One question many people have when a loved one has a bedsore in a nursing home is, how long does the wound take to heal? How long a bedsore takes to heal depends on: (1) how serious the wound is; (2) the patient’s lifestyle and comorbidities; and (3) the treatment provided for the wound.
Once a bedsore (also called a pressure injury or pressure ulcer) develops, it is critical to have treatment start immediately. Delaying treatment can cause the wound to worsen, or take longer to heal. Bedsores or any open wound make a huge impact on a person’s general health, so healing quickly is critical.
We investigate cases involving serious (stage IV) bedsores in nursing homes, some of which cause infection, sepsis, or death. Sometimes the development of bedsores, or the worsening of a resident’s bedsores, are signs of nursing home negligence. Read more about whether bedsores mean the nursing home was negligent.
As a general matter, the less severe a wound becomes, the more quickly it can heal with proper treatment. Bedsores are “staged” in terms of how serious they are. (We cover bedsore staging here.) So Stage I and Stage II bed sores should heal more quickly with proper bedsore treatment than more serious Stage III and IV wounds. Stage II and stage IV bedsores may take weeks or longer to heal, or worsen with poor care or a seriously compromised resident.
Any open wound is unlikely to heal quickly, and always has the risk of infection, which will make it more difficult to heal. Infected wounds can cause other problems, too, such as sepsis or spreading infection to other areas. Damaged skin may not heal well, depending on how the injury occurred.
Treatment for less serious less pressure ulcers will usually not involve surgery, and may heal within a few weeks with proper treatment. More serious wound treatment may involve surgery or other aggressive treatments, and will take much longer to heal and close.
Here are some common approaches to basic bedsore care:
- Clean the wound: This can involve gentle cleansers, saline rinses, and frequent dressing changes.
- Relieve pressure from the sore by moving the patient or using foam pads or pillows to prop up parts of the body.
- Control incontinence and regularly change incontinent residents.
- Remove dead tissue: surgically removing dead or necrotic tissue—called debridement—may help the wound heal and prevent infection.
- Antibiotics or antibiotic creams: can help treat or prevent infection from worsening.
More significant care can include:
Negative pressure wound therapy, which may heal wounds more quickly and at lower cost than surgery.
Surgery may become necessary if bedsores become too severe. Surgery aims to remove dead tissue, treat or prevent infection, and lower the risk of further complications. Using tissue from other parts of the body—called “flap reconstruction”—is another surgical option.
Regular follow up is critical to monitor and document improvement, or change treatment plans if the wound is not healing or is getting worse. Follow-up on a minor wound that is healing should be performed every 3 weeks for the first several months.
Once a wound is healing, it is still critical to avoid new pressure damage. Residents must be repositioned regularly, with help from caregivers if needed dues to physical or mental limitations. Patients in bed should be repositioned at least every 2 hours when they are not at significant risk of skin breakdowns.