Nursing: Floating Sores Away

Some hospital patients get sicker simply from lying in bed. Whatever else may be wrong with them, patients who suffer long sieges in bed or wheel chair are prone to develop bedsores, ugly and dangerous wounds that often harbor fatal infections.

Called decubitus ulcers, bedsores develop quickly when tissue dies after blood is squeezed out by body weight acting on such pressure points as the base of the spine. Flesh is opened right to the bone in oozing craters. The extra nursing care that is called for costs thousands of dollars, and insurance companies allot 25% of expenses in all spinal-cord injuries for bedsore treatment alone. Serious and persistent as it is, the bedsore problem is usually handled by a method that is decades old: sheepskin sheets that soften pressure on patients and permit air to circulate under their bodies. Today, several young doctors have rediscovered and redesigned a discarded system for floating bedsores away.

Two years ago, Drs. James Weinstein and Barry Davidson, young doctors at Tufts—New England Medical Center, started experimenting with water beds made from sheets of plastic stretched over tubs. The basic idea came from 19th century doctors who tried water mattresses constructed on the same principle. But like its predecessors, the Weinstein-Davidson product weighed in at an impractical, beam-breaking 3,000 Ibs. The doctors did not give up, though, and lightweight improvements on their design, manufactured by the Scott Paper Co., now fit standard hospital beds. The hollowed-out, foam-rubber mattresses have inserted plastic sacs that fit patients like a cloud and allow their weight to be distributed so uniformly over the supporting surface that they would not even break eggs.

Last week, along with Scott’s water mattress, another bedsore preventive was exhibited by the Stryker Corp. at the American Congress of Physical Medicine and Rehabilitation in San Francisco. Dr. Wayman Spence, a 29-year-old resident at Ohio State University Hospital, worked on the theory that “you don’t have to float the whole body—just the butt.” Spence observed that the body protects itself from friction by fatty tissues that move under pressure but return to their original shape when pressure is removed. As a substitute for natural cushions, he first tried placing wads of soft pie dough under his patients, then lumps of a children’s jelly-like plaything called Silly Putty. Next, he designed 16-sq.-in. pads of silicone gel, which have the resiliency of flesh itself. Protected by such pads, sores in bedridden patients were not only prevented but also healed. When the gel is used in wheel-chair seats, says Spence, the decreased threat of pain and tissue breakdown even serves as a form of psychotherapy.