BMJ 2002;325:623 ( 21 September )

Filler

Bedsores, what bedsores?

When I was 19 I went down to Cambridge to play soccer for my hospital against one of the colleges. My right arm was in plaster from an earlier rugby injury. It was a rough game, and in the changing room I peed what looked liked pure blood. This led to seven days' flat bed rest in Addenbrooke's Hospital. Twice a day I was rolled on my side and my back and heels were washed, rubbed with alcohol, creamed, and powdered. I got no bedsores.

When I was 28 I worked in a west country casualty department. We had our fracture ward upstairs full of cases immobilised in full plaster casts. When one of these patients developed a bedsore all hell broke loose. Two nurses were moved off the ward, and we were all up in front of Matron in a drumhead court. It was the only case in the six months that I was there.

When I was 47 I came back from overseas and joined a practice in the west country. I was astonished to see patients coming out of hospital with big infected bedsores. There was no explanation or apology for this. Our district nurse, old and wise, cured them all with some difficulty.

When I was 74 I had a total hip replacement. During the operation, I lost four pints of blood, which were not replaced for two days. Until then, I was feeble and immobile, and I got a bedsore on my heel. After I got home, the bedsore turned green and grew Staphylococcus aureus. I got a massive infection in the surgical wound, softening the muscles, and eventually I dislocated the new hip. Back into hospital on full bed rest. This time my wife insisted on a ripple bed, and she herself did a full alcohol rub, cream, and powder on my heels twice a day. No bedsores that time.

The nurses, mostly middle aged, asked what she was doing. They had never been taught to do this. I suppose it's a shortage of young, active, and trained nurses. Until they arrive, how many patients less stroppy than me plus wife will get bedsores and maybe die of the infection?


© BMJ 2002

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