Bedsores, more properly known as pressure ulcers or decubitus ulcers, are lesions caused by many factors—such as unrelieved pressure, friction, humidity, shearing forces, temperature, age, continence, and medication—to any part of the body, especially portions over bony or cartilaginous areas such as sacrum, elbows, knees, and ankles. Although often prevented and treatable if found early, they can be very difficult to prevent in frail elderly patients, wheelchair users (especially where spinal injury is involved) and terminally ill patients. Bedsores are often fatal—even under the auspices of medical care—and are one of the leading iatrogenic causes of death reported in developed countries, second only to adverse drug reactions. The primary cure and treatment is to remove the pressure by turning the patient regularly (every two hours is often quoted, though the evidence for this figure is not strong and four hourly turns may be as effective in some patients). However the relief of pressure to avoid further sores is well documented since at least the 19th century; regular turning was advised to prevent sores by Galloway (though some of her other recommendations are not current practice, for example massage of the pressure area is probably contra-indicated) and virtually all authors since.
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