Among the many factors that contribute to pressure sores, bed sores and decubitus ulcers are spasticity, joint contractures, muscle paralysis and poorly fitting wheelchairs. Electronic Stimulation (ES) may reduce the risk by reducing the involuntary movements in spasticity, by improving joint range of motion, and by increasing the bulk of muscles that cushion the bony prominences and so distribute pressures more evenly over the skin.
Once a pressure sore, bed sore and decubitus ulcer has occurred, ES may be helpful in speeding the healing process says California Nursing Home Abuse and neglect Attorney Steven C. Peck. While most of the research in this area has been done in spinal cord injury or diabetes, the findings are applicable to multiple sclerosis. Possible mechanisms include improving the oxygen supply to the skin and the muscle in the area of the sore, improving the rate of deposition of connective tissue, or scar, and minimizing the infection in the wound. The chance of healing is, of course, better if the pressure sore is a partial thickness lesion, meaning that only the more superficial layers of the skin are missing. In this case, the skin can grow from the base or bed of the dermis, similar to the way grass grows after mowing. If the sore is deep enough to go through the skin, it must heal in from the sides and surgery is often needed. If there is infection underlying the skin and in the exposed bone, surgical intervention is required to clean the area and to graft skin and sometimes muscle over the bony prominences. After wound closure, the mechanical integrity of the skin will not return to normal and it will be necessary to continue routine skin checks and to use custom seating devices for pressure relief as needed.
Successful ES protocols have included daily stimulation for a total time of two or more hours. Some investigators have employed a very low intensity, direct current. Others have used a pulsatile current and created a muscle contraction in the area of the pressure sore. Electrodes may be placed adjacent to the wound or one of the electrodes may be placed in the wound. In the latter case, an electroconductive dressing is used as the electrode.
Like many cases involving bed sores (also referred to as: pressure sores, pressure ulcers or decubitus ulcers) the nursing homes main argument is usually that the patients wounds were 'unavoidable'.
While there may be a limited number of circumstances where skin-breakdown occurs despite the implementation of all feasible preventative measures--- most cases of bed sores simply result from downright neglect and faulty care-- the facility simply not doing its job in caring for the patients says California Nursing Home Abuse and Neglect Attorney Steven C. Peck who can be contacted toll free at 1.866.999.9085.
