The one who once cared for the bed patient, knows how difficult it is - both physically and mentally. Especially, if a close and dear person acts as a patient. Often people become bedridden due to neurological diseases, stroke, paralysis, fractures. If the disease is long-lasting, it may be accompanied by the appearance of pressure sores. It is not easy to treat them, but it is even more difficult to prevent them from reappearing. Today we will talk about bedsores, how and why they appear, how to deal with them with pharmaceuticals and homemade prescriptions, and most importantly, how to protect themselves from them in the future.
What is bedsores
Pressure ulcers are tissue necrosis due to constant pressure, which is accompanied by impaired blood circulation in the affected areas. Most often, pressure sores appear in the places of contact of the body with the surface of the bed. As a rule, this is a bone area. If a person is lying on his back, bedsores appear in the region of the neck, elbows, shoulder blades, sacrum and heels. If the patient is lying on his stomach, pressure sores are most often formed on the cheekbones, pubis, knees. It is dangerous that the patient often does not feel this tissue necrosis, wounds develop rapidly, which becomes noticeable only after the examination.
Why bedsores occur
Here are some reasons that contribute to the development of pressure sores in bedridden patients.
- The main reason is the one that led to the immobilization. Paralysis most often occurs after brain injuries that are acquired during an accident. In this case, the patient does not feel pain.
- Pressure ulcers occur more often in older people, because their tissues lose their ability to regenerate with age.
- Increased humidity also contributes to the development of bedsores. Especially if the patient cannot control the bowel movement or urination. Also, bedsores develop if the patient is in a wet or hot room, if he sweats, etc.
- The risk of bedsores increases if the patient has a disease associated with impaired normal blood circulation in the tissues.
- Another very good reason for the formation of pressure sores, which in 90% of cases gives rise to the development of tissue necrosis, is inadequate care for bed patients. And the care can be thorough, but unprofessional. A person caring for a patient must not only keep clean, but also be aware of many rules that will help prevent the appearance of pressure sores. We will talk about them later.
- A large or low patient weight also increases the risk of developing pressure sores. With overweight, pressure on the skin increases. Low weight is also a problem, because in this case the bones of the patient bulge, the skin tightens, necrosis develops very rapidly.
- If the skin is prone to dryness - this may be the cause of pressure sores.
- Another risk factor is insufficient protein in the patient's diet. Protein is necessary for the restoration and regeneration of tissues and muscles.
Knowing the main causes of the development of bedsores, you can protect the patient from this disease. But what if the bedsores have already appeared?
How do bedsores develop
The bedsores can be divided into 4 stages. The disease of the first stage is not accompanied by tissue damage. The skin is intact, not damaged. However, in the first stage, you can already see redness, inflammation, swelling and partial loss of sensitivity. Press down on the skin, if the redness does not go away even after the cessation of pressure, then this is the initial stage of the development of bedsores.
The second stage is characterized by superficial violations of the integrity of the skin. That is, there are sores on the skin, blood and blood-like secretions, the skin around the affected area is red, inflamed, and it can flake off. The third stage of the development of bedsores is the defeat of the muscle fibers. Usually at this stage, the wound secretes a lot of blood-like fluid, a depression appears in the affected tissues, the edges of the wound are usually even. The fourth, last stage is the defeat of all tissues - skin, muscles, tendons, down to the bones. Sometimes naked bones are visible in the cavity of a deep wound. 3 and 4 stages of the development of bedsores are usually treated surgically.
How to treat bedsores
Treatment of pressure sores depends on the stage of development of the disease.
- At the first stage of the development of the disease, it is possible to manage with thorough care and implementation of all preventive measures. Usually patients are prescribed drugs that increase blood circulation in the tissues - Solcoseryl, Actovegin.
- Inflamed and reddened skin should be oiled with Xenoform ointment.
- At the second stage of the development of the disease, it is necessary to carefully treat the wound, remove dead skin. You can wash the affected areas with saline or hydrogen peroxide. In no case do not use water from the tap, you can put pathogens into an open wound, which will cause the development of the inflammatory process.
- If the inflammation has already begun (the wound around the edges has become red and painful), anti-bacterial ointments should be used. Among them are Levomekol, Tetracycline ointment, Baneocin, etc. Often a bedsore is a hole in the skin, many do not know how to treat the wound with ointment - around or inside. The ointment should be applied directly to the open tissue, inside the affected area. On the edge of the wound must be treated with antiseptic to prevent the ingress of microbes. As an antiseptic, you can use simple iodine.
- The third stage of the development of bedsores is treated more comprehensively. In this case, you can not self-medicate, be sure to call the doctor for an examination. In this case, it is usually prescribed local and internal anti-inflammatory drugs, agents for improving blood microcirculation, as well as drugs that can restore tissue regeneration.
- The fourth stage of the development of bedsores is treated only in the hospital. Doctors should surgically cut off all necrotic and dead tissue. It is very important that the affected skin does not interfere with the regenerative process. At the fourth stage, physiotherapeutic treatment is actively used - Laser, UHF, Electrophoresis. Various effects on the skin increase blood circulation in the tissues, improve the penetration of drugs into the affected areas, relieve inflammation and stop the progress of pressure sores in the tissues.
- To improve the situation at any stage will help such ointments as Iruksol, Argosulfan, Levosin, Multifar, Boro-plus, Panthenol. Help restore the skin regeneration drug Methyluracil. Dermazin and Vishnevsky ointment helps very well.
- To get rid of excessive dryness of tissues, you can use sea buckthorn and camphor oil.
- In the fight against pressure sores and using folk remedies. You can lubricate the affected area with Kalanchoe juice, lungwort and agave. Effectively make lotion from fir oil. In case of serious purulent processes, baked onions can be applied to the wound. Dry and disinfect the bedsores can be using soda compress. In a glass of warm water you need to dissolve three tablespoons of soda, moisten gauze in solution and apply it to the wound.
These are the basic rules for the treatment of pressure sores at different stages of the development of the disease. Even if you manage to defeat the disease, it can come back again if simple preventative measures are not followed.
Competent and sufficient hygiene, the correct position of the patient, as well as the use of professional mattresses and pillows can not only prevent the appearance of pressure sores, but also cure the first stage of their development.
- Be sure to change the position of the patient every 2-3 hours. So you will reduce the pressure of the body on a certain point, which leads to impaired blood circulation in these tissues. You can reduce the pressure by placing rollers and pillows under some parts of the body.
- Every day, morning and evening, you need to perform hygienic procedures. Wash the patient using antibacterial soap. Wash the patient's skin with great care, it can be damaged and literally flake off. After hygiene procedures, thoroughly dry the patient's skin.
- Use clean bedding, do not allow crumbs and garbage in the bed. Bed linen and clothing of the patient should be made of natural fabrics, without fasteners and buttons. Avoid rough seams and warehouses on the sheet.
- If the skin is too dry in places where the body comes into contact with the bed, use oil or baby cream to moisturize it.
- If the patient has urinary incontinence, the question should be solved by careful toilet of the perineal area.
- Severe sweating can be managed with vinegar. A spoonful of vinegar should be dissolved in a glass of warm water and wipe the skin in places where it sweats more than usual.
- Be sure to buy an anti-decubitus mattress for the patient. It reduces the body's load on certain points, the pressure zones change each time, thus providing a kind of massage and increased blood circulation in the affected tissues.
- Ventilate the room regularly so that fresh air is available.
- In no case do not tight and airtight bandages on the bedsores. The skin and the wound must constantly breathe.
- If a person cannot be rotated due to a spinal injury, you should use rubber pads like a lap for swimming. So the zone of the sacrum will be freed from excessive pressure.
- If there is even the slightest opportunity, you need to try to help the patient move - at least with his hands and feet.
Pressure ulcers are not just an open wound, which manifests itself as a result of a long stay in one position. Pressure ulcers can be dangerous. If they are not treated in time, complications such as sepsis, gangrene, cellulitis, erysipelas can develop. Often, bedridden patients are unable to tell us about their feelings, discomfort and pain. If you find a patient’s bedsores, take action immediately. After all, only an integrated approach in the form of medical treatment, local treatment and adequate hygienic care can give a real result.
Care for a bed patient is the difficulty associated with constantly staying nearby, following all doctor's instructions. Moreover, it is very difficult emotionally to endure such a situation. But if a close person got into trouble, you need to come to the rescue. Only the conditions of residence and recovery of the patient depend on you.