Pathological changes in the dermis, which are formed in patients confined to a wheelchair or bed, are called bedsores or ulcers. They can appear with good care. The reason is a violation of blood flow in parts of the body, the access of oxygen to which is difficult. The main reason for their formation is considered to be a lack or lack of movement, as a result of tissue do not receive enough nutrients and oxygen, which leads to their destruction. First of all, the skin is damaged in those places where the hard surface of the bed or chair is in contact with the bone. Therefore, it is important to see the pathology in time and begin timely treatment, as well as carry out preventive measures. In this article, we will try to figure out how to treat bedsores in bedridden patients.
Types and causes of pressure sores
There are external pressure sores, which are formed in places of protrusion of bones and internal - in areas of catheters or drainages in an organ or wound. By location - on the hips, spine, feet, buttocks, sacrum, shoulder blades, nape, ankles, elbows, heels.
By origin there are endogenous and exogenous. The former are formed as a result of a violation of innervation in the tissues. The second - are formed from mechanical stress.
The main causes of pressure sores are slipping, pressure, friction, and humidity. Factors that provoke their development:
- swelling
- oncology;
- vascular disease;
- age-related changes in the dermis;
- motionless state;
- fecal, urinary incontinence;
- fractures of the limbs;
- dry dermis;
- stroke;
- diabetes;
- hypotension;
- anemia;
- malnutrition;
- low weight.
Pressure ulcers form quickly if the dermis is very dry or too wet. In the first case, peeling of the protective layer of the skin occurs, and in the second, the probability of infection is high. Circulatory disturbance exacerbates this process.
General recommendations
The treatment of pressure sores depends on the stage of development. It happens conservative and surgical, the latter is used in case of inefficiency of all other methods. When treating pressure sores at home, you must adhere to the following rules:
- be sure to carry out preventive measures to prevent the transition to another stage;
- do not apply dressings that prevent the evaporation of moisture and oxygen;
- do not use external funds in the form of creams or ointments with softening properties;
- at the initial stage of bedsores or with dry tissue necrosis, do not apply wet dressings;
- the use of antibacterial agents is indicated for a wet wound.
Symptoms of pressure sores. Complications
The clinic depends on the stage, of which there are only four:
- There is redness or irritation on the skin; other lesions are absent. There is pain and increased sensitivity.
- There is an open wound surface, the skin is affected. The wound is red, the edges are swollen. In some cases, there is a bubble that bursts or is whole, inside which is a liquid.
- Tissue necrosis. The wounds are deep, down to the bones. Pressure ulcer spreads between the layers of a healthy dermis.
- The hardest. Muscles and tendons are visible through the wound. Extensive necrosis. Healthy tissues are actively affected.
Treatment of neglected bedsores at home is difficult, since in this case surgical intervention is required. The consequences of poor-quality therapy are quite severe: sepsis, meningitis, cancer of the dermis, damage to bones and joints. In some cases, if the pathology touched the walls of the vessels, it is possible that bleeding develops.
Preventative measures
If pressure sores began to form, then stopping this process is difficult, almost impossible, and each new stage only aggravates the patient's condition. It is quite difficult to treat bedsores at home, and prevention in this case plays an important role.
It must be started at the first sign of a pathological process. As preventive measures, the following conditions should be provided to the patient:
- Nutrition and drinking regimen.
- Keep your skin clean. Regular cleansing, disinfection and maintenance of a certain dryness.
- Regular change of underwear and bedding.
- Purchase an anti-decubitus mattress.
- Eliminate in certain places prone to the formation of pressure sores, pressure on the patient's body with the help of special pillows, linings.
- Change the position of the patient every 120 minutes.
- Apply bandages and tires correctly.
- Timely change catheters, tubes, drains.
- Simulate muscle activity using massage or electric underwear.
The basic rules of therapy to be followed
The treatment of pressure sores at home involves the fulfillment of certain conditions:
- Maintain a clean dermis, do not over-moisten and do not over-dry. Regularly arrange air baths. To wash the patient's body, use ordinary soap, a sponge made of cotton cloth, water. Wipe the patient's skin slightly. Blot damaged areas carefully.
- Monitor the state of the dermis. Wet dry using a powder, talcum powder, potassium permanganate solution or zinc ointment. Dry - moisturize with baby cream. Oily skin can be treated with alcohol-containing solutions. However, these actions are permissible only in the first stage.
- Patients with urinary incontinence are advised to change pads or diapers more often.
Treatment of pathology at home
Elimination of pressure sores is possible provided that blood circulation resumes in the affected area, and if it continues to come into contact with the surface, then any actions are not effective. The treatment of pressure sores at home consists of the following:
- Change the position of the patient to restore blood movement in the damaged area of the dermis. At the first detection of redness or a wound, the contact of this place with the bed should be completely excluded. To do this, you can put soft rollers under the body. Prophylactic massage and rubbing with camphor alcohol is allowed in the absence of a wound surface.
- Remove dead skin. The lifeless areas of the epidermis are removed using antiseptic agents: hydrogen peroxide or chlorhexidine solution. If the wound festers, use "Iruksol" or "Proteox-TM"
- Wound healing. The medication used to treat ulcerative lesions is prescribed by the doctor, depending on the stage of pressure sores.
Pressure ulcers on the tailbone and buttocks
If there is damage to the buttocks, the patient should lie on his stomach or on his side. It is necessary to exclude the negative impact and restore blood supply to the tissues, otherwise the effectiveness of therapy will be reduced to zero. To treat pressure sores on the buttocks at home, you will need:
- Restore blood flow to the damaged area.
- Remove dead skin from the dermis.
- Clean the wound.
- Treat with a drug that contains silver ions. Due to its antiseptic and analgesic properties, it will help to heal the wound surface faster.
On the tailbone, the bedsores are the largest and quite often necrosis occurs in this place. To prevent them, the patient should be periodically laid on a special circle so that the coccyx does not touch the surface of the bed. A good effect in the treatment of pressure sores on the tailbone at home is obtained using dressings moistened with a salt-cognac solution in a ratio of 30 to 150 grams, which are applied under compress paper. Change it as needed. Before applying a new dressing, thoroughly rinse the damaged surface from salt.
For healing, use antibacterial ointments, sea buckthorn oil. For purulent wounds, apply streptocide, which must first be crushed in a mortar to a powder state or boric acid. These agents have bacterial and antiseptic properties.
Pressure sores on the heels
They appear in every second patient. The reason for their formation is a violation of blood flow, lack of motor activity, poor-quality care. The treatment at home for pressure ulcers on the heels of the first and second stages is as follows:
- daily foot hygiene;
- air baths;
- contrasting dousing;
- removal of keratinized skin;
- treatment of damaged areas with a solution of sodium chloride;
- the application of drugs that improve blood circulation, as well as special dressings soaked in antiseptic drugs.
The use of drugs is possible only after consulting a doctor.
Any therapeutic measures should be aimed at improving blood circulation in the tissues, removing dead parts of the dermis and healing of wound surfaces.
The treatment of deep bedsores at home involves the following:
- Disinfect the heel with a solution of chlorhexidine or hydrogen peroxide. If the bone is visible, then it is treated with special means containing biologically active substances.
- The dead parts of the dermis are removed, the wound is cleaned of pus using sterile material and medical devices. In some cases, surgery will be necessary to remove damaged tissue.
- A medicine is applied to the wound surface and a bandage is applied on it for a period determined by the doctor.
Home therapy
The treatment of pressure sores in the initial stage at home does not require specific therapy. All medical measures should be aimed at eliminating congestion:
- light massage;
- hygiene;
- maintaining the integrity of the dermis;
- the use of various anti-decubitus devices;
- turning the patient every two hours.
In some cases, the doctor may recommend treating the damaged area of the dermis with an alcohol solution of camphor, Sophora, Japanese or sea buckthorn oil.
At the second stage, at home, the following activities are carried out:
- treat bedsores with chlorhexidine or hydrogen peroxide;
- apply a sterile dressing with the following medicines: Solcoseryl, Levomekol, Actovegin, Levosin or use special plasters, for example, Cosmopor, as well as hydrogel dressings that maintain the necessary moisture in the wound and provide healing act;
- preventative measures.
Treatment of purulent bedsores at home
In these cases, it is necessary to carefully select therapy, since there is necrosis, inflammation and infection. The pathological process quickly spreads to parts of the body with impaired blood circulation. Dead tissue is not rejected on its own; surgical intervention is required to remove them and open the purulent cavities.
For the healing of deep ulcers, antibacterial and antiseptic drugs are used inside and out. Treatment of bedsores of the 3rd degree at home involves regular cleansing of the wound from pus and protecting the dermis from overdrying. The list of ointments used for these purposes is given below. In addition, you can use medicines in the form of gels:
- "Metronidazole". The drug helps to slow the growth of pathogens, eliminates unpleasant odor from the wound.
- IntraSite. With this hydrogel, necrotic tissue is removed. The drug is used along with a bandage. The medicine absorbs the detachable contents from the wound and gently cleanses the damaged area.
With the fourth degree of pressure sores, ulcerative lesions extend not only to the dermis, but also capture bones, joint capsules and tendons. The treatment of pressure sores consists in excising a site of necrosis, removing pus from the wound, and moisturizing the healing ulcer. Provided that in two weeks of conservative treatment, the bedsore decreases by thirty percent, the doctor changes the therapy. After the acute stage of necrosis, surgery is performed, in which the wounds are cleaned, while maintaining live articular bags, tissues and vascular bundles. Further, physiotherapy procedures for tissue repair are recommended, which include mud applications, laser, UHF, ultrasound, electrophoresis, electroacupuncture. The treatment of stage 4 bedsores at home is similar to the therapy used in the third stage.
Dressings, bandages for bedsores
Ulcers in bedridden patients, especially in old age, are difficult to treat at home. In addition to solutions, ointments, gels, tablets, doctors increasingly began to recommend the use of plasters and dressings. Special medical products protect the wound from infection and microbes, create a favorable environment that prevents drying of the open wound. The treatment of pressure sores at home with the use of dressings gives a good effect:
- Comfil Plus promotes rapid wound healing.
- "Multiferm" is used at the initial stage without infection.
- Hydrosorb Comfort is used for shallow wounds.
- "Biaten" for deep damage to the dermis.
- "Proteox-TM" relieves inflammation, removes pus, and restores tissue. Used for infected ulcers of the last degree.
The doctor determines the frequency of dressings in the treatment of pressure sores at home individually. When treating at home, all instructions and instructions of the doctor should be followed. Anti-decubitus healing patches create a moist environment, which contributes to faster wound healing. The patch is quite convenient, since it can be glued for several days, provided that there are no allergic reactions. Using a patch, in five courses it is quite possible to cure a bedsore in the second stage.
External medicines
The use of ointments for the treatment of pressure sores at home will help to avoid many negative consequences. Their advantages are as follows:
- availability;
- contribute to improved blood circulation;
- eliminate discomfort;
- have painkillers and wound healing effects;
- destroy bacterial and viral infections.
The disadvantages include individual intolerance and the inability to use in advanced cases. The selection of the drug for external use should be entrusted to the doctor. Commonly prescribed ointments for the treatment of pressure sores include the following:
- Zinc. This tool, having anti-inflammatory and antiseptic properties, dries and protects the wound surface from the irritating effect of environmental factors. Apply it at least six times a day. A small amount of the drug is applied to the damaged area. The course of therapy is about two months.
- Argosulfan. The composition of this medication includes silver, which has a healing and antibacterial effect. Ointment helps to eliminate pain and burning sensation. It is applied to the wound in a thick layer at least twice a day. The previously damaged surface is treated with an antiseptic solution and dried.
- Levosin. Thanks to the antimicrobial, antiseptic and wound healing effect, the use of ointment in the treatment of pressure sores at home helps to cleanse the wound from purulent contents and dead cells.
- "Solcoseryl." The drug, when applied externally, has a regenerative effect on tissues. The wound is disinfected, then ointment is applied, as a result, a thin film forms, which protects the damaged surface from external factors. Apply ointment until complete healing.
- Levomekol. The antibacterial and restorative effect is used to treat infected bedsores.
The use of drugs for the treatment of pressure sores must be combined with preventive measures.
Herbal pressure sores treatment
There are quite a few recipes with which it is recommended to treat bedsores. However, it should be remembered that the use of alternative medicine methods is possible as a prophylaxis, in the first, rarely in the second stage, and only after consulting a doctor.
When treating pressure sores at home, folk methods use infusions and decoctions prepared from different herbs. They wash the wounds and make lotions using a sterile dressing. Medicinal plant materials are selected depending on its medicinal properties:
- Calendula is an excellent anti-inflammatory, antibacterial and regenerative agent that successfully treats wet sores. .
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Such a disaster can happen with a pet. The cause of pressure sores is paralysis of the hind limbs, which develops due to spinal injury; prolonged illness, squeezing the skin with a collar. Pressure ulcers in a paralyzed animal are formed on those parts of the body that experience the greatest pressure. The skin is covered with ulcers, swells, unpigmented areas redden, an unpleasant odor appears. If they are found, you should contact your veterinarian, who will advise special protective pads or dressings.
Damaged skin is treated with a solution of brilliant green, potassium permanganate, hydrogen peroxide, camphor alcohol. A sick dog should be turned over more often and picked up a soft litter. For the prevention and treatment of pressure sores, there are special designs in the form of an orthopedic bed for animals. In addition, massage is a preventative measure.