FOR IMMEDIATE RELEASE
Friday, March 21, 2003

For many bedridden elderly patients, bedsores are a fact of life. Typically caused by constant pressure to the skin and muscle as a result of immobility, a bedsore can develop within several hours. Anyone who must stay in a bed, chair or wheelchair, or who cannot change positions without help, is at high risk. The elderly are particularly vulnerable because age has made their skin thinner and more fragile.

In an individual who cannot change position, pressure closes tiny blood vessels that nourish the skin and supply oxygen. The lack of nutrients and oxygen causes the tissue to die and a bedsore to form, usually over a bony prominence.

Wetness can increase the skin’s vulnerability to damage from pressure. Moisture – from such common sources as perspiration, wound drainage, urine and feces – softens the skin and increases the risk of breakdown.

“It’s a serious problem in the elderly bed-bound patient, who is often immobilized in a hospital bed or nursing home,” said Dr. Gordon Lutchman, a general and vascular surgeon at Coney Island Hospital in Brooklyn. “It’s a multi-billion dollar problem, one that medicine often neglects. A recent Medicare study, in fact, found that 9% of nursing home residents in the U.S. have bedsores.”

Dr. Lutchman is one of the few surgeons in the U.S. to perform a procedure known as laser debridement on patients suffering from bedsores (aka decubitus ulcers or pressure wounds). He performs over 500 laser surgeries a year.

He does it in an operation room using a carbon dioxide laser, rather than at the patient’s bedside with a scalpel (as do other surgeons). Virtually all patients are placed under local anesthesia during the procedure, which takes 20 minutes for a single wound to an hour or longer for multiple sites. It is usually done on an outpatient basis.

“If a bedsore progresses to a late stage wound, it needs to be treated surgically,” said Dr. Lutchman. “With the traditional ‘bedside surgery,’ it usually takes four or five treatments to clean the wound.”

The laser, said Dr. Lutchman, removes the necrotic or decayed tissue that has formed in the wound and sterilizes it. This allows for the infection to be eliminated and the wound to start healing.

“Not only does the laser procedure benefit the patient, but it makes for a cleaner, less odorous wound for the caregiver to deal with,” he said. “Otherwise, it can be very unpleasant.”

Late stage skin ulcers can extend through the skin and muscle layers, and involve underlying organs and bone. Left untreated, it can become limb and even life threatening.