Many people wonder if there may be pressure sores on the heels. We will understand in this article.
Pressure ulcers on the heels occur, as a rule, in bedridden patients. Damage occurs due to the death of soft tissues. They are most often found on the elbows, knees, sacrum, hips, heels and buttocks.
Treatment of pressure sores on the heels should be timely and comprehensive.
Description of the problem
Pressure ulcers appear in bedridden patients due to the inability to move. For this reason, there is a violation of the circulation of oxygen in the tissues, the vessels are strongly compressed, and the fat layer is thinning. Then there is redness on the skin, as well as inflammation and ulcers. Thus, the necrotic process of tissue death begins. First there is a dry pressure sore on the heel.
In addition to being in the same position, bedridden patients practically do not respond to pain, they do not feel discomfort from being in static. If a healthy person caused the pain to turn on the other side, then for a bed patient this is impossible.
The explanation of this phenomenon is that in such patients nerve fibers are damaged, especially for paralyzed patients. They have the risk of developing pressure sores is considered the highest.
Stages of bedsore on the heel
At the first two stages of the progression of pressure sores in the heel area, the pathological process is localized in the form of a pinkish-blue spot. This indicates a circulatory disturbance in this place. If you press on the back surface of the heel, then it turns white. Moreover, at the initial stage of the appearance of pressure sores, there are no signs of a violation of the integrity of the skin.
The second stage of the disease is characterized by peeling of the skin. Small bubbles filled with liquid appear on its surface. The presence of fluid in the epidermis provokes swelling of the skin cells and further breakthrough of tissue on the heel surface. At this point, the integrity of the tissues in the upper layer of the epidermis is violated. These symptoms are indicators that stagnation of blood occurs and the flow of oxygen into the tissue is impaired. Nutrients also stop entering the skin in the second stage.
The initial stages of the development of pressure sores do not pose a serious danger, they are easily eliminated by folk methods. Pressure sores are treated in this case, like any other skin irritation.
Starting from the third stage, the symptoms are aggravated, it is no longer possible to cope with them using traditional medicine methods. In areas where the integrity of the skin has been impaired, non-fouling and bleeding wounds are formed that can begin to suppurate when harmful bacteria enter them.
In addition, there is a complete thinning of the fat layer under the skin, muscle tissue is disturbed. Inflammation and suppuration is dangerous to the health and even life of the patient, as it can cause sepsis.
At the last, fourth stage of bedsores, serious defects occur, cavities are formed, the walls of which are suppurating. This is evidence that blood circulation is completely impaired, that is, tissue necrosis begins.
Pressure ulcers on the heels of black are a bad sign.
The death of tissues, in turn, provokes intoxication of the patient's body, and parasites can appear in infected wounds .
What is the treatment for pressure ulcers on the heels?
Therapy of the initial stages
The treatment of the affected area of the skin at the initial stage of the development of the disease consists in the application of ointments in the form of a compress. Drugs should be used wound healing. To carry out a preliminary cleaning of the affected area, it is enough to wash the skin with clean soapy water.
For the treatment of ulcers and wounds, aggressive substances such as hydrogen peroxide or iodine should not be used. This can negatively affect regeneration and aggravate the condition of the wound. Instead of concentrated chemicals, you can use saline, as well as pharmaceuticals such as solcoseryl and actovegin ointment. A dressing impregnated in Derinat has a similar wound healing effect.
Alternative methods of treating the initial stage of bedsore disease is the use of sea buckthorn oil. It softens and regenerates the skin, eliminating irritation.
Treatment at the 3rd and 4th stages
With extensive skin lesions, suppuration and necrosis, it will not be possible to do without the help of a specialist. Treatment of pressure sores on the heels should be carried out under the supervision of a surgeon. This will help avoid additional infection of the wound and prevent damage to bone tissue during the necessary procedures.
An important stage of treatment is the cleansing of wounds from pus and necrotizing tissues. Before cleaning, the heel is treated with a disinfectant. Chlorhexidine or hydrogen peroxide is well suited for this. If too much pus is observed in the wound, it makes sense to cleanse with a special tool for Protex-TM bedsores.
After disinfecting procedures, you should proceed directly to the treatment of pressure sores on the heels. To do this, a bandage impregnated with special ointments based on streptocide and synthomycin is applied to the wound. After 20 minutes, the bandage is removed. This sequence of steps for treating pressure sores allows you to completely clean the wounds from dead tissue and pus.
Ointments from bedsores for bedridden patients will be considered below.
Prevention
Pressure ulcers are a common problem in patients who are constantly in a lying position. To prevent their occurrence, it is necessary to carry out preventive measures every day. This is easier than treating wounds later on.
Every three hours, it is necessary to change the position of the patient's body, turning it on his back, on his stomach and from side to side. It is important to do this carefully so as not to damage the sensitive skin of the patient. It is also important to avoid squeezing the patient's skin.
If a person is able to move his limbs, you can choose special exercises for him to improve blood circulation and increase the elasticity of connective tissues. You can also get specialist advice on special simulators, which are selected depending on the capabilities of the bed patient.
There are also medical devices that create the appearance of muscle contraction. This can be electric underwear, the principle of which is based on conducting a weak impulse into the muscle, due to which its contraction occurs.
Patient care
During the day, you need to conduct several massage sessions of those parts of the body on which the patient lies most. This will help reduce blood stasis resulting from an immobile lifestyle. Massage, among other things, tones the muscles, which also has a good effect on blood circulation.
Modern orthopedics is ready to offer bedridden patients many devices that can reduce the risk of bedsore disease. In particular, you can purchase a special mattress. It has a structure that creates a comfortable position for the patient, while relieving pressure from some parts of the body.
A special compressor is built into the mattresses, and the surface itself is a massage element that helps to improve the blood supply to the body. If small bedsores have already appeared, the mattress will contribute to their early healing. You can also buy an anti- decubitus pillow or cushion under the heels of pressure sores, which can be used as a prophylactic. They are often used by people suffering from osteochondrosis or radiculitis. You can use the pillow not only in the bed, but also in a wheelchair when transporting the patient.
There is also an anti-decubitus circle, which allows you to distribute the pressure exerted on the body and restore blood circulation. The circle can be placed under the areas of the body that are subjected to the greatest load. A simpler option is the use of bags with grain, which are dotted under the most problematic areas of the body, prone to the appearance of pressure sores.
It is also important to pay attention to bedding. It should be with a natural composition, soft and smooth. Such underwear will not rub sensitive skin of a lying patient. It is necessary to ensure that the sheet does not gather in folds, but is tightly stretched to the surface of the mattress. The best option is to use sheets with an elastic band.
It is not worth choosing clothes with various three-dimensional reliefs and embroideries. Such jewelry will rub the patient's skin and provoke the appearance of pressure sores. Crumbs can also become wound provocateurs. An ideal option would be to purchase a bed for bed patients, which can be adjusted. In addition, it maximally meets all the needs of such patients.
What else involves the treatment of pressure sores on the heels at home?
Hygiene
Another important point in caring for the bed patient is compliance with hygiene rules and ensuring proper management of needs. Bed and underwear should be changed once every few days. Allowed to use disposable diapers, linings, napkins and diapers. The latter must be changed as often as possible in order to prevent the multiplication of bacteria that injure the surface of the skin.
In addition, various medications can be used to prevent skin irritation and diaper rash. A modern pharmacy can offer a wide range of different skin products. It can be powders, ointments and creams, antibacterial agents. Such drugs are selected based on the recommendation of a doctor to avoid the development of allergies or skin irritation.
Treatment should begin at the first sign of pressure sores. It is better to have various oils on hand and treat the skin immediately after damage. Do not rub the skin with a washcloth. It must be treated with a soft cloth dipped in soapy water, and then carefully dried. After treatment, moisturizing lotion or a special cream for pressure sores is applied.
Food
A significant role in the prevention of pressure sores is played by the patient's nutrition. His diet should have enough protein. This helps to improve the connection between connective tissues, which increases the resistance of the skin to various injuries. If it is not possible to enrich the patient’s nutrition with proteins due to certain circumstances, special mixtures can be used as the main or additional source of nutrients. The most popular food mixtures are Peptamen, Nutrizon, Eshnur, etc. Even if you follow a proper diet, it will not be superfluous to supplement it with the listed mixtures.
For muscle tissue and the body as a whole, it is important to observe the drinking regime, which involves the use of two liters of water per day. Freshly squeezed juices, such as carrot, grape, apple, tomato, orange, cabbage, etc., will also benefit. They enrich the body with vitamins, nutrients, and also help increase muscle tone.
If the bed patient is able to eat food himself, then you can give him fresh fruits, as they contain fiber, useful for the structure of the epidermis.
How to choose an ointment for bedsores for bed patients?
Drugs for the treatment of pressure sores
The modern pharmaceutical market is ready to offer quite a lot of ointments and creams intended for the prevention and elimination of pressure sores. The most popular among them are preparations based on silver ions.
Argosulfan
Quite often, an ointment with silver "Argosulfan" is prescribed. It is suitable for eliminating the first signs of pressure sores. Effectively stops the spread of infection, improves the regenerative properties of the skin and helps cleanse wounds. Silver ointment has an antibacterial and wound healing effect. It includes the antibiotic Sulfathiazole, as well as silver ions. The drug can be used both in a dressing and an open method.
Menalind
Cream "Menalind" is a group of drugs that are used to care for the skin of patients who cannot move independently. The drug in the form of ointment, shampoo and special wipes is allowed to be used in combination with other medicines. Cream "Menalind" promotes wound healing, removes irritation from the skin.
Zinc ointment
Zinc ointment also effectively eliminates the first manifestations of pressure sores. However, if you believe the reviews, its use has only a preventive effect and will not give a result when applied at later stages of the development of the disease. It creates a transparent protective layer on the surface of the skin, which prevents the penetration of harmful bacteria. In addition, this bedsore cream eliminates pain and swelling.
It should be remembered that proper care for the bedridden patient is the most reliable way to prevent such an unpleasant and dangerous phenomenon for the patient’s health and life as bedsores. If it was not possible to avoid the appearance of wounds, you should consult a doctor.