STEP ONE: Eliminate the Cause

Bedsores are caused by unequal pressure over the bony prominences. Bedsores can be prevented by equalizing and relieving pressure on the "bedsore zone." When pressure on the bedsore zone is relieved, blood can flow out to the capillary ends, the smallest branches of the blood circulation system. Thus, by equalizing and relieving pressure over the bony prominences, blood flow is restored enabling the body to supply the natural healing resources to the wound site.

"Pressure Ulcers are entirely preventable.*

They need not and should not occur... The program of preventative maintenance must be continous."¹
 

- Michael Kosiak, MD Director of Physical Medicine and Rehabilitation St. Paul Ramsey Medical Center.

"My contention is that [Dr. Kosiak] is absolutely correct... The major determinant of pressure ulcer development is not how sick the patient is, but how good the caregiver is."²
 

- Kenneth Oshansky, MD, Expert Witness for HCFA

* Excerpted from "Treating Pressure Ulcers: Legal Reasons to Maintain the Minimum Standard of Care" published by Medical Resources Dec 1996. The cited publication has successfully passed through extensive peer review. A limited number of copies are available from WoundHEAL.com.

In the case of existing bedsores, restoration of the blood supply halts further deterioration in the bedsore zone. Constant supply of nutrients and healing properties in the blood stabilizes the sore naturally allowing the body to begin the natural healing processes.

How fast a bedsore heals is dependent upon the individual's general health conditions, which determine the amount of natural resources that the body can provide for healing rate. The frail elderly or those under stress from other health conditions will obviously require a longer healing time. Most importantly however, they will heal.

Excerpted from Staging Pressure Ulcers

• Stage I: 14 days

• Stage II: 45 days

• Stage III: 90 days

• Stage IV: 120 days

For an explanation of the Pressure Ulcer Stages see Staging Pressure Ulcers.

Once a bedsore has been observed, one should never be without the protection of a Pressure Relieving Device (PR/Device). This PR/Device should be a support surface for sitting and a support surface mattress system for the bed. The PR/Device is needed to relieve and equalize pressure on the bedsores until medical conditions improve. As long as the medical conditions exist that initially caused the bedsore, reoccurrence is probable if the patient is left unprotected by a PR/Device.

PR/Devices are classified by Medicare as Class One, Two or Three Support Surfaces / Specialty Beds. These medical devices are used to equalize or relieve pressure over the bony prominences. PR/Devices are grouped into three distinct categories, from 1 to 3 with category 1 being the lowest, based on their ability to relieve pressure.

These devices are designed more for comfort than for actual treatment value. The better products in this group can provide protection from breakdowns leading to bedsores. The Department of Health and Human Services* however, does not recommend Group Level I devices for treatment where one or more bedsores have developed. Such inexpensive devices are usually used in nursing homes for Medicaid patients.

GROUP LEVEL II ADVANCED PRESSURE REDUCING-RELIEVING MEDICAL DEVICES

Although available in various shapes and configurations, all Group Level II devices have received Medicare's SADMERC registration and approval. All Group Level II PR/Devices accomplish the goal of advanced pressure relief over the bony prominences.

The ROHO® DRY FLOATATION Mattress System (Medicare HCPCS Code EO371) is placed over the mattress and does not require electrical power or other modifications to your home. Only the ROHO® accomplishes both pressure equalization and advanced pressure relief).

HCPCS Code EO277 is an electrically powered air mattress device that replaces the standard hospital mattress in a hospital bed frame.

To be an Informed Consumer, you must be willing to ask for and obtain written certification that the support surface or specialty bed you choose is fully qualified by Medicare. Manufacturers of Medicare qualified products have submitted their device to a product review process enabling registration with HCFA's SADMERC, who assigns a HCPCS Code. If the device does not have a HCPCS code assigned and has been classified as a Group/Level II Support Surface/Speciality Bed, you cannot be certain the device will actually relieve pressure. More importantly, Third Party Reimbursement will often be unavailable.

Use of Powered Air Device Not Advised for people who suffer from Chronic Obstructive Pulmonary Disease (COPD) which decreases the ability of the lungs to perform their ventilation function. Chronic bronchitis, pulmonary emphysema, chronic asthma, chronic bronchitis or any condition that impairs lung function demands extreme caution when using any electrically powered pressure-relieving device over any extended period of time. (See "Environmental Concerns for Patients in Powered Air Beds" for more detail)

STEP Two: Supply Additional Bedsore Healing Resources

The cause of Bedsores is unequal pressure over the bony prominences. When this cause is relieved and blood supply is restored to the bedsore site, the Bedsore is treated as any other Chronic Non-Healing wound. If the body cannot provide its own natural resource to the wound site, resources must be provided from an outside source or the body will be unable to complete the natural healing process.

Today, new revolutionary biomaterials are available to supply the biological resources needed to stop bleeding, absorb infectious fluids and promote closure. These collagen biomaterials rebuild damaged tissue.