridement, the process of removing dead tissue. For instance, collagenase-containing ointments can break down dead tissue, facilitating the body’s natural healing processes. Other agents like phenytoin, when applied topically, have shown a capacity to promote collagen deposition and fibroblast proliferation, which are integral to tissue repair. These types of creams are usually part of a comprehensive wound care plan directed by a healthcare professional.
Proper Application and General Skin Care
Proper application of creams to bed sores is crucial for their effectiveness and for promoting healing.
Before applying any cream, the affected area should be gently cleaned with a mild soap and water or a saline solution. After cleaning, the skin should be carefully patted dry to prevent further irritation or maceration.
Creams should be applied in a thin, even layer over the affected skin area. Applying too much cream can sometimes hinder the skin’s ability to breathe and may prolong recovery. The frequency of application can vary depending on the specific product and the wound’s condition, but it is often recommended to apply with each dressing change or as directed by a healthcare provider. Gentle handling of the skin during cleaning and application is paramount to avoid additional damage.
Beyond cream application, general skin care practices play a role in supporting healing and preventing new bed sores. Maintaining good hygiene by keeping the skin clean and dry helps reduce the risk of irritation and infection. Adequate nutrition, including sufficient calories, protein, and vitamins like C and zinc, also supports skin health and wound healing. Regular repositioning of an individual, approximately every two hours in bed or every 15 minutes in a chair, helps redistribute pressure and protect vulnerable areas.
When Professional Medical Guidance is Necessary
While creams can be a component of bed sore management, professional medical evaluation and care are frequently required, especially for sores beyond the earliest stages.
It is important to seek medical attention if any signs of infection are present, such as increasing redness, warmth, swelling, pus-like drainage, a foul odor, or fever. These indicators suggest a worsening condition that topical creams alone cannot address.
Medical consultation is also necessary if a bed sore does not show improvement or appears to be worsening despite consistent care and the use of appropriate creams. Any bed sore that is deep, large, or that exposes underlying structures like muscle or bone demands immediate professional intervention. New sores developing despite preventive measures also warrant medical assessment. Individuals experiencing significant pain associated with a bed sore should consult a healthcare provider for appropriate pain management and treatment adjustments.