Hospitals and nursing homes could alleviate suffering and save money by improving treatment of bedsores, a painful ailment that afflicts hundreds of thousands of bedridden patients and people in wheelchairs each year, experts said this week.

Bedsores, also called pressure ulcers, can form in less than two hours and infect muscle and bone unless checked. The advisers, backed by a U.S. Public Health Service agency, said prompt, simple treatments can undo the damage in most cases.One in 11 hospital patients and almost one in four nursing home patients are afflicted by these festering sores. Most elderly patients who fracture their hips and quadriplegic patients in wheelchairs suffer from them.

They cost an estimated $1.3 billion a year to treat and cause untold suffering.

The experts said hospitals and nursing homes could save at least $40 million if they follow the practice guidelines released Wednesday by the Agency for Health Care Policy and Research.

"These recommendations can save pain, lives and money," said Clifton R. Gaus, the agency's administrator.

Nancy Bergstrom, a professor of nursing at the University of Nebraska Medical Center who was chairman of the 16-member advisory panel, said, "The fundamentals of good care are making sure the patient has good nutrition . . . relieving pressure on the skin frequently and properly cleansing and dressing the wound."

Pressure sores tend to form on parts of the body over bony prominences such as the hips or heels that bear weight when someone is seated or lying down for a long time. Healing takes two to four weeks, or even longer for infected sores.

The sores form when pressure squeezes shut tiny blood vessels that normally supply tissue with oxygen and nutrients.

The experts recommended:

- Keep pressure off the sore.

- Change positions at least every two hours.

- If you cannot move yourself, tell your care giver to change your position at least every two hours in bed and every hour while seated.

- Sores should be cleaned with saline solutions. Never use antiseptic agents and skin cleansers such as peroxide and betadine.

- Maintain good nutrition to promote healing.

- Do not rest directly on your hip bone when lying on your side. A 30-degree side-lying position is best.

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- Keep your heels off the bed by placing a thin foam pad or pillow under your legs from mid-calf to ankle.

- Avoid doughnut-type devices; they are more likely to cause pressure sores than prevent them.

This was the 15th clinical practice guideline published by the health care agency, which Congress created in 1989 to encourage the dissemination of the most effective medical treatments. One of its first guidelines dealt with how to avoid bedsores.

For free copies of the pressure sores guideline, call 1-800-358-9295.

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