Bedsore care, prevention in elderly population require dermatologist's input

Key Points

Rootstown, Ohio - Decubitus ulcers or bedsores can be a serious condition, especially for the elderly patient. But one expert says prevention, treatment and a dermatologist's early involvement offer the best combination for a positive outcome.

"The dermatologists' role is in skin integrity, treatment and prevention of infection, and identification of ulcers that might be related to malignancy or things other than pressure," says Dr. Mostow, who is also associate professor of clinical dermatology at Case Western Reserve University College of Medicine, Cleveland. "Sometimes, the dermatologist is the only one who can distinguish a pressure ulcer from something else."

The incidence of bedsores in the elderly population has risen, most likely because "the senior population has grown, with multiple medical problems complicating their lives," Dr. Mostow says.

At highest risk among the elderly are those who are immobile and those who are malnourished. While bedsores can be healed, they can also be fatal if left untreated or diagnosed in a late stage. For this reason, Dr. Mostow encourages early and accurate diagnosis, preferably by a dermatologist.

A recent study found the incidence of pressure ulcers in the nursing home environment ranges from 3 to 25 percent. Seniors admitted to acute care hospitals for nonelective procedures such as hip replacement and treatment of fractures were at even greater risk, with an incidence of 66 percent.

Even non-hospitalized seniors are at risk for bedsores. The pressure from sitting or lying in one position for long periods of time may initially cause an area of redness of the skin.

"Some clinicians may see this as just a red area, but a dermatologist might diagnose it as a stage I ulcer or a precursor to an ulcer," Dr. Mostow says.