Pressure Ulcers - Causes, Degrees, Places Of Formation, Treatment, Prevention

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Bedsores

Brief description of the disease

Bedsores are damaged areas of the skin that result from compression of tissues during prolonged contact with a hard surface (bed, wheelchair, splint, etc.) Bedsores appear as a result of exsanguination and tissue necrosis at the site of compression of the skin.

Causes of bedsores

As you know, nutrition and oxygenation of the skin occurs due to the presence of blood vessels in it. The smallest of them, called capillaries, penetrate every centimeter of the skin and nourish it. With prolonged squeezing, the vessels are pinched, and blood does not flow. This leads to the fact that certain areas of the skin are exsanguinated, and tissue necrosis occurs.

Another reason for the formation of pressure ulcers is the displacement of the upper layers of the skin. This happens when the patient is pulled on the bed, or a boat or wet underwear is pulled under him. All this can lead to disruption of blood supply, resulting in the formation of bedsores.

Pressure ulcer risk factors

The most susceptible to bedsores are people who are overweight or, conversely, exhaustion, eat poorly and drink little, have a history of diabetes mellitus or heart disease, sweat a lot, have brain and spinal cord injuries, and suffer from urinary and fecal incontinence. Dirty skin, folds and seams on the bed, the presence of crumbs and small objects, and allergies to skin care products are also considered unfavorable factors.

Places of formation of bedsores

Areas of the body above the bony ridges that touch a hard surface are most prone to pressure ulcers. This is due to the almost complete absence of subcutaneous fat in these places, which can reduce the pressure on the tissues.

If a person lies on his back for a long time, then bedsores are formed on the sacrum, ischial tubercles, shoulder blades, back of the head, heels and elbows.

When lying on your side, bedsores form on the thighs in the region of the greater trochanter, on the knees and ankles.

Prolonged position on the stomach leads to the formation of necrosis on the pubis and cheekbones.

The severity of the pressure sores

Depending on the severity of the bedsores, they are divided into six stages:

Stage I - redness of the squeezed skin areas occurs;

Stage II - the skin swells, becomes covered with blisters, necrosis (death) of the upper layer of the skin begins;

Stage III - ulcers appear on the skin;

Stage IV - ulcers grow and penetrate the muscle layer;

Stage V - muscle necrosis and destruction occurs;

Stage VI - the most severe stage, the ulcer reaches the bone, which can be damaged and infected.

Prevention of bedsores

Prevention of pressure sores includes a number of measures aimed at reducing tissue compression and maintaining normal blood circulation in the skin.

For bedridden patients, careful care is essential. To reduce tissue compression, bedridden patients need to purchase a soft and elastic mattress. There is a special anti-bedsore mattress on the market that has a massage effect, improving blood circulation in certain areas of the skin. You can also use a foam mattress if you are unable to purchase a pressure sore mattress. It is necessary to change the position of the patient's body as often as possible, and this must be done carefully enough to avoid friction and displacement of soft tissues. The patient's bed should be level and clean, without crumbs or foreign objects. Under the areas of the body where bedsores usually occur, it is necessary to put rollers or soft foam pads. A special rubber circle can be placed under the sacrum. All these devices (rollers,bed sore mattress) increase the area of the body that is in contact with the surface on which the patient is located. This significantly improves blood circulation in the tissues and reduces the risk of pressure sores.

Prevention of pressure ulcers also includes proper and gentle turning of the patient, with minimal risk of injury and soft tissue friction. If you cannot cope alone, look for yourself an assistant. Do not pull and pull wet clothes and sheets from under the patient; first, you must lift it. All manipulations for skin care and bedding should be carried out with care and gentleness.

To reduce skin irritation, use soft linen (the more washes, the softer the bed) without seams, patches or buttons. For toilet skin, use mild, low-allergenic cosmetics. Clean the genitals and perineum more often, as urine and feces tend to irritate the skin. Provide the optimal temperature regime in the room, cover and dress the patient depending on the temperature, avoiding overheating. Sweat irritates the skin and increases the risk of ulcers.

Proper skin care is one of the ways to prevent pressure sores. Don't let your skin get too wet or dry, keep it clean. Use moisturizers and nourishing creams, dusting powders, drying ointments.

Do not rub the skin when washing or drying the patient, but blot easily. Sponges and washcloths should be soft. For urinary incontinence, use diapers or urine bags (for men).

Treatment of pressure sores

No amount of pressure sore remedy will help completely eliminate the problem until the compression of the tissues is eliminated. The main treatment for pressure ulcers should be aimed at restoring blood circulation in damaged tissues. To do this, use all measures to prevent pressure ulcers.

To reject dead tissue, various means for bedsores are used. Iruksol ointment has a good effect. For faster wound healing, it is necessary to use gauze dressings soaked in petroleum jelly. You can apply special hydrocolloid dressings if you can buy them (they are quite expensive). There are also special healing agents for bedsores, in the form of various ointments. You can use sea buckthorn oil. With the development of a secondary infection, which often happens when pressure sores occur, antibacterial agents must be used.

Decubitus ulcers, which are large and difficult to heal, can only be treated with surgery (tissue grafting).

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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!