Bedsores, Pressure Sores, and Decubitus Ulcers Are Caused by Different Types of Tissue Forces

Written by Adam Peck Category: Bed Sores January 26th, 2013 2 min read

Bedsores also known as Pressure Sores and Decubitus Ulcers are accepted to be caused by three different tissue forces:

Pressure, or the compression of tissues

In most cases, this compression is caused by the force of bone against a surface, as when a patient remains in a single decubitus position for a lengthy period. After an extended amount of time with decreased tissue perfusion, ischemia occurs and can lead to tissue necrosis if left untreated in an immunocompromised patient.

Shear force

Shear force occurs when the skin of a patient stays in one place as the deep fascia and skeletal muscle slide down with gravity. This can also cause the pinching off of blood vessels which may lead to ischemia and tissue necrosis.

Friction

Friction is a force resisting the shearing of the skin. This may cause excess shedding through layers of the epidermis.

Aggravating the situation

Other conditions such as excess moisture from incontinence, perspiration or exudate can aggravate the situation. Over time, this excess moisture may cause the bonds between epithelial cells to weaken thus resulting in the maceration of the epidermis. Temperature is also a very important factor. The cutaneous metabolic demand rises by 13% for every 1°C rise in cutaneous temperature. When supply can’t meet demand, necrosis, therefore, occurs. Other factors in the development of bedsores include age, nutrition, vascular disease, diabetes mellitus, and smoking, amongst others.

There are currently two major theories about the development of pressure ulcers, bedsores and decubitus ulcers.

The first and most accepted is the deep tissue injury theory which claims that the ulcers begin at the deepest level, around the bone, and move outward until they reach the epidermis. The second, less popular theory is the top-to-bottom model which says that skin first begins to deteriorate at the surface and then proceeds inward.

– from Steven Peck, Senior Attorney at Peck Law Group

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Written by Adam Peck

Expertise: Personal Injury

Adam J. Peck, ESQ is a principal with Peck Law Group, APC. In 2008, Mr. Adam Peck received his Juris Doctorate from Whittier Law School where he graduated Cum Laude. His practice is primarily dedicated to representing Elders, Dependent Adults, along with their loved ones and family members, who have suffered horrific personal injuries.