Orlando - People who spend long periods of time in bed or in wheelchairs often have more to contend with than boredom.
Decubitus ulcers, or pressure sores - an affliction that affects more than 1 million people each year in the United States and adds as much as $60 million to the nation's healthcare bill - looms as an ever-present problem for any patient who must sit or lie in one position for long periods of time.
If untreated, decubitus ulcers can lead to severe debilitation; they account for an estimated 60,000 deaths each year in the United States.
The condition occurs when blood vessels in the skin, compressed as the result of the patient's physical immobility, do not permit the blood supply to reach and nourish the surrounding tissue, prompting the cells in the affected area to die. Typically, decubitus ulcers develop in such places as the back of the head, shoulders and shoulder blades, elbows, hips, buttocks, sacrum, ankles, heels, chin, and knees.
"Decubitus ulcers can be found in 3% of hospital patients and a higher percentage of residents in nursing homes and other resident settings," said Loretta Silberman, RN, vice president of Professional Relations for National Medical Enterprises' (NME) Hospital Group.
Silberman estimates that the cost of treating a single incident of decubitus ulcers averages $15,000. However, she added, the actual costs range from $5,000 to $40,000, depending on how advanced the sore or sores become. Several treatments exist for such ulcers in the early stages of development. Some more advanced cases require the use of the CO2 laser.
"The advantage of the laser for tissue debridement is that it cauterizes and sterilizes the wound," Silberman said. "In addition, the laser causes less bleeding."
"By helping prevent pressure sores, we can reduce the length of stay for many of our patients, which, in turn, cuts costs," she noted. "Many patients with decubitus ulcers become outliers, or patients who exceed the DRG-mandated limits for payment to the hospital."
Silberman pointed out that development of decubitus ulcers can be greatly reduced by identifying patients at risk through in-depth assessment upon admission and devising an individualized treatment schedule, based on risk, to observe the patient's progressive skin condition.