How and how to treat pressure sores?

Treatment of recumbent patients has always been difficult: careful care and monitoring of the patient's condition and health is necessary. This is not only the timely use of drugs, but also daily hygiene, balanced nutrition, compliance with ventilation and gymnastics regimes. Bedsores are a huge problem for heavy patients. They are formed because of the excessive pressure of the bone protrusions on the skin. How to treat bedsores to cure them? Let's try to answer this question in the article.

The concept of bedsores, their varieties and place of education

Bedsores are the process of tissue necrosis,which occurs in typical parts of the body. Damage affects the skin, blood vessels, fatty tissue and other structures. Usually, pressure sores arise in places where the bones protrude. This is due to the fact that in such areas the skin layer is very thin, so any excessive pressure on it is fatal.

Classify bedsores by different signs. Depending on their origin, exogenous ones are released, that is, due to external mechanical action, and endogenous ones - formed due to neurotrophic changes in the skin. The latter are usually formed inside the tissues due to the installation of catheters or drains.

Bedsores are not unique to bedridden patients- they are formed also with frequent external squeezing of the skin, which is observed for other reasons. Of course, more often lesions are formed due to violations of innervation of tissues. Depending on where the patient is most of the time, there are necrotic changes in certain areas:

• sitting in a wheelchair, the weight of the body presses on the buttocks and heels;
• in the supine position on the side, the ankles, thigh, knees are subjected to increased pressure;
• bedsores can occur in the area of ​​the heel, sacrum, sciatic tubercle, scapula, elbow, occiput;
• if a person lies on his stomach, the skin of the cheekbones and pubis suffers.

Accelerates the process of excessive moisture or drynessinteguments. In order not to wonder: "How to treat bedsores?", You should carefully take care of the skin of the patient. If dryness is noticeable - apply a children's moisturizer. With excessive moisture, they fight with powder. Oily skin should be treated with alcohol-containing solutions. It is important to organize hygienic measures in time: rubbing, bathing, frequent change of linen, pajamas, bedding.

Risk factors, complications

Any person undergoing treatment withcompliance with bed rest or the use of a wheelchair, is at risk. There are also other factors that increase the chances of decubitus formation:

• age - the older the patient, the more receptive the skin, and the regeneration of the tissues is much more difficult and longer;
• disorders of sensitivity, innervation of tissues, neurological diseases;
• muscle atrophy and weight loss - the natural barrier between the bone and the skin decreases, resulting in increased pressure on it;
• insufficient water intake, poor nutrition - lack of a balanced diet and a sufficient amount of fluid worsen the skin condition;
• incontinence of stool or urine - is the cause of the spread of bacteria;
• excessive moisture or dry skin;
• diabetes mellitus and vascular disease;
• smoking, drinking alcohol or drugs;
• impaired consciousness and uncontrolled muscle spasms.

If the patient has at least one of thelisted factors, it is worth seriously thinking about the prevention of pressure sores. They appear very quickly, but they are treated long and hard. Having discovered the first signs of squeezing the tissues, one should immediately begin treatment and strengthen preventive measures. How to treat pressure sores? In the initial stages, the main thing is to pay attention to timely hygiene. You can use ointments that promote tissue regeneration. It is necessary to inform the doctor about the process that has begun. Procrastination or improper treatment can lead to such consequences:

• sepsis - a life-threatening condition in which the infection enters the bloodstream and spreads rapidly throughout the body;
• inflammation of the subcutaneous tissue - characterized by severe pain syndrome, hyperemia, edema;
• infection of joints and bones, which threatens their destruction;
• Skin cancer, arising from long-term non-healing chronic wounds.

That is why it is important to understand that pressure sores are a serious problem in the treatment and care of bedridden and seriously ill patients. The method of dealing with them differs depending on the degree of skin damage.

Bedsores I degree

The initial stage of the development of the disease is considered the mostfavorable time for treatment. It is during this period that it is possible to completely restore the skin and avoid necrotic process. Bedsores of the first degree externally appear as reddened areas. If you press a little on the skin, the place of contact turns white. At this stage of development, the lesions are superficial, which allows for effective treatment leading to complete recovery.

If you find reddened areas of the skin is importantKnow what to treat bedsores and what preventive measures to take. First of all, you should pay attention to hygiene: the patient's skin should always be dry and clean. For washing it is better to use loofers made of cotton material. After soaking them in soapy water, gently wipe the patient's skin. Use antibacterial soap is not recommended, it is better to choose the usual or child. After removing the remnants of the soap solution, pat the skin. Do not forget to change bed and underwear in time. In this case, the fabric should not crumple, press. It is necessary to closely monitor the skin condition: dry time to moisturize, grease wipe alcohol-containing substances, too wet to treat with powder. You should periodically organize air baths.

How to treat bedsores in a bedridden patient? At the initial stage, cleansing of the affected skin is carried out with the help of physiological saline or camphor alcohol. On the wetting areas you can apply zinc ointments. They lightly dry the skin and protect it from further damage. Formed bedsores are processed with ointments "Solcoseril", "Actovegin", "Dermazin". You can use the powder "Xeroform". A polyurethane film bandage is applied to the affected area. It is a transparent film with an adhesive surface. Its application provides protection against bacteria, moisture evaporation and oxygen access to tissues. How to treat bedsores in bed patients correctly? It is necessary to adhere to this technique: cleansing, applying the main ointment, applying bandages. Skin condition must be constantly monitored.

In addition to basic treatment and compliancehygiene of the patient, preventive measures are necessary to prevent the development of pressure sores. For this, the position of bedridden patients in bed is changed every two hours. For those sitting in a wheelchair it is necessary to carry out the procedure once an hour. In addition, you can use special anti-decubitus mattresses and pillows, which significantly reduce the body weight pressure on the skin. Nutrition of the patient should be balanced, enriched with vitamins and minerals. Do not interfere with the course of immunotherapy.

Treatment of pressure sores for the first degree with traditional medicine

Treatment of beginning bedsores can notonly pharmacy ointments and solutions, but also folk remedies. It is important to understand that the progression of the disease occurs quickly enough. Therefore, the use of non-traditional methods should be agreed with the doctor, and the results of treatment are strictly controlled. How can you treat pressure sores? At the initial stage, vegetable oils: sea-buckthorn, olive, camphor have proved to be very good. They are applied to the reddened areas of the skin several times a day.

Effective is the Balynin ointment prescription. It is made of natural ingredients and stored long enough. To prepare the following ingredients:

• fir (sold in a church shop) or olive oil - 100 ml;
• beeswax or wax candle - 40 g;
• sugar - a third of a teaspoon.

Take the enameled container and put it in it.Components. Heat on a water bath until completely dissolved, then cool. Store in a glass jar in the refrigerator for up to a year. During cooking, you can add crushed dry flowers of calendula (a tablespoon) into the mixture.

How to properly treat pressure sores in the homeconditions? You should know that the damaged skin in any case can not be massaged. Contact with pressure sores should be minimal. First, the skin is treated with saline or camphor alcohol, after which the main product is gently applied (in case of using traditional medicine - oil). On top, you can impose a sterile bandage.

Bedsores in stage II of development

If the initial symptoms of skin damage in time are notseen or treatment is ineffective, the disease progresses quite rapidly. The next stage is the second stage, which is characterized by the presence of an open wound. Sometimes a bedsore looks like a burst or, on the contrary, an inflated bladder with a clear liquid. At this stage, the risk of infection increases, so treatment is complex. It is made up of antibiotics and healing preparations. Preventive measures and recommendations for care should be observed with special care, otherwise the treatment will be delayed for a long time.

How to treat bedsores in a bed-patient in stage II? The most important item is the disinfection of an open wound. For this, solutions can be used:

• chlorhexidine - provides disinfection, destroys bacteria, fungi and some viruses;
• Colloidal silver - eliminates discomfort and pain, enhances the effect of antibiotic, disinfects;
• furatsilina - promotes the death of pathogenic microorganisms;
• 3% hydrogen peroxide - gently cleans the wound and disinfects the surface;
• physiological - accelerates healing, cleanses of bacteria.

After application of antiseptic agents leave the skin to air and dry a little. Quartz lamps are often used in hospitals for these purposes.

Further actions depend on the nature of the wound. If there is no pus, apply healing ointments, for example, "Metiluratsil" or "Tiotriazolin". To prevent the development of infection can be using such means as "Betadin" and "Iruksol." These drugs break down dead tissue, thereby clearing the wound and promoting its healing.

The better to treat pressure ulcers in a bed-patientat the first sign of infection? It is recommended to use ointments based on antibiotics. For example, "Levomekol", "Levosin", "Argosulfan", "Iruksol". If the infection is significantly developed, the dressing should be carried out by medical staff. Wash the wound with antiseptic solutions, remove surgical scissors dead tissue. After that, apply ointment and bandage.

Folk recipes for treatment of pressure ulcers in stage II

Can bedsores II stage of treatment withhelp with medicinal infusions or vegetable oils? Yes, but an essential condition is the use of specific ointments and preparations. How to treat bedsores at home in this case? You can alternate the use of pharmacy ointments and vegetable oils. At the same time experts in folk medicine say about the high effectiveness of such means:

• Baking soda - a tablespoon is bred in twoglasses of boiling water and moisten with a solution linen towel, which is immediately applied to the affected area (blister). As a result, all pus comes out. Then take a new towel and re-wet in the solution. The procedure is continued until the tissue is clean when removed from the pressure sore.
• Goat fat - mix with onions (finelycut) and table salt in the same proportion. Apply to affected areas for half an hour. At the beginning of the treatment, the wound will be sore, this period needs to be sustained.

Effective at the II stage of bedsores called aprescription: mix Vishnevsky ointment and 1% dioxygen solution in a ratio of 3: 1. Connect the substances in a sterile container. Mix the prepared mixture on the wound and close it with a bandage. After two days, change it. The procedure is recommended for clean wounds, without pus and visible signs of infection.

Rules of dressing and types of dressings

Just to treat bed sores patient is not enoughfor effective treatment. One of the key activities is dressing. This is a mandatory procedure for any degree of tissue damage, and infection can not be avoided without its use. Before applying the bandage, you should know how to treat pressure sores in the home. The initial stage will always be disinfection of the affected skin surface. This can be done with the help of special solutions that are easy to buy in any pharmacy. How to properly treat pressure sores? The following rules should be observed:

• Do not touch the wound with your hands, carry out the procedure with sterile wipes;
• a solution is poured onto the wound or napkin, after which the affected surface is gently dipped until it is completely cleansed;
• In the end of the procedure, wipe the wound with blotting movements with a dry sterile cloth.

It is important not to overdo it withantiseptics. In addition, they should be gently cleaned and disinfected without causing burns and irritation. It is not recommended to use zelenok, a solution of potassium permanganate or iodine.

How to treat bedsores in bed patients aftercleansing the wound? The cream (healing, antibiotic) is applied to a sterile napkin or wound itself, after which it passes to the dressing. The dressing should not be applied too tightly. In addition, it must let in air and at the same time be airtight and dense. Its edges also affect healthy skin. The procedure is performed daily. On the moving parts of the body, the bandage is additionally fixed with a bandage. In other cases, it is attached with a plaster, gluing the edges of the material with healthy skin. There are many modern dressings that can be additionally covered with active substances.

Treatment of pressure sores for stage III

The third stage of development is characterized by extensivetissue necrosis - up to the fascia. The epidermis, dermis and subcutaneous fatty tissue are destroyed. The skin exfoliates. Most often the wound becomes infected, which provokes the formation of pus. In this case, a thorough cleansing of the affected skin is mandatory. At home, it is necessary to treat deep decubitus with antiseptic solutions, achieving maximum tissue clearance. When accumulating dead tissue, it should be surgically removed. To prevent the spread of necrosis is possible only with the help of timely opening of abscesses and purification of the wound from necrotic tissues, which is carried out with the help of necrectomy.

The better to treat pressure ulcers in stage III? The same healing creams and antibiotics are used as in the second degree of lesion. These are Iruksol, Tiotriazolin, Levosin, Levomekol, Algofin, Solkoseril. Help with cleansing the wound from necrotic tissues will help ointments "Trypsin", "Terrylitin", "Collagenazine", "Chymotrypsin".

Good results are given by special dressingsmaterials. For example, "Multi-farm", "Pam-T", "Dalcex-Trypsin". Their surface is impregnated with enzymes and other active substances, contributing to the speedy healing and regeneration of tissues. The dressing is carried out daily. Recovery with proper care comes within 2 weeks.

Treatment of the IV stage of development of pressure sores

The last stage of the formation of pressure soresis characterized by deep tissue necrosis. It is a wound with a dark bottom of dead tissue, through which you can see muscles, tendons or bones. The process quickly spreads to healthy skin. Treatment is appointed by the doctor. A conservative approach may be recommended, which implies the use of the same means as in the treatment of pressure ulcers of grade III. Appoints ointments for tissue repair, removal of necrotic contents and fighting infection. Often dressings are performed in the treatment room or the patient is hospitalized.

How is decubitus treated in a hospital? Used antiseptic solutions (often saline or chlorhexidine). The dead tissue is removed with the help of medical instruments, after which the wound is thoroughly washed. Ointment is prescribed depending on the patient's condition. With extensive infection - antibiotics, in other cases - drugs that stimulate tissue repair and wound healing. If conservative treatment does not work within two weeks, an operation is prescribed. This is the most extreme measure, because there is a high risk of complications and an increase in the area of ​​decubitus. Determine the boundaries of necrosis is difficult enough, so remove only part of the dead tissue. Then the recovery course begins. Physiotherapy and medication are prescribed. Unfortunately, surgical treatment does not always give good results. The risk of recurrence of the disease is high.

Preventive measures

A huge role in the treatment and prevention ofdecubitus is played by their prophylaxis. It is much easier to comply with a number of requirements for caring for a patient than to deal with progressive tissue damage. To treat the skin for the prevention of pressure ulcers should be camphor alcohol, physiological saline or other mild antiseptic agents. This is especially true in cases when the patient has urinary or fecal incontinence. Always keep the skin clean and dry. If necessary, moisturize it with baby cream or, conversely, use a powder (zinc ointment). Several times a day to arrange air baths. Change the position of the body of a lying patient every two hours. At the first signs of development of bedsores begin immediate treatment.

Bedsores very easily appear and quicklydevelop. It is enough to leave the patient in a wet bed once, and the skin will react instantly. To combat this difficult problem, it is necessary to properly treat the integument: in the prevention phase, clean, dry and take care of in time. At the first signs to connect special ointments, strengthening preventive measures.