How do bedsores seem to just “happen”?
They don’t. They are allowed to happen, and lousy hospital and nursing home food is the major culprit.
No, it’s not the mattress. It is malnutrition.
I think bedsores might better be termed “scurvy sores,” and in centuries past, they often were. Like bleeding gums on a large scale, they are a development of spontaneous pinpoint hemorrhaging. Pressure of brushing the teeth, or lying on a mattress, is enough to break blood vessels grossly weakened by a lack of vitamin C.
Look into this for yourself and see. When you do, you will note that the symptoms of scurvy include poor healing, weak capillaries, easy bruising, open wounds that suppurate (discharge pus), and spontaneous bleeding and internal hemorrhage, often from very minor trauma. Such describes the development of a bedsore.
Bedsores have been associated with necrotizing ulcerative stomatitis (severe inflammation and destruction of soft tissue and bone). Both share a number of symptoms, both occur in malnourished patients, and both are treatable with nutritional supplementation. (J. A. G. Buchanan, M. Cedro, A. Mirdin, T. Joseph, S. R. Porter, T. A. Hodgson (2006) Necrotizing stomatitis in the developed world. Clinical and Experimental Dermatology 31 (3), 372–374.)
Pellagra, a deficiency of niacin (vitamin B-3), causes bedsores as well. This has been known for nearly a hundred years. (Pellagra: History, Distribution, Diagnosis, Prognosis, Treatment, etc. by Stewart Ralph Roberts, p 104. http://books.google.com/books?id=XCxQAWDWAh4C&printsec=titlepage )
Also: The Nursing Care of Pellagra, by Lillian Cumbee. The American Journal of Nursing, Vol. 31, No. 3 (Mar., 1931), p 272-274
The cure, the only cure, for pellagra is niacin. Not surprisingly, niacin also helps heal bedsores. (Dtsch Gesundheitspolit. 1951 Nov 29;6(48):1388-9. [Therapy of ulcus cruris and decubitus.] GERNAND K. PMID: 14905956)
So does the mineral zinc. Even the medically orthodox Merck Manual says that “supplemental vitamin C and zinc may help with healing as well.” I would recommend at least 50 mg day, and 150 would be better, divided into three separate doses. Zinc gluconate is readily available, cheap and well-absorbed.
Vitamins A, B-1 (thiamine), B-2 (riboflavin), and E are probably also helpful. Vitamin A and the B-vitamins are in any multivitamin preparation. Vitamin E from capsules may be dripped directly onto a bedsore, painlessly. The benefits are more rapid healing, less discomfort, and reduced risk of infection and scarring.
Conservative treatment is always best, and vitamin supplementation is about as conservative as it gets. Remember what vitamin-discoverer Dr. Roger J. Williams said: “When in doubt, use nutrition first.”
Patients given optimally large amounts of these nutrients will be more comfortable in days, and although healing will take weeks, you can expect to see real improvement. Reconstructive surgery is the last resort. Think about this: if a patient cannot keep their normal skin well, how are they going to recover from a skin graft? Do not subject a patient, especially an elderly patient to such pain and trauma if you can possibly avoid it.
And yes, you can possibly avoid it. But you will not know if nutrition works until you try it.
I have seen this with my own eyes, so don’t try to tell me differently: hospitals are not trying nutrition first. My aunt, an activist Registered Nurse, is campaigning to end elder abuse. Good. Here is an excellent opportunity for you to join her. Don’t let your loved one suffer from a bedsore. Demand oral and intravenous high-potency multiple and B-complex vitamin therapy. Demand oral and intravenous vitamin C as well.
Let the hospital and doctors tell you it is unsafe if they must. If they try to do so, they have not read their own journals. Here is some of the evidence:
“Most patients with chronic skin ulcers suffered micronutrient status alterations, and borderline malnutrition. Meals did not cover energy requirements, while oral supplements covered basic micronutrient requirements and compensated for insufficient oral energy and protein intakes, justifying their use in hospitalized elderly patients.” Raffoul W, Far MS, Cayeux MC, Berger MM. Nutritional status and food intake in nine patients with chronic low-limb ulcers and pressure ulcers: importance of oral supplements. Nutrition. 2006 Jan;22(1):82-8.
“In the group treated with
ascorbic acid there was a mean reduction in pressure-sore area of 84% after
one month compared with 42.7% in the placebo group. These findings are
statistically significant (P less than 0.005) and suggest that ascorbic acid
may accelerate the healing of pressure-sores.”
(See also: Ascorbic acid and pressure sores. Br Med J. 1971 Jun 12;2(5762):604-5.)
“Only patients receiving additional arginine, vitamin C and zinc demonstrated a clinically significant improvement in pressure ulcer healing (9.4+/-1.2 vs. 2.6+/-0.6; baseline and week 3, respectively.” Desneves KJ, Todorovic BE, Cassar A, Crowe TC. Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial. Clin Nutr. 2005 Dec;24(6):979-87.
“(O)ral nutritional supplement(ation) resulted in a significant reduction in wound area and an improvement in wound condition in patients with grade III and IV pressure ulcers within three weeks. . . Median healing of wound area was 0.34 cm2 per day, taking approximately two days to heal 1 cm2. . . the amount of exudate in infected ulcers (p = 0.012) and the incidence of necrotic tissue (p = 0.001) reduced significantly.” Frías Soriano L, Lage Vázquez MA, Maristany CP, Xandri Graupera JM, Wouters-Wesseling W, Wagenaar L. The effectiveness of oral nutritional supplementation in the healing of pressure ulcers. J Wound Care. 2004 Sep;13(8):319-22.
The RDA/DRI is not enough:
“Refeeding of pressure sore patients who often are catabolic and have increased needs for protein and energy, should include micronutrients not only to cover recommended dietary allowances, but sufficient to reach normal nutritional status for the individual micronutrient.” Selvaag E, Bøhmer T, Benkestock K. Reduced serum concentrations of riboflavine and ascorbic acid, and blood thiamine pyrophosphate and pyridoxal-5-phosphate in geriatric patients with and without pressure sores. J Nutr Health Aging. 2002;6(1):75-7.
(Also: Powers JS, Zimmer J, Meurer K, Manske E, Collins JC, Greene HL. Direct assay of vitamins B1, B2, and B6 in hospitalized patients: relationship to level of intake. JPEN J Parenter Enteral Nutr. 1993 Jul-Aug;17(4):315-6.)
1,000 mg of vitamin C is not enough:
ter Riet G, Kessels AG, Knipschild PG. Randomized clinical trial of ascorbic acid in the treatment of pressure ulcers. J Clin Epidemiol. 1995 Dec;48(12):1453-60.
For more information on administering vitamin C by IV, and the safe and effective use of high oral doses of all the vitamins, please use the “Search Box” at the www.doctoryourself.com main page. Type in “IV vitamin C.”
Don’t forget to try a topical application of aloe vera gel, squeezed fresh from the plant’s thick leaves. It is soothing and healing.
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