Already after 2 chasa being in complete immobility in the "sitting" and "underlying" areas of the body begin problems with blood flow due to compression of smaller vessels. Bedridden patients are in a steady state for much longer, and some - all the time, so they have become resistant disorders pathological.
What it is?
Bedsores - a pathological change in the skin, the subcutaneous tissue, muscle, bone and other tissues of the body, by developing a neurotrophic type disorders whose causes - violation innervation, blood and lymph circulation local area of the body, for prolonged contact with the solid surface.
Causes of
The simplest reason bedsores - a violation of blood circulation, and hence - immobilization of the patient. At the same time, pressure sores are formed at constant heels lying on his back, as well as problems with the buttocks area.
Among other reasons for the formation of pressure ulcers can be identified:
- serious iron deficiency anemia;
- increased dryness of the skin;
- concomitant endocrine diseases: diabetes, goiter etc;
- Increased body temperature is constant or decrease;
- problems with the natural needs and continual incontinence;
- heavy weight of the patient;
- reduced nutritional foods with a small amount of proteins and nutrients;
- wrong care of bed-patients.
These are the main reasons for the formation of pressure ulcers in bedridden patients.
symptoms
Subjective feelings that the patient can tell caregivers to persons while in the consciousness and pain sensitivity stored body parts:
- sensitivity loss (numbness), approximately 2-3 hours at this area of the body;
- tingling of the skin in places of probable development of pressure sores, due to the stagnation of body fluids (blood, lymph) feeding the nerve endings.
Visible signs of incipient bedsores, which are obliged to know the person caring for the sick:
- desquamation of the skin epidermis with the preliminary formation of purulent or without bubbles;
- stagnation of peripheral blood and lymph circulation, initially in the form of venous erythema bluish-red color, with no clear boundaries, with localization in the point of contact of bone, muscular body overhangs and a bed bed, the intensity of staining of the skin, from subtle to saturated.
These are signs of incipient bedsores. It is urgent to take measures to prevent further deterioration of the disease.
stages of pressure sores
Bedsores in bedridden patients photos have 4 stages of development:
- I stage. Sustainable redness may seal swelling is sometimes present, the skin is not broken. This step successfully treated with antibacterial and wound healing preparations.
- Step II. Infestation upper epidermis layer, its integrity is violated, there flaking and erosion. The process extends to the subcutaneous tissue.
- Step III. Deep subcutaneous lesion layer, which is accompanied by irreversible necrosis (dying off) fabric, sometimes with a liquid release from a wound. Difficult to treat.
- Step IV. The excessive damage and necrotic changes in soft tissue (visible in cavities formed tendon and bone tissue), which can lead to severe intoxication and infection blood.
A patient who is awake and who is not disturbed sensitivity of individual areas of the body, even before bedsores may complain of tingling and numbness in the places where the most likely to develop the disease.
The dangerous pressure sores?
Bedsores are pathologies which treatment is best avoided. If this could not be done, then the formation of pockets of skin maceration, the pathogenesis is growing rapidly, with the formation of tissue necrosis and is characterized by long-term treatment of purulent wounds.
The danger is pressure sores. In some cases, pressure sores are the cause:
- lower limb amputations.
- necrotic lesions of the periosteum and bone tissue in the form of osteomyelitis, periostitis.
- depletion of the body's defenses, complicating treatment of the underlying disease.
- extensive excision of soft tissue and the formation of defects in violation of the innervation and blood circulation of lower body parts.
With the development of pressure sores on the type of moist wound infection necrosis occurs, with the development purulent processes (phlegmon, Sepsis, gas gangrene).
With the development of decubitus type dry necrosis develops with long lingering pathogenesis defect healing periods.
How are pressure sores: photo
The photo below shows how to manifest the disease in bedridden patients.
Treatment in early stage bedsores
So, how to treat bedsores 1 degree? In the early development of pressure sores must be carried active prevention of progression of necrotic tissue changes, since at this stage the only sealing and flushing of the skin:
- Health assessment with a view to maximum possible elimination of internal and external risk factors for development and progression of bedsores.
- Treatment of all related syndromes and pathologies contributing bedsores.
- Immunostimulatory therapy - vitamins, immunomodulators and immunostimulants.
- Detoxification of the body - blood transfusion, reopoligljukin, gemodez.
- Reducing the pressure force on the fabric and providing a pressure discontinuity.
- Removal of continuous pressure. It recommended every 2 hours to turn bedridden patients from one position to another.
The event involves the use of special means:
- plastic tire;
- special anti-bedsore bed;
- system with adjustable vibration and pressure;
- pillows, mattresses, pads, following a gel, foam, air, water filling or with a combination of several fillers.
You should also know the simple rules for the care of immobile patients in the home:
- Oily skin can be treated with an alcohol.
- Keep an eye on the condition of the skin - if you retain moisture, use a moisturizer (hypoallergenic moisturizing cream, baby cream is better) for which the patient is not allergic.
- the patient's skin should always be clean, moist and not dry - do air baths. Hygiene, do not use antibacterial soap (it kills and healthy, protective bacteria), use plain soap, natural sponge (or c / b sponge) and clean water. Do not rub the skin, and gently wipe after washing do not dry the skin, and blotted.
- If the skin is too moist, without fanaticism can use powder, talc or ointment podsushivayuschee skin - 1% potassium permanganate solution strength, zinc ointment or solution of brilliant green, but only for the prophylaxis or 1 step further not necessary to use an ointment and a solution containing zinc potassium permanganate.
- If the patient has urinary incontinence - should regularly change diapers or homemade gaskets x / cotton fabrics and produce toilet perineum, men make better use mochepriemnuyu system. At high temperature or when the patient sweats profusely for other reasons, better wipe the perspiration weak solution of vinegar - 1 tbsp. spoonful per 250 ml. water than with soap and water.
- Upon detection of redness - not to massage it, have a massage just around the damaged skin. You can specifically make the mitten of terry towels and massage it to make.
Current local treatment of decubitus scheme includes:
- Powder xeroform helps with bedsores.
- Toilet skin using physiological saline solution or drugs that do not have ion exchange properties - camphor alcohol.
- Drying and skin treatment agents that improve local blood circulation of tissues (Aktovegin, Solcoseryl).
- It is performing well and this procedure as skin wash with cold water. Vasoconstriction and subsequent compensatory expansion leads to improved local blood flow and strengthen the supply of tissues.
- Overlaying the polyurethane film dressings. This modern dressings produced in the form of transparent film with adhesive surface and provides protection bacteria, access of oxygen to the tissues and the evaporation of moisture, and also allows visual inspection of the skin condition. When sticking-plasters such dressings should avoid excessive tension, because the movement of the patient formed small folds that aggravates the condition.
The treating pressure sores in bedridden patients:
- Effectively remove the pus ointment Levosin, Levomekol and analogues. Bookmark based on them can be left in the cavity to a day.
- Ointment on fat basis (Vishnevsky, neomycin, tetracycline, etc.) have a low absorbent and antibacterial activity. These means are allowed when a small amount of pus.
- A solution of boric acid, 10% saline and pochie outdated preparations require replacement every 4 - 6 hours.
Than to treat bed sores in bedridden patients at the stage of the beginning of the healing:
- Anti-inflammatory drugs Levomekol, methyluracyl, Troksevazinovuyu ointment Bepanten and other external agents;
- For protection, mitigation and recovery - oil from the fruit of sea buckthorn, wild rose, the juice of fresh leaves of aloe, kalanchoe extract;
- For active epithelialization of tissues - laser treatment.
For washing wounds use of antiseptics new generation approved:
- yodopiron solution at a concentration of 0.5%;
- dioksidina solution of 1%.
In their absence allowed irrigation hydrogen peroxide Furacilinum, solution of boric acid. Also to absorb the pus used enzyme therapy. In the wound clean introduced proteolytic enzymes (chymotrypsin, trypsin, ribonuclease) or as part of an ointment (Iruksol, Iruksovetin).
Antiacarian mattress is the most effective way to prevent bedsores in the initial stage. Such mattresses are constantly changing pressure on the body at different points, due to the inflating and deflating air every 7 minutes in special chambers of the mattress. Alternate shift eliminates pressure points cause the formation of pressure sores and maintains normal blood circulation in the tissue is squeezed. Mattresses Yacheistova type are used for the treatment and prophylaxis of step 1-2, step 3-4 balloon-type bedsores.
Anti-bedsore mattresses with alternating pressure
Folk remedies
Folk remedies cleaned the wound and promote the formation of new tissue. However, in this case it is necessary to take into account the likelihood of an allergic reaction. Before turning to traditional medicine, consult your doctor.
There are some simple and effective ways to treat ulcers:
- Fir oil helps in the treatment of pressure ulcers.
- Baked onions used in strong suppuration.
- lungwort juice is used for external treatment of bedsores.
- Kalanchoe leaves, cut in half. After that, the leaves attach to the sore spot inside and secure. This procedure is desirable to carry out before bedtime.
- Aloe heals wounds, even in severe cases. Compress soaked in the juice of the plant, you need to hold it for 15 minutes on the affected spot.
- Soda lotion accelerate the healing of ulcers. In a glass of water, add 1 tbsp. soda spoon. Compresses soaked in this solution, it is necessary to apply to the sore spot. Means well dries and disinfects bedsores.
Prevention of pressure ulcers in the home
events listed below will not only prevent the appearance of areas of soft tissue necrosis even in patients with long-term bedridden, but also improve the efficiency of the algorithm processing bedsores home.
- The best option - the use of anti-bedsore mattresses and adjustable beds.
- Rubbing the delicate skin on the buttocks, back, legs and elsewhere, comes to rest on the bed.
- Changing the position of the patient every 2 h.
- Drinking regime - at least 1.5 liters of fluid a day.
- Complete hygiene - sponging the patient with a soft cloth soaked in warm water with a further thoroughly dry, frequent changes of underwear / bed linen, the use of duck / vessel.
- Bedding and underwear only natural, smooth texture (without embroidery, cross seams and embossed patterns). Be sure no folds spread out on sheets and pillowcases.
- Good nutrition with a sufficient amount of protein, if necessary - gavage nutrient mixtures Nutrizone, Optimum etc...
All bedsore prevention is thorough care of bed-patients. It is recommended to ventilate the room like, and the skin of the patient (air bath), because bedsores very "love" moist skin areas. Good nutrition also contributes to the rapid recovery of the body after trauma or disease. And it must be remembered that their development often begins unnoticed. Because prevention is considered a good measure of preventing the formation of bedsores.
