Decubitus ulcers in bedridden patients: prevention and treatment
Decubitus ulcers are areas of necrosis and ulceration of soft tissues. The reasons for their occurrence are pressure on tissues from hard surfaces and bony protrusions and friction, which lead to impaired blood circulation. The presence of moisture contributes to the appearance of bedsores. Bedsores appear when the patient stays for a long time without moving and changing the position of the body. The localization of bedsores depends on the position in which the patient lies. Most often, tissue compression occurs in the area of the sacrum, heels, elbow joints, shoulder blades.
The following stages of bedsores develop:
- Change in skin color (erythema that does not turn pale when pressed).
- Emergence of erosion (defoliation of the epidermis), surface ulcer. At the same time, subcutaneous fat is not involved in the pathological process.
- Impression of subcutaneous fat. Muscles are not involved in the process.
- Skin, muscle and fascia impressions.
Decubitus bedsores: risk factors, prevention, treatment
Risk factors for bedsores in bedridden patients are age over 65 years, immobilization, impaired blood circulation, urinary and/or fecal incontinence. Read more about urinary incontinence on our website Dobrobut.com. To prevent bedsores, the position of the patient's body should be changed every two hours if possible. Anti-decubitus mattresses, circles, pillows, pads prevent the development of this pathology, but do not cancel other preventive measures - the patient must be turned over even when using mattresses with low pressure.
Prevention of bedsores consists in regular hygienic measures. The patient's skin should be clean and dry. It is necessary to change underwear for bed linen often. Bedsores occur more often in bedridden patients with urinary and fecal incontinence. Such patients are thoroughly washed, the skin is dried, then a special cream with zinc is applied, which protects the skin from the irritating effect of urine and feces and skin maceration (moist corrosion). The rubbed areas are sprinkled with talcum powder. The patient should also be turned regularly.
How are bedsores treated at home? For this, sea buckthorn and rosehip oil, essential oils with antiseptic and wound-healing effects are used. The use of camphor oil and ointments based on it is effective for stage I bedsores.
How to treat bedsores in bedridden patients
Treatment of bedsores of the first stage consists in eliminating long-term continuous pressure on soft tissues and minimizing the effect of damaging factors. Topical treatment of the ulcer that forms involves thorough toileting of the affected skin. The area of inflammation is treated with an antiseptic solution, dried and ointments are applied to improve healing.
For bedsores of the II stage, to protect the wound from bacterial flora, polyurethane film bandages are applied, which do not prevent the access of oxygen. At this stage, the skin damage has a small area, so it is enough to carry out a toilet with the removal of the epidermis in the places where bubbles are formed. The ulcer is observed until the restoration of the epithelial layer. Antibacterial therapy should be started immediately if any signs of inflammation appear.
The next, III stage is characterized by a necrotic impression of the skin with absorption of subcutaneous fatty tissue. How to treat bedsores in bedridden patients in these cases? The main task of treatment is surgical removal of necrotic masses and cleaning of the ulcer from purulent exudate. It is necessary to prevent the drying of the wound, which is healing. Proper care for her includes washing and applying an aseptic bandage. Irrigation is usually carried out with saline solution under pressure. If necessary, necrotic tissue is removed. Mechanical, surgical and enzymatic cleaning of the wound is carried out.
Treatment of bedsores of the IV stage includes excision of necrotic tissues, removal of secretions, moisturizing of the wound that is healing. In addition to medications used in the treatment of stage III, various physiotherapeutic methods are used: UHF, laser, phonophoresis, electrophoresis with antibiotics.
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