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Video: What Are Bedsores And How To Deal With Them
What are bedsores and how to deal with them
Caring for a bedridden patient is a very difficult task. Even small defects on the skin gradually turn into painful bedsores. And the added infection can lead to the death of the patient. Andrei Anikin, head of the department of purulent surgery at Moscow City Clinical Hospital No. 17, told how to properly care for an immobilized patient in order to prevent the formation of bedsores.
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Caring for a bedridden patient is a very difficult task. Even small defects on the skin gradually turn into painful bedsores. And the added infection can lead to the death of the patient. How to properly care for an immobilized patient in order to prevent pressure ulcers from forming on his body - Andrei Anikin, head of the department of purulent surgery at Moscow City Clinical Hospital No. 17, answers the most common questions.
Why does an immobilized patient develop bedsores?
If a person lies for a long time or sits in one motionless position, then the parts of the body that are in contact with the bed, mattress, wheelchair seat are under constant pressure. A healthy person, feeling that his hand is numb from an uncomfortable position, will immediately begin to move. An immobilized patient cannot do this. Inactivity disrupts blood supply, oxygen and nutrients cease to flow to the squeezed area. And tissue death occurs.
When the patient is forced to lie on his back, bedsores are formed in places where the bones are closest to the skin - on the elbows, back of the head, shoulder blades, spine, sacrum, buttocks. If a person is constantly on their side, the shoulders, knees, lower back and cheekbones can suffer from pressure sores. Those who spend most of their time in a wheelchair are vulnerable to their shoulder blades, buttocks, and heels.
With age, blood circulation deteriorates, tissues lose their ability to quickly recover, therefore, in older people, pressure sores form more quickly. In seven out of ten cases, problems due to bedsores occur in the elderly. Pressure ulcers are more likely to appear on the body in emaciated patients, because with weight loss, muscle and adipose tissue, protruding between the bony protrusions and the skin, go away. But the situation can be aggravated by being overweight. Bedsores are more likely to form in diabetics and allergy sufferers who have a reaction to washing powders and cosmetics that are used to treat the patient's skin.
If a person is able to perform at least some minimal movements, use this chance - hang a belt over the bed so that he learns to pull up, buy him a massager for arms and legs. Remember, movement is the best prevention of pressure ulcers.
How not to miss a bedsore?
At first, a red or crimson spot appears on the skin. When pressed with a finger, it does not turn white. And if you do not take any measures, very soon a painful wound will form in this place. Then deep soft tissues are exposed, over time muscles, joints, bones are visible. In the most severe stages, pus appears.
Why does an ordinary cut on the skin heal quickly, but a pressure sore heals slowly?
A bedsore is different from a cut. In a normal wound, if properly cared for, the fresh edges will easily heal. And in the place of the bedsore, tissue death occurred, so healing occurs very slowly.
Are there any effective measures that need to be taken to prevent the patient from developing pressure sores?
If the patient is in bed, the most important thing is to change his position at least every two hours so that the parts of the body that are in contact with the bed do not experience pressure. Turn the patient onto the right side, then the blood supply to the left side of the body will be restored. And vice versa. If it is difficult to do this, it is enough to even change the position a little, literally by a few degrees, placing a support in the form of a blanket or a sheet under your back, only without lint and folds.
If the patient is forced to sit for a long time in one position in a wheelchair, shift his weight. Tilt him to the right, place a pillow for comfort so that he sits on his right leg. Then tilt to the left to change position and not get bedsores on the buttocks and sacrum.
You can massage the area prone to pressure ulcers. Be sure to keep the problem area clean and dry. This is especially true if a person is forced to lie in diapers. If the patient cannot be shower, wipe them off in bed with wet wipes and then dry them. The skin will breathe - blood supply will be restored in it.
When changing bedding or underwear - pajamas, nightgowns, try not to wrinkle them. In weakened people, the skin is flabby, easily displaces, forming folds on itself. In these places, bedsores occur, as from contact with the bed. For the same reason, avoid buttoned and zipped clothing. Bedsores are more likely to form if the patient is wearing or lying on synthetic underwear. Avoid heat in the room - this will prevent sweating.
What to do if bedsores are still formed?
The main rule of care is that a person should not lie or sit on bedsores. If the problem appears on the back or buttocks, and the lying patient cannot be seated - he can only be on his side or back, try to make sure that the bedsore does not come into contact with the bed. It is good to use additional devices. You can buy special circles, bagels, pads for changing the pressure on the body areas at the pharmacy or purchase on the Internet. If this equipment is rubber, be sure to cover it with a cloth to prevent the skin from scorching on contact with the surface.
You can lubricate the bedsore with brilliant green, iodinol (aqueous solution of iodine) and other antiseptics - miramistin, chlorhexidine. Sea buckthorn oil won't help. And it is good to apply baby cream not on the bedsore itself, but on the skin around it so that it is moisturized and does not dry out.
Does a decubitus mattress help?
The mattress is useful and really helps to avoid bedsores. It is a connected air cylinder. They inflate unevenly and create variable pressure at different points. The principle of operation of the mattress - it locally changes the points of contact with the body of the person lying. But do not delude yourself that the mattress will solve all problems. If you do not regularly move the patient and carry out hygiene procedures for him, bedsores will appear anyway.
Do physiotherapy help with bedsores?
Phonophoresis of antiseptic drugs and laser therapy help to speed up the healing process in case of first-degree bedsores. electrophoresis of antibiotic drugs, UHF exposure.
What to do if the bedsore is inflamed and festering?
Here you cannot do without the help of a surgeon. He must prescribe treatment - ointments, injections and powder. It is imperative to change the bandages, monitor the cleanliness of the body and still try so that the person does not lie in a problem area.
In the event of the development of purulent complications with pressure ulcers, the patient must be hospitalized.
With the formation of extensive areas of dead tissue or suppuration of the patient, they operate. Remove non-viable tissue, perform dressings, prescribe antibiotics, anti-inflammatory and restorative treatment. After the inflammation around the pressure sore has subsided, the patient is discharged from the hospital for further care with an outpatient surgical service.
In cases where bedsores are formed in young patients, after the purulent process has been stopped, plastic surgeries are possible, which are performed in some hospitals, including in our hospital. After such operations, a person gets rid of the bedsore itself, and his health improves significantly.
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