Bed Sore Glossary

The following are frequently encountered terms used in the course of diagnosis and treatment of bed sores. Many of these terms are referenced on Bed Sore FAQ and more information on each can be obtained using the search function on our site.

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Active Support Surface – A type of support surface with the ability to change load distribution properties with or without the applied load.

Adult Day Care – A non-residential facility which provides activities for elderly and/or handicapped individuals; most centers operate 10-12 hours per day and provide meals, social/recreational outings, and general supervision; adult daycare centers operate under a social model and/or a health care model, they may focus on providing care only for persons with Alzheimer’s and related dementias or their services may be available for any disabled adult; some have on-site nursing, some may provide transportation and personal care as well as counseling for caretakers.

Air – A component of supportive surfaces used to minimize the development of bed sores.  Example: alternating air mattress.

Air Fluidized Therapy – Aiding the person with a bedsore by using a bed that has body support using thousands of mini soda-lime glass beads which are suspended by pressurized, temperature-controlled air; the person is on a sheet which is over the beads; the specific bed is for people with or at high risk for posterior pressure sores, burns, grafts or donor areas; the pressure against the patient’s skin surface is less than the capillary refilling with blood flow which in turn helps re-grow tissue.

Albumin – Any protein with water solubility, which is moderately soluble in concentrated salt solutions, and experiences heat coagulation; egg whites contain albumin.

Alginates – An absorbent dressing for a wound that is made from soft non-woven fibers made from seaweed; the dressing forms a gel-like covering so the wound area is moist, but the dry dressing is lightweight.

Alternating Pressure – A feature of mattresses commonly used in patients who are at risk for developing bed sores or who may have developed bed sores already.  Alternating pressure mattresses provide redistribution of pressure via programmed changes in the hardness of the mattress.

Amputation – Removal of a body extremity by trauma or surgery.

Amyloid protein – Insoluble fibrous groups of proteins that share specific traits in structure.

Amyloidosis – Disease which occurs when amyloid proteins build up in organs.

Antimocrobials – Substance that kills or stops the growth of microorganisms.

Assisted Living Facility – A place that supervises and assists residents of that facility with activities of daily living, help with planning the services outside of the facility for health related needs, and watch the everyday activities to promote and keep their health, safety, and well-being. These facilities are regulated and licensed at state level.

Autolytic Debridement – The use of the body’s own enzymes and moisture to re-hydrate, soften and liquefy eschar and slough; the only tissue that is liquefied is necrotic and causes no pain to the patient.

Autonomic Dysreflexia – AD or “autonomic hyperreflexia” is characterized by large amounts of sympathetic discharge occurring in association with a spinal cord injury or disease; this is a medical emergency.

Autonomic Nervous System – A section of the peripheral nervous system that acts as the control system functioning below the level of consciousness and controls visceral functions such as: heart rate, salivation, sweating, pupil diameter, urination, and sexual arousal.

Autopsy – A way to determine the cause of death or progression of a disease through body examination post-mortum.

Bedridden Patients – People who are confined to a bed secondary to illness for a long, indefinite period of time.

Bed sore – A wound that develops secondary to unrelieved pressure in patients with limited mobility. A bedsore may begin as a small area of discoloration and gradually progress to an open wound.

Bone Infection – When bacteria invades the bone through the blood or open contact with the environment. The infection disintegrates the bone and causes harm to the local blood supply which prevents the antibiotics from reaching the bacteria.

Care Centers – Also referred to as Residential Care Facilities for the Elderly (RCFE), are a relatively recent care option for seniors who can no longer live independently.  Residential Care Facilities for the Elderly provide assistance with daily living requirements like meals and laundry, bu the facilities have no medical accreditation and hence can not provide medical care.  RCFE’s have a duty to relocate their residents when their condition deteriorates or when then they require medical attention for conditions such as, bed sores.

Cellulitis – A highly spread bacterial infection in the skin and tissues beneath the skin; cellulites usually begins as a small tender area with swelling and redness to follow (this can be accompanied by chills, fever, sweating, and swollen lymph nodes)

Chemical Debridement – A way to dissolve necrotic tissue by using enzymes and other compounds.

Clinitron Bed – Air fluidized bed that combines air fluidized therapy and low air loss therapy on an articulating frame that allows relief from bed pressure sores to the patient; the head can also be raised.

Closed Cell Foam – A component frequently used in supportive devices composed of non-permeable structure in which there is a barrier between the cells, preventing gasses or liquids from passing through the foam.

Colostomy – A surgical procedure, which can be undone later, where a stoma is formed by drawing the healthy end of the large intestine or color through an incision in the anterior abdominal wall and sewing it into place; this allows for an alternative way for feces to exit the body.

Coefficient of Friction – A scientific method for measuring the amount of friction existing between two surfaces.

Contingency Fee – Any fee for services provided where the fee is only payable to the representative party if there is a favorable outcome; in the law; in the law, it is defined as “a fee charged for a lawyer’s services only if the lawsuit is successful or is favorably settled out of court… contingent fees are usually calculated as a percent of the client’s net recovery.”

Contractures – The loss of joint motion because of structural changes in non-bony tissue (muscles, ligaments and tendons).

Debridement – Removing non-living tissue from pressure ulcers, burns, and other wounds.

Dehydration – Occurs when the body does not have enough water and fluid as it should to keep working; the loss of too much fluid in the body; can be caused by vomiting and diarrhea; sever dehydration is a life threatening emergency.

Dementia – Symptoms that are caused by disorders that affect the brain; it is not a simply defined disease; the people affected are unable to do normal activities (dressing themselves, eating, problem solving, emotional control, agitation increase, change of personality and memory loss)

Duoderm – A wound dressing to keep the healing area moist and protected from contaminants.

Envelopment – The ability of a supportive surface to conform or mold to the unique form of the body.  Medical professionals look at the envelopment features of surfaces when determining if a surface is acceptable for a patient who may be at risk for developing bed sores.

Eschar – The dry scab or slough that forms on the skin as the wound begins to heal or by action of a corrosive or caustic substance.

Exudate – When fluid which is high in protein and cellular elements excrete out of blood vessels secondary to inflammation and is deposited in nearby tissues.

Fatigue – A characteristic of a support surface to perform as specified over an extended period of time.  Many materials suffer from fatigue due to prolonged use, chemical exposure, heat, or physical forces.

Flap Reconstruction – A type of breast reconstruction post mastectomy which involves the creation of a skin flap using tissue from a different part of the body; the skin flap is attached to the chest to create a pocket for an implant or to build a breast mound.

Force – An important factor to look at when determining a patients susceptibility to develop bed sores.  Force is a measure of push / pull analyzed with the magnitude and direction of the shear.

Friction – Resistance to motion in a parallel direction relative to two surfaces. Friction is an important factor to analyze when determining a patients risk for developing bed sores.

Gangrene – When an area of the body dies due to a cut off of blood supply; dry gangrene is when there is a reduction of blood flow which occurs slowly while wet gangrene is due to untreated, infected wounds.

Gel – A component commonly used in pressure relieving devices composed of solid aggregates mixed with some type of liquid.  Various types of gels can be used in medical devices and controlled based upon their density.

Hyperreflexia – When there are overactive responses of reflexes at reflex sites.

Hypoperfusion – Diminished blood flow through an organ.

Hypotension – Low blood pressure.

Immersion – A physical property of supportive material measuring the patients depth of penetration into the material.

Incontinence – The decrease of ability or loss of ability to control urination or defecation.

Integrated Bed System – A bed frame and support surface that are combined into a single bedding unit.

Kennedy Terminal Ulcer – A specific bedsore that is defined by a rapid onset and quick tissue breakdown; they occur because of poor blood circulation due to unrelieved pressure. These are different than other types of bedsores due to the rapid onset – wounds progress within hours; they grow downward instead of horizontal; usually on the sacrum; almost always in elderly; they are usually an irregular shape; death occurs quickly (2- 48 hours of onset).

Mattress – Since many bed-bound patients are particularly susceptible to develop bed sores, a proper mattress of utmost importance. Varying types of mattresses can be used depending on the patients needs and physical strength.  In most situations, a physician must prescribe a specialized mattress.

Mechanical Load – Force distribution acting on a supportive surface.  It is important to evaluate the mechanical load when analyzing a patients susceptibility to develop bed sores.

Medical Malpractice – A cause of action brought by an injured person or family of a deceased person against a doctor or hospital due to their alleged negligence.  In order to recover from the facility or doctor, the plaintiff must prove: 1) a duty of care was owed by the physician or hospital; 2) the physician or hospital agents, violated the applicable standard of care; 3) the person suffered an injury or death; and 4) the injury was caused by the acts of the physician or hospital and proximately caused by the substandard conduct.

Medical Negligence – A physician or hospitals failure to use reasonable care in the treatment of a patient. In order to recover damages from a hospital or doctor, the injured patient must establish that the physician or entity deviated from the standard of care in the medical community.

Multi-Zoned Surface – A surface, such as a mattress that has different segments that have different pressure distribution characteristics to help reduce the development of bed sores in areas where they are most likely to develop.

Necrotizing Fasciitis – Flesh eating disease in which the soft tissue is infected by bacteria; rare but very sever and can destroy deep skin tissue, muscles and skin.

Negligence – A failure to use reasonable care.

Never Event – Series of 28 outcomes in a healthcare setting; these 28 outcomes were taken by the National Quality Forum and are defined as “adverse events that are serious, largely preventable, and of concern to both the public and health care providers for the purpose of public accountability.”

Pad – A device commonly used to reduce the amount of pressure put on a patients body.  Pads are also commonly used to provide comfort for patients with varying stage bed sores, to protect an open wound or to help in maintaining a patients position in bed.

Pressure – An important factor to be analyzed when determining the chance of a patient to develop bed sores.  Pressure is commonly defined as the force per unit area exerted perpendicular to the plane of interest.

Pressure Redistribution – One of the basic premises regarding reducing pressure sores is the minimize the direct pressure put on the body.  In this sense, pressure redistribution surfaces seek to distribute the pressure put on the body.  Also known as: pressure reduction and pressure relief surface.

Pressure Sore – Parts of skin that are damaged due to a lack of blood flow because of pressure to that area. Also: pressure sores.

Pressure Ulcer – Skin area that breaks down and opens open when you are in one position for an extended period of time without a weight shift, the pressure reduces the blood supply and the tissue affected dies. Also: pressure ulcers.

Sepsis – (Blood Poisoning) Medical condition which is serious that is characterized by a whole body inflammatory state and the presence of a known or suspected infection; the infection may be microbes in the blood, urine, lungs, skin, or other tissue.

Serum Osmolality – A test that shows the amount of chemicals that are dissolved and absorbed in the liquid part of blood.

Shear – A characteristic looked at when selecting a supportive surface.  Shear measures the force per unit exerted parallel to the plane of interest.

Shear Strain – A method of calculating the damage to a supportive surface as a result of shear stress.

Skin Care Assessment – A written and documented assessment of the skin on the patient around the wound to show how the wound is healing or regressing; describe size, color, shape, texture, etc..

Squamos Carcinoma – Skin cancer that starts out looking like a bump or red scaly patch of skin, often found on the ear rim, face and lips.

Stages of Bed Sores – 4 stages based on severity of the wound:

  • Stage 1 Bed Sore – Fluctuation in skin temperature; change in tissue consistency; changes in sensation. The sore is definite area of redness in lightly pigmented skin and red, blue or purple in darker skin. Stage 1 bedsores are a warning for caregivers and/or family members to take action because bedsores develop quickly and progress rapidly.
  • Stage 2 Bed Sore – The top layer of skin (epidermis), dermis, or both have partial thickness skin loss; the sore is looking like an abrasion, blister, or shallow crater at this time. After this stage passes, the bedsore becomes much harder to treat.
  • Stage 3 Bed Sore – Full thickness skin loss with damage/death of the subcutaneous tissue that can go to, but not penetrate, the connective tissue underneath.; the bedsore will appear as a deeper crater with black edges. The sight of a Stage 3 bedsore is disgusting.
  • Stage 4 Bed Sore – Full thickness skin loss with destroying tissue leading to tissue death, damage to muscles, bones, or connective structures (joints, tendons); these bedsores appear as large, deep openings in the skin surface which show bone and connective tissue.

Staph Infection – Bacteria that causes many other diseases as a result of infection to tissues of the body; the infection can range from mild to severe; there are more that 30 types of staph infections that can be found in human beings; skin damage can allow the bacteria to go in an opening where the staph is usually not found and lead to infection.

Statute of Limitations – A rule in a common law legal system that defines the maximum amount of time after an event that legal proceedings pertaining to that event can be initiated.

Strep Infection – A group of contagious diseases that develop when bacteria that is normally on the skin or inside the body invade other parts of the body and contaminate the blood or tissues; some strains show symptoms and some are fatal.

Support Surface - A device designed to redistribute the pressure generated by a person’s body weight.  Common devices to redistribute pressure include: pressure relieving mattresses, mattress overlays, seat cushions or heel protectors.

Surgical Debridement – Using a surgical tool to cut and remove the dead tissue from a wound to clean it out.

Tissue Tolerance – The resilience of the skin and supporting structures to endure and handle the effects of pressure without adverse reactions or breakdown.

Tunneling – A connection through a solid body which has end open from entering and exiting and otherwise is closed.

Ultra Sound Assisted Wound Therapy – Debriding deep wounds using ultrasound.

Unstageable Bed Sore – A bedsore that has full tissue loss and the base of the sore is covered with dead cells and hard scabs with fluid that excretes out of them to hide how deep they are in the skin.

Wound Documentation – A detailed description in the medical record of the wound on the patient being treated; type of wound; location of wound; full or partial thickness of wound; stage of wound; size; tracts; drainage; odor; tissue characteristics/types; wound edges; surrounding tissue; indicators of infection; pain; conditions affecting healing; topicals; patient/caregiver education.

Wound Vac – Machine which uses negative pressure to help heal an open wound and close it from the inside out.

Wrongful Death – An individual’s loss of life as a result of the willful or negligent act of another person/persons/facility.

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