With prolonged treatment requiring bed rest, pressure sores may form on the patient’s skin. The treatment of pressure sores is a very important event, which must be carried out in accordance with all the rules. An unpleasant defect arises as a result of the deterioration of blood circulation in the organs and tissues of a person, forced to lead an immobile lifestyle. Doctors recommend a lot of measures, with which no bedsores will occur on the patient's body. The treatment and treatment of pressure sores is a very laborious and complex process. It is much easier to prevent them than to fight them.
What are bedsores?
In a person for a long time lying in one position, the circulatory system does not work at full strength. Under the influence of body gravity, small capillaries are compressed. This prevents blood from entering certain areas. As a result, oxygen saturation and tissue nutrition are stopped. The latter, without receiving the necessary nutrients, begin to die. It is in these areas that bedsores are formed. The treatment of pressure sores, begun before their appearance, as a preventive measure, can dramatically change the situation. In most cases, such measures protect the patient from unpleasant and painful formations.
What do bedsores look like?
The death of the skin occurs in several stages. The type of pressure sores depends on the severity of the stage:
- At the first (initial) degree, areas of the skin that are in a compressed state for a long time swell and blush. Visually, it looks like a simple annoyance, sometimes with blue. Pain may be felt on these parts of the body. With such symptoms, prevention of pressure sores should begin immediately. Processing with camphor alcohol over compressed areas will provide excellent results.
- The second stage is characterized by the formation in the irritated areas of a shallow wound with pinkish and swollen edges. It looks like an ulcer. Sometimes a bedsore in the second stage is like a bursting bubble.
- In the third stage, the wound deepens. Inside it is visible yellow dead tissue.
- The fourth stage is characterized by an even greater deepening of the ulcer. She begins to affect the internal tissues. Tendons, muscles, and sometimes bones are visible in the wound hole.
The occurrence of pressure sores depends on the position of the patient. If the patient lies on his back, then ulcers form in the area of the shoulder blades, sacrum and heels. On the hips, shoulders and knees, bedsores occur in those people who are located on their sides. In patients in a wheelchair, ulcers can appear on the buttocks, sacrum and back of the hands.
These areas should be remembered and carefully inspected. Do not forget that such people are recommended daily treatment for pressure sores and their prevention.
Causes of occurrence
Pressure ulcers appear in areas where there is no muscle tissue between the bones and the skin. There are ulcers in people who have lost the ability to move. For example, strict observance of bed rest after operations or fixation of the human body as a result of injuries can serve as a prerequisite. Sometimes the cause of pressure sores can be:
- poorly applied tires and plaster casts;
- improperly selected corsets and prostheses;
- too tight bandages, folds on the bed, tight clothes.
However, in some bedridden patients, such pathologies can develop quite rapidly. In such people, even with careful care, ulcers can form on the body. Such patients require more careful care and frequent treatment of pressure sores. In patients with diabetes, for example, the blood supply is disturbed. And if such a patient stays for a long time in a stationary state, in which the tissues are compressed, then the risk of bedsores formation increases significantly. In addition, the following factors contribute to the formation of pathology:
- Smoking.
- Obesity.
- Wrong diet.
- Dehydration
- 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
Bedridden patients need special care. It is very important that the treatment of pressure sores and their prevention are carried out correctly. From the very moment the patient was bedridden. Such events include:
- Daily visual inspection of the patient’s skin. In this case, it is especially necessary to check the state of the dermis in areas where the bones protrude.
- Treatment of pressure sores in seriously ill patients with camphor alcohol (10% solution) or ammonia (0.5%). Such procedures are recommended to be carried out in “hazardous” areas even if there is no redness yet. During the event, light massage movements should be carried out with a swab dipped in an alcohol solution. Such massage helps blood circulation and stimulates tissues.
- Periodic change in patient posture. The position of the patient can be changed using special means (for example, an rubber ring or rollers). Particularly carefully you need to transform the position of the buttocks and heels in order to protect the integument from the formation of folds. A good preventive measure is a special orthopedic mattress.
- Be sure to use only natural fabrics for bedding and clothes of the patient. Avoid skin-injuring elements (zippers, buttons, hooks).
- Maintaining a comfortable temperature and humidity in the room where the patient is located.
- Keeping the patient clean. The skin of the patient should not be wet. Do not use drugs that can provoke irritation of the integument.
- Stimulation of motor functions of the patient. Turning and moving parts of the body, massage helps prevent pressure sores.
- The correct, balanced diet. It consists of foods that are low in calories, but rich in minerals and vitamins. In this case, it is necessary to monitor the water exchange. The patient should consume fluid, not more than one and a half liters per day.
These are the main activities that make up the prevention of pressure sores.
Skin treatment for pressure sores
Medicines, even the most effective, will not be able to benefit if the area on which the defect is formed remains in a compressed state. It is impossible to eliminate the pathology if blood does not begin to flow into this zone, nourishing the tissues with the 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 treatment of pressure sores occurs. The implementation technique below will allow you to complete the event correctly and efficiently.
Procedures for restoring blood flow in the affected area
If a pressure sore occurs, it is first necessary to exclude contact of the skin with the bed in places of irritation. To do this, an inflatable circle or a roller is placed under the body so that the wound is constantly in the air. A good preventive measure against bedsores is massage. Make it morning and evening. The skin of the patient should be dry and clean. When performing massage, you can use special creams and oils. Areas where wounds have formed are not massaged! Such treatment of pressure sores in patients is possible only at the first stage.
Procedure:
- Lay the patient on his stomach. Stroking the legs from the heels to the buttocks.
- Now go to the hands. Stroke from hands to neck.
- Massage of the lower back and sacrum is performed downward, and then to the sides.
- Stroking the entire back.
This procedure is performed within 5 minutes. Movements should be light at first, and then more intense. Then rubbing, vibration and kneading of the same parts of the body are done. Each reception lasts 5 minutes. At the end, a head massage is performed, especially the back of the head, which is more at risk of pressure sores. Then the patient is laid on his back and a similar massage of the front of the body is performed. Carefully massage those areas that are more protruding (knees, ribs, pelvic bones).
Procedures for tearing away dead tissue
Some patients develop pressure sores very quickly. Treatment of pressure sores, if wound surfaces occur, begins with the release of the affected area from dead cells and pus. For this, special medicines are used. In complex cases, surgical intervention is recommended.
Pressure sores are being treated:
- Camphor alcohol. This tool is used only in the initial stages. Its use on open wounds is completely unacceptable.
- Hydrogen Peroxide (3% solution).
- "Chlorhexidine." The product is more neutral for the skin.
If it is required to remove pus and dead cells, special means for cleaning wounds are used: Izuksol and Proteoks-TM.
Activities for healing the wound surface
After the ulcer is cleared, it is necessary to begin treatment. Excellent healing of pressure sores is facilitated by alginates and hydrocolloid dressings:
- Comfil Plus.
- "Multifrem."
- Hydrocall.
- Hydrosorb.
- Duoderm.
The above funds are quite expensive. Therefore, not all people can purchase them to treat bedsores. The treatment of pressure sores can be performed with special ointments and creams that promote wound healing, while not having such a high price. Among these drugs, there are:
- Synthomycin.
- "Dexpanthenol."
- "Actovegin."
- Levomikol.
- "Vulnostimulin."
- "Solcoseryl."
- Levosin.
- Hypericum oil.
- Sea buckthorn oil.
To prevent infection, when treating ulcers, you must strictly follow the rules of antiseptics. After the use of wound healing agents, a sterile dressing must be applied. If it is not possible to dress the treated wound, you can fix the disinfecting pad at the site of the lesion with a special adhesive plaster. But it must allow the skin to breathe. It should be noted that bandages and adhesive plasters should not pull the covers to prevent their further damage. Dressings are carried out as necessary. Before each procedure, pressure sores are treated with antiseptics. Sometimes, if indicated, patients are prescribed antibiotic treatment.
When is surgical treatment performed?
Unfortunately, even high-quality and effective treatment of pressure sores 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 surgery, perform the following procedures:
- bedsore cleaning (to remove dead areas);
- antibiotic treatment;
- cleansing the body of toxins;
- restoration of water, protein and electrolyte balance.
There are several surgical methods for treating pressure sores, which depend on the stage of development of the ulcer, the size of the affected area and the presence of infection:
- Free skin plastic. Do with bedsores 2 and 3 stages. The wound heals in 2-3 weeks.
- Excision and plastic by surrounding tissues. Conducted with bedsores 4 stages. The ulcer heals within 2 weeks in most patients.
- Excision and plastic surgery with a skin flap with or without muscle. The operation is indicated for bedsores of stage 4 and with a large surface of dead tissue. The wound heals within 2-4 weeks in 2/3 of the patients.
Sometimes only surgical intervention can help the patient get rid of pressure sores and prevent complications such as renal failure, liver disease, sepsis and death. After the operation, the affected areas of the skin heal quite quickly. Surgical intervention can significantly alleviate the condition of seriously ill people.
Ointments for bedsores
The range of drugs for the treatment of these pathologies is quite large. In order to effectively treat pressure sores at home on your own, you should choose the right medication. Ointments intended for the treatment of pathology should:
- restore blood circulation;
- stimulate tissue regeneration;
- have an antibacterial effect;
- eliminate pain.
However, do not forget about the technique of the event. Before using the ointment, you should 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 selected depending on the degree of development of the ulcer and the presence of infections. For the first stage, improvement of blood circulation and antimicrobial effect are necessary. At this stage, apply:
- Zinc ointment.
- "Dermazin."
- Argosulfan.
- Tsindol.
If bacteria enter the wounds, antibiotics are required. For such cases, at the first stage, drugs are used:
- Argosulfan.
- Iruxol.
- Levomekol.
- Levosin.
In the second stage, ointments are used to remove dead cells. At the same time, they must have anti-inflammatory and drying effects:
- Betadine.
- "Methyluracil."
- Iruxol.
- Thiotriazolinum.
The third stage shows ointments that stimulate healing:
- "Algofin."
- "Solcoseryl."
- Bepanten.
- Levosin.
- Thiotriazolinum.
- Iruxol.
Bedsores of the fourth degree should be treated in a hospital, as there is a high risk of complications. Naturally, all ointments and funds should be used only after consulting with your doctor. Based on the tests performed, the specialist will prescribe the best and most effective therapy. Self-medication in this case is strictly contraindicated. After all, there is a very high risk of death with inappropriate therapy.