The Danger of Bed Sores
Bed sores (also known as pressure sores) can be a serious concern if you are living with advanced MS, because of the amount of time you spend lying down or sitting in a wheelchair. These skin lesions occur when the skin is under constant pressure, impairing the blood supply to the skin, fat and muscles. This causes the skin to break down and increases the risk of infections and deep ulcers.
Stages of Bed Sores
There are several stages of bed sores, each worse than the last. They are:
- Stage I – Skin appears pink or red in color, but is not broken.
- Stage II – Abrasions and blisters may start to appear as the skin starts to wear away.
- Stage III – Skin over the sore has worn away. The wound can go as deep as the fat layer.
- Stage IV – Muscles, tendons and bones may be exposed.
MS and Bed Sores: Prevention
Understanding the risk factors for bed sores will help you take action sooner rather than later.
- Stay active – Decreased mobility is the biggest risk factor for bed sores, so stay as active as you can for as long as you can.
- Shift frequently – If you are in a wheelchair or are in bed most of the time, shift your position regularly to avoid constant pressure on one area. If you're not able to move yourself, your caregiver will have to help you with this. Aim to shift your position every 15 minutes or so in a chair and every couple of hours in a bed. Do regular stretching exercises if you're able.
- Maintain a healthy weight – Aim for an optimal weight: not overweight but not underweight either. If you are overweight or obese, those extra pounds will put additional pressure on your skin. If you are underweight, the skin will be in close contact with your bones, and the bony prominences will irritate the skin. Pay attention to your diet and nutritional requirements.
- Keep clean – You or your caregiver will need to wash your skin daily with a gentle cleanser and warm water. Dry well and use talcum powder to absorb excess moisture. If you experience bowel or bladder incontinence and are using diapers, bacteria like E Coli can cause skin and urinary infections. Change diapers and clean your skin regularly.
- Aim for an ideal moisture balance – Not too dry, not too moist. Again, you need to find balance. Dry skin can get cracked, damaged and infected easily. Too much moisture can also make a good environment for bacteria and fungi to grow. Stay well-hydrated and use lotions, but not excessively. There are lotions available specifically designed to prevent bed sores.
- Check for injuries – Since nerve function is affected by MS, you may experience decreased skin sensation. Decreased skin sensation can be problematic, as you can not feel a skin injury (which can turn into a bed sore) and as a result, not treat it properly. Examining your skin regularly will help you spot any changes or injuries that need taking care of.
- Other conditions – Other conditions such as diabetes, anemia, and heart diseases can affect your body's ability to heal/repair damaged skin and fight infections. Be extra vigilant if you have one of these in addition to your MS.
- Good mattress/cushion – Have a comfortable mattress and pillow so the pressure applied by your body on the mattress is optimally distributed. Your wheelchair should also have a comfortable cushion.