What is pressure sores? Treatment of bedsores and their prophylaxis

With prolonged treatment that requires adherence to bed rest, bedsore can form on the skin of the patient. Treatment of pressure sores is a very important exercise that must be carried out according to all the rules. An unpleasant defect arises as a result of deterioration of blood circulation in the organs and tissues of a person forced to lead an immobile lifestyle. Doctors recommend a lot of activities, under which there will not be bedsores on the patient's body. Treatment of decubituses and their treatment is a very laborious and complicated process. It is much easier to prevent them than to fight them.

What is pressure sores?

In a person who has been lying in one position for a long time, the circulatory system does not work at full strength. Under the influence of the weight of the body, small capillaries are squeezed. This prevents blood from entering certain areas. As a result, the oxygen saturation and nutrition of the tissues are stopped. The latter, without receiving the necessary nutrients, begin to die. It is on these sites that bedsores are formed. Treatment of decubituses, begun before their appearance, for preventive purposes, can dramatically change the situation. In most cases, such activities protect the patient from unpleasant and painful formations.

How do bedsore look?

The necrosis of the skin occurs in several stages. The type of decubitus depends on the severity of the stage:

1. At the first (initial) degree, skin areas that are in a compressed state for a long time, swell and blush. Visually, it looks like a mild irritation, sometimes with a blue. On these parts of the body can be felt pain. With this symptomatology, prophylaxis of pressure sores should begin immediately . The treatment with camphor alcohol of the squeezed places will ensure excellent results.
2. The second stage is characterized by the formation on the irritated areas of a shallow wound with pinkish and swollen margins. It looks like an ulcer. Sometimes a sleeping-room in the second stage is similar to a bursting bubble.
3. At the third stage, the wound deepens. Inside it there is a yellow, deadened tissue.
4. The fourth stage is characterized by an even deeper ulcer. It begins to affect the internal tissues. In the wound hole, tendons, muscles, and sometimes bones are seen.

The place of occurrence of pressure sores depends on the patient's position. If the patient lies on his back, ulcers are formed in the area of scapula, sacrum and heels. Beds on the hips, shoulders and knees arise from those people who are located on their sides. In patients moving in a wheelchair, ulcers can appear on the buttocks, sacrum and back of the arms.

These sites should be remembered and carefully examined. Do not forget that such people are recommended daily treatment of bedsores and their prevention.

Causes

Bedsores appear on those areas where there are no muscle tissue between the bones and the skin. There are ulcers in people who have lost the ability to move. For example, a strict observance of bed rest after surgery or fixation of a person's body as a result of injuries can serve as a prerequisite. Sometimes the cause of pressure sores can be:

• Badly imposed tires and plaster casts;
• Improperly selected corsets and prostheses;
• Too tight armbands, folds on the bed, tight clothes.

In some recumbent patients, similar pathologies can develop quite rapidly. Such people, even with careful care, are able to form ulcers on the body. Such patients need more attentive care and frequent treatment of pressure sores. In patients with diabetes mellitus, for example, blood supply is impaired. And if such a patient remains for a long time in a stationary state, at which the tissues are squeezed, the risk of bedsore formation increases at times. In addition, the following factors contribute to the formation of pathology:

• Smoking.
• Obesity.
• Wrong diet.
• Dehydration of the body.
• Diabetes.
• Diseases of the heart and blood vessels.
• Increased sweating.
• Traumatic or therapeutic disorders in the brain or spinal cord.
• Allergic reactions to cosmetics for skin care.

Preventive actions

Lying in need of special care. It is very important that the treatment of pressure ulcers and their prophylaxis be carried out correctly. From the very moment when the patient was confined to bed. Such activities include:

1. Daily visual inspection of the patient's skin. In this case, it is especially necessary to check the condition of the dermis in the areas where the bones protrude.
2. Treatment of decubitus in severely ill with camphor alcohol (10% solution) or ammonia (0.5%). Such procedures are recommended to be carried out in "dangerous" areas and in the event that redness does not exist yet. During the exercise, you should perform light massage movements with a swab soaked in a solution of alcohol. This massage helps circulation and stimulates tissues.
3. Periodic change in the patient's posture. The position of the patient can be changed with the help of special means (for example, an inflatable circle or rollers). Particularly need to transform the position of the buttocks and heels, to protect the cover from the formation of folds. A good preventive measure is a special orthopedic mattress.
4. Be sure to use only natural fabrics for bed linen and clothes of the patient. Avoid skin traumatizing elements (lightning, buttons, hooks).
5. Maintain a comfortable temperature and humidity in the room where the patient is.
6. Keep the patient clean. The patient's skin should not be wet. Do not use drugs that can provoke irritation of the integument.
7. Stimulation of the motor functions of the patient. Turning and moving parts of the body, massage helps to prevent the occurrence of pressure sores.
8. Correct, balanced diet. It consists of food with a small amount of calories, but rich in minerals and vitamins. It is necessary to monitor water exchange. The patient should consume liquid, not more than one and a half liters per day.

These are the main measures, of which prevention of bedsores consists.

Treatment of the skin with the appearance of pressure sores

Medications, even the most effective ones, can not benefit if the area on which the defect was formed remains in a compressed state. It is impossible to eliminate pathology if blood does not flow into this zone, feeding tissues with necessary substances.

Thus, care includes 3 basic conditions:

• Restoration of blood circulation in the damaged area;
• Ensuring the rejection of dead tissue;
• Therapeutic measures aimed at healing wounds.

Let us consider in more detail how the decubitus is treated. The technique of execution, given below, will allow to carry out the measure correctly and qualitatively.

Procedures for restoring blood flow in the affected area

In the event of a pressure sore, the contact of the skin with the bed in the places of irritation must be avoided in the first place. For this, an inflatable circle or roller is placed under the body so that the wound is constantly in the air. A good preventative against decubitus is massage. Do it in the morning and in the evening. The skin of the patient should be dry and clean. When performing massage, you can use special creams and oils. Sites on which wounds were formed are not massaged! This treatment of bedsores in patients is possible only in the first stage.

Procedure:

1. Lay the patient on the stomach. Carry the legs from the heels to the buttocks.
2. Now go to your hands. Stroke from the brushes to the neck.
3. Massage of the waist and sacrum is performed in a downward direction, and then - in the sides.
4. Stroking the entire back.

This procedure is performed for 5 minutes. Movements must first be light, and then more intense. Then rub, grind and knead the same parts of the body. Each reception lasts 5 minutes. At the end, a head massage is performed, especially the occiput, which is more prone to the risk of pressure ulcers. Then the patient is laid on his back and a similar massage is performed on the front of the body. Carefully massage those areas that are more prominent (knees, ribs, pelvic bones).

Procedures for the rejection of dying tissues

Pressure ulcers develop very quickly in some patients. Treatment of decubitus, if there are wound surfaces, begins with the release of the affected area from dead cells and pus. For this, special medicines are used. In difficult cases, surgical intervention is recommended.

The treatment of decubitus is carried out:

1. Camphor alcohol. This tool is used only in the initial stages. It is completely unacceptable to use it on open wounds.
2. Hydrogen peroxide (3% solution).
3. "Chlorhexidine." The agent is more neutral to the skin.

If it is required to remove pus and dead cells, special means are used to clean wounds: "Iuxol" and "Proteox-TM."

Measures providing wound surface healing

After the ulcer is cleared, it is necessary to start treatment. Excellent healing of pressure sores is promoted by alginates and hydrocolloid dressings :

• Comfil Plus.
• «Multifreem».
• "Gidrokoll".
• "Hydrosorb".
• The Duoderm.

The above funds are quite expensive. Therefore, not all people can buy them to treat decubitus. Treatment of decubitus can be performed with special ointments and creams that promote wound healing, while not having such a high price. Among such drugs are:

• "Synthomycin."
• "Dexpanthenol."
• "Actovegin".
• "Levomikol".
• "Vul'timulina".
• Solcoseryl.
• "Levosin".
• St. John's wort oil.
• Sea buckthorn oil.

To prevent infection, when handling ulcers should strictly follow the rules of antiseptics. After applying the means for wound healing, a sterile bandage should be applied. If there is no possibility to bandage the treated wound, it is possible to fix the disinfecting patch on the site of the lesion with a special adhesive plaster. But he must let his skin breathe. It should be noted that dressings and adhesive plaster should not overtighten the covers to prevent their further damage. Dressings are performed as needed. Before each procedure, it is necessary to treat the bedsore with antiseptics. Sometimes, in the presence of indications, patients are prescribed antibiotic treatment.

When is surgical treatment performed?

Unfortunately, even high-quality and effective treatment of bedsores in seriously ill patients does not always lead to the healing of wound surfaces. In the event that conservative treatment does not help, surgical intervention is required. Usually it is used for bedsores 3-4 stages.

Before the surgery perform the following procedures:

• Cleaning decubitus (to remove necrotic areas);
• Antibiotic treatment;
• Purification of the body of toxins;
• Restoration of water, protein and electrolyte balance.

There are several surgical methods for the treatment of pressure sores, which depend on the stage of development of the ulcer, the size of the affected area and the presence of infection:

1. Free skin plastic. Do with bedsores 2 and 3 stages. The wound heals in 2-3 weeks.
2. Excision and plastic around surrounding tissues. Carried out with bedsores 4 stages. The ulcer is healed within 2 weeks in most patients.
3. Excision and plastic skin flap with muscles or without. The operation is indicated for bedsores of stage 4 and for a large surface of dead tissue. Heals the wound for 2-4 weeks in 2/3 of the patients.

Sometimes only surgical intervention can help a patient get rid of bedsores and prevent complications such as kidney failure, liver disease, sepsis and death. After the operation, the affected areas of the skin cover heal fairly quickly. Surgical intervention can significantly alleviate the condition of severely ill people.

Ointments for bedsores

The assortment of drugs for treating these pathologies is quite large. To treat pressure sores in the home on its own was carried out effectively, you should choose the right medicines. Ointments intended for the treatment of pathology should:

• Restore blood circulation;
• Stimulate the regeneration of tissues;
• Have antibacterial action;
• Eliminate pain.

However, do not forget about the technique of the event. Before applying the ointment, disinfect and treat the affected area with an antiseptic. For this, drugs are used: "Chlorhexidine Bigluconate", "Colloidal Silver", "Furacilin".

Ointments for the treatment of pressure sores are chosen depending on the degree of ulcer development and the presence of infections. For the first stage, blood circulation and antimicrobial effects are necessary. At this stage apply:

• Zinc ointment.
• "Dermazin".
• "Argosulfan".
• "Tsindol."

When bacteria get into the wounds, antibiotics are required. For such cases, the first stage uses drugs:

• "Argosulfan".
• "Iruksol".
• "Levomekol".
• "Levosin".

In the second stage, ointments are used to remove dead cells. In this case, they should have an anti-inflammatory and drying effect:

• "Betadin."
• "Methyluracil".
• "Iruksol".
• "Tiotriazolin."

The third stage shows ointments that stimulate healing:

• Algofin.
• Solcoseryl.
• "Bepanten."
• "Levosin".
• "Tiotriazolin."
• "Iruksol".

Bedsores of the fourth degree should be treated in a hospital, since the risk of complications is high. Naturally, all ointments and funds should be used only after consultation with the attending physician. The specialist, on the basis of the analyzes performed, will prescribe the best and effective therapy. Self-medication in this case is strictly contraindicated. After all, the risk of death is very high with inadequate therapy.