What causes bed sores. Pressure ulcers in the elderly: signs of manifestation and countermeasures. Treatment of the skin with the appearance of bedsores

Update: October 2018

Pressure sores are a serious complication of many diseases associated with malnutrition of tissues or arising from their external compression with displacement. In medical practice, bedsores are often referred to as ulcers.

This complication is by no means the fate of only bedridden patients; bedsores can form with any external compression, especially often at the sites of bone protrusions.

Bedsores are susceptible to patients suffering from impaired tissue innervation due to pathology or damage to the spinal cord. In such patients, the treatment of bedsores on the heels, on the buttocks becomes relevant, i.e. places receiving the most pressure from body weight.

In bedridden patients, compression of the skin and blood vessels occurs, as a result, stagnant processes and tissue death occur in places of maximum contact of the body with the hard parts of the bed, so bedsores are formed depending on the position of the body:

  • When lying on the stomach - the pubis and cheekbones are affected
  • When positioned on the side - knees, hips, ankles
  • Lying on your back - sacrum, heels, ischial tuberosity, elbows, shoulder blades, back of the head

This process is promoted by overdrying or vice versa, excessive hydration of the skin. Dryness leads to exfoliation of the horny (protective) layer of the skin, and moisture provokes infection of the affected areas, all this is aggravated by a violation of the blood supply to the areas of compression.

Such a complication as bedsores, their prevention and treatment are relevant to this day - the search for the latest means of therapy and prevention of these formations is constantly being conducted. Pressure ulcers form quickly enough, but their treatment is problematic and does not always bring the desired effect.

70% of patients who develop bedsores are elderly:

  • 66% - older people with fractures of the hip (femoral neck)
  • 60% - patients with tetraplegia
  • 33% patients in intensive care units
  • 9% of hospitalized patients
  • 3-25% - people at home (bed patients)

General approach to the treatment of pressure ulcers

Methods and means of treating bedsores vary depending on the degree of the pathological process. A huge place in importance is occupied by the prevention of bedsores, which is actively carried out from the first days of the disease, which contributes to the appearance of this complication.

Treatment is divided into: conservative and surgical. The latter is indicated for severe degrees of bedsores that are difficult to treat and do not heal. All conservative treatment measures are aimed at achieving the following key points:

  • Improvement of trophism (blood supply) of tissues.
  • Cleansing the surface of bedsores from necrotic masses.
  • Healing of the surface of bedsores.

Principles of pressure ulcer therapy:

  • At each stage of pressure sore development, prevention of its progression is carried out.
  • It is unacceptable to use softening ointments, deaf bandages that block oxygen access and moisture evaporation, wet bandages in the initial stages and with dry necrosis - all this leads to the formation of wet necrosis and tissue death.
  • Ointments with antibacterial action are prescribed for the formation of a wet wound with purulent contents, with wet tissue necrosis.
  • General antibacterial therapy is carried out taking into account the sensitivity of the pathogenic flora.

Superficial bedsores - stage 1-2

Treatment of bedsores 1 and 2 degrees

Anti-decubitus cushion with shape memory

So, how to treat bedsores of the 1st degree? At the beginning of the development of bedsores, active prevention of the progression of necrotic changes in tissues should be carried out, since at this stage only thickening and hyperemia of the skin occurs:

This event involves the use of special tools:

  • plastic tires;
  • special anti-decubitus beds;
  • pillows, mattresses, pads, circles with gel, foam, air, water filling or with a combination of several fillers;
  • vibration and pressure controlled systems.

Anti-decubitus mattress is the most effective way to prevent pressure sores. Such mattresses constantly change the pressure on the body at different points, due to the deflating and inflating of air every 7 minutes in special mattress chambers. The alternating change of pressure points eliminates the cause of pressure sores and maintains normal blood circulation in the compressed tissues. Cellular type mattresses are used for the treatment and prevention of stages 1-2 (price 2000-2800 rubles), balloon type 3-4 stages of bedsores (approximate prices 4800-9000 rubles).

You should also know the simple rules when caring for bedridden patients:

  • The patient's skin should always be clean, not wet, and not dry - do air baths. For hygiene, do not use antibacterial soap (it also kills beneficial, protective bacteria), use plain soap, a natural sponge (or cotton washcloth) and clean water. Do not rub the skin, but gently wipe it; after washing, do not wipe the skin, but blot it.
  • Carefully monitor the condition of the skin - if it is too dry, then use moisturizers (moisturizing hypoallergenic creams, preferably a baby cream), to which the patient is not allergic.
  • If the skin is too wet, without fanaticism, you can use powders, talcum powder or ointments that dry the skin - 1% potassium permanganate solution, zinc ointment or brilliant green solution, but only for prevention or at stage 1, in the future you should not use ointments containing zinc and a solution of potassium permanganate.
  • Oily skin can be treated with alcohol-containing products.
  • If redness is found, do not massage it, massage only around the damaged skin. You can specially make a mitten from a terry towel and use it to massage.
  • If the patient has urinary incontinence, you should regularly change diapers or homemade cotton pads and make a perineal toilet, for men it is better to use the urinary system. At a high temperature, or when the patient sweats profusely for other reasons, it is better to wipe the sweat with a weak solution of table vinegar - 1 tbsp. spoon for 250 ml. water than soap and water.

Local treatment of bedsores that form

This event requires a competent approach, since incorrect actions can provoke the further development of necrosis.

Previously, the treatment of bedsores in bedridden patients was mistakenly carried out with ion-exchange drugs such as chlorhexidine, iodinol, etc. However, these drugs change the permeability of cell membranes, kill white blood cells and reduce cellular resistance to bacteria.

The modern scheme of local treatment of bedsores includes:

  • Skin toilet using saline or preparations that do not have ion-exchange properties - camphor alcohol.
  • Drying of the skin and treatment with drugs that improve local blood circulation in tissues (, Solcoseryl).
  • Powder Xeroform helps with bedsores.
  • Applying a polyurethane film bandage. This modern dressing material is produced in the form of a transparent film with an adhesive surface and provides protection against bacteria, oxygen access to the tissues and moisture evaporation, and also provides visual control of the skin condition. When sticking such bandages, excessive tension should be avoided, since when the patient moves, small folds form, which aggravates the condition.
  • A technique such as washing the skin with cold water also shows itself well. The contraction of blood vessels and their subsequent compensatory expansion leads to an improvement in local blood flow and increased tissue nutrition.

How to treat bedsores stage 2?

This stage is a transitional state of the skin, when small superficial lesions are already visualized. At this stage, minimal surgical intervention and measures are carried out that stop tissue necrosis and promote the regeneration of damaged areas:

  • Toilet of the formed wound with removal of the dead epidermis from the blisters. Ideally, it is carried out in a dressing room: cutting the dead epithelium with surgical scissors, washing the wound with saline, hydrogen peroxide.
  • Observation of pressure sores in dynamics with an assessment of the development of the process.
  • Antibacterial therapy in case of progression of bedsores and the onset of an inflammatory reaction.
  • Applying antiseptic dressings to bedsores devoid of epidermis, after consulting with a doctor, which of the dressings is best used to treat this wound surface, taking into account the stage (presence, absence of necrosis), the area of ​​the lesion:

Treatment of bedsores 3 and 4 degrees

At the 3rd stage of the development of the bedsore, necrosis of the dermis and subcutaneous fatty tissue to the fascia occurs. Treatment of pressure sores of the 3rd degree is aimed at surgical cleansing of the wound from necrosis and purulent exudate and further absorption of the wound discharge with protection from drying out.

The peculiarity of the necrotic change in bedsores is the rapid spread of the pathological process to neighboring tissues with poor blood supply. An erroneous tactic in this case is to expect independent rejection of dead tissues and cleansing of the wound. Necrectomy with opening of purulent cavities is recommended before the appearance of capillary bleeding.

After necrectomy, the decubitus ulcer is sanitized with the use of antibiotic therapy, local antiseptics and other drugs. Groups of drugs used in the treatment of pressure ulcers:

Comprehensive treatment allows you to stop the septic condition and achieve cleansing of the ulcer. Local treatment is carried out using the following popular drugs of choice:

Argosulfan cream

the active basis of which is the antibiotic sulfathiazole, which inhibits the growth and further reproduction of pathogenic microorganisms. The auxiliary active substance is silver ions, which enhance the therapeutic effect of sulfatisol and at the same time reduce its sensitizing (allergic) effect. action, as well as inhibit the growth of bacterial flora.

The hydrophilic base of the drug provides an analgesic effect, moisturizing the wound and accelerating its healing. The concentration of the active base of the cream in the wound is at the same therapeutic level for a long time, and the minimum resorption ensures the absence of toxic effects.

Formed bedsores, the treatment of Argosulfan ointment can be carried out in an open way or used with an occlusive dressing. The drug is applied to the entire surface of the cleaned wound with a thickness of 2-3 mm twice or thrice a day. Applies up to 2 months.

Sulfargin ointments (50g 200 rubles) and Dermazin (50g 200 rubles, 250g 530 rubles), Argosulfan (15g 200 rubles 40g 350 rubles) have a similar effect
Ointment Iruksol

The active composition of the ointment contains: collagenase, chloramphenicol and related enzymes. This enzymatic preparation provides cleansing of bedsores, disintegration of anesthetized tissues, which deprives bacteria of a nutrient medium, as well as a bacteriostatic effect. The use of Iruxol on cleaned tissues ensures their speedy granulation.

It is applied to a wound cleaned or moistened with saline twice a day until the wound is completely cleansed and tissues are granulated.

Iruksol ointment, the price is about 1300 rubles. for 30 gr.
Ointment Levosin

The drug is based on the antimicrobial substances levomycetin and sulfadimethoxine, the wound healing component methyluracil and the local anesthetic trimecaine. The ointment has a high hydration activity, thereby providing a rapid therapeutic effect. The use of the ointment leads to the cleansing of the decubitus wound from pus and necrotic masses and the subsequent healing of the wound.

It is applied daily to the cleaned surface, which is loosely filled with ointment and covered with a dressing. Perhaps the introduction into the purulent cavities through a syringe.

Price Levosin for 40 gr. 80 rub.
Levomekol

- in addition to methyluracil, the composition includes chloramphenicol. This drug improves tissue regeneration and has antibacterial properties. It is used for infected bedsores in the purulent-necrotic phase of the wound process.

Levomekol (price 80-100 rubles)
Metronidazole gel 0.75%

Metgil is based on the antimicrobial substance metronidazole. The gel is used with dressings and provides relief from the stench of pressure ulcers and inhibition of microbial growth. For bedsores with abundant discharge, foam dressings with metronidazole are used, for dry bedsores or with a slight discharge, hydrogel dressings with metronidazole are used.

Metrogyl gel price 100-120 rubles.
Hydrogel Intrasite - for cleaning the skin from necrotic tissues

For gentle cleansing of necrotic skin tissues in case of bedsores. The hydrogel is recommended to be used with an external dressing, the frequency of which change and the choice of dressing depend on the condition of the pressure ulcer. It provides soft, fast cleaning of the wound from necrotic tissues, as it adsorbs excess exudate and wound detritus. Intrasite is a pure amorphous hydrogel containing water, propylene glycol and a modified carboxymethylcellulose polymer.

Price: INTRASITE gel 2100 rub. (Great Britain)

At the 4th stage of the formation of a bedsore, deep necrosis occurs with the involvement of muscles, tendons of the articular capsules and bones in the pathological process. Treatment includes excision of the necrosis, absorption of the pressure ulcer, and moistening of the healing ulcer.

With conservative treatment, if the size of a deep pressure ulcer does not decrease by 30% in 14 days, then the degree and severity of the patient's condition should be re-evaluated and the method of treatment should be changed. After stopping the acute phase of the ulcer process, the issue of surgical treatment is decided.

Complete surgical excision of all dead tissues is impossible and impractical (it is rather difficult to accurately determine the border of necrosis). Surgical cleansing of the wound is carried out with the maximum possible preservation of living tissues in the areas of articular bags of the neurovascular bundles.

Drug therapy is similar to that used in the treatment of grade 3 bedsores.

During surgical treatment and to stimulate tissue repair, physiotherapeutic treatment of bedsores is performed:

  • Reducing the microbial contamination of the ulcer - ultrasound, UHF in a thermal dose, phonophoresis of antiseptics.
  • Stimulation of reparative processes - darsonval of healthy tissues surrounding the bedsore (see), low-intensity laser, mud applications, direct current, electroacupuncture.
  • Stimulation of blood supply and microcirculation - massage of healthy tissues bordering on bedsores.

Surgery

Surgical treatment is carried out according to strict indications, since with incorrect and inappropriate intervention, an increase in the area of ​​​​the bedsore is likely. The effectiveness of surgical methods of treatment is evaluated in order to avoid further complications.

Free skin plasty (autodermoplasty), decubitus excision with matching of wound edges, plasty with local tissues are used. Unfortunately, this treatment is not always effective, since the transplanted tissue does not take root well in a place with insufficient blood supply, and a decubitus ulcer is a priori non-sterile.

Early surgical complications are the accumulation of exudate under the skin flap, suture divergence, marginal necrosis of the skin flap, wound necrosis, and bleeding. In the future, a fistula may form, forming a purulent cavity and leading to a recurrence of the bedsore.

Treatment of bedsores at home

Treatment of bedsores in bedridden patients at home is very important and presents certain difficulties. At home, it is difficult to carry out a complete cleaning of a purulent wound and ensure good gas exchange to dry the surface and repair the tissue. The modern industry produces convenient disposable antiseptic self-adhesive dressings made of innovative materials and applicable at different stages of bedsores, infected or not, which must be taken into account when choosing them.

  • Proteox-TM with trypsin and mexidol

Used to treat infected bedsores in the last stages.
Cleans ulcers from purulent masses, necrosis, stimulates the reparation process, relieves inflammation. (price 180 rubles).
  • Multiferm - a complex of enzymes and chitosan (Moscow)

Treatment of bedsores with and without slight exudation, infected and not, 1 and 2 degrees.

Exposure time for 1 dressing (10x10cm) 24-48 hours (price 180 rubles)
  • Biaten AG (Denmark)

Treatment of bedsores with an extensive weeping surface, infected.

The course of treatment is 1-10 dressings, the frequency of changing dressings is once every 1-7 days (as far as soaking). Price 950 rubles.
  • Komfil plus (Denmark)

Treatment of large pressure sores with little or no exudation, uninfected. (price 140 rubles)

Alternative treatment of bedsores

When bedsores have formed, treatment with folk remedies is an auxiliary measure that helps cleanse wounds and form new tissues. It should be remembered that almost all folk methods involve the use of medicinal plants, which can cause an allergic reaction in case of hypersensitivity in a patient, and also depend on the stage of the process, therefore, before using them, you should consult a doctor about the advisability of such treatment. Do not use herbal remedies with a tanning effect - willow bark, green walnut infusion, oak bark, acorn oil, etc.

  • Freshly squeezed juice from the leaves of the lungwort lubricate the area of ​​​​the bedsore several times a day.
  • The leaves of Kalanchoe officinalis, cut in half, fit with a cut to the bedsore and fix with a bandage for the night.
  • Young leaves of black elderberry, scalded with boiling milk, are applied to the surface of the bedsore 2 times a day.
  • Ointment from calendula flowers (1 tbsp of crushed flowers mixed with 50 grams of petroleum jelly) is applied to bedsores 2 times a day.
  • Lotions from fresh chopped potatoes, mixed with honey in a ratio of 1: 1, are applied to places prone to the formation of bedsores.
  • Tea tree oil or several times a day lubricate places with bedsores (stage 1-2).
  • and, mixed with honey in a ratio of 2:2:1, applied to areas with bedsores 2 r / day.
  • A compress of sterile fish oil based on a sterile napkin is left overnight.
  • Sprinkling bedsores with starch.

Complications of bedsores

Bedsores can lead to purulent arthritis, phlegmon, wound myiasis (when adult tumbu flies lay eggs on the wound surface),. When corroding the walls of blood vessels, arrosive bleeding can occur, and with prolonged non-healing bedsores, the risk of skin cancer increases.

The most severe complication of bedsores is sepsis, when the infection from the wound with the blood flow spreads throughout the body, which leads to multiple organ failure and death.

Prevention of bedsores

In the prevention of bedsores, it is worth considering the provoking factors and risk factors for their occurrence:

  • Dirty leather, crumbs and other particles, folds, buttons, rough seams on bedding
  • Incontinence of feces and urine, allergic manifestations in a patient to hygiene products care
  • obesity, diabetes,
  • Poor nutrition, malnutrition, insufficient drinking
  • Smoking, diseases of blood vessels and heart, brain and spinal cord
  • Fecal and urinary incontinence
  • Continuous pressure, moisture, friction
  • Men are more likely to suffer from pressure ulcers
  • Age - over 70 years old
  • Immobility or broken bones
  • Low blood pressure, anemia, cancer, stroke
  • Dry skin, swelling

Prevention of bedsores should be carried out from the first day of the disease, with special perseverance and thoroughness. As practice shows, if a pressure sore has already begun to form, it is rather difficult to prevent its progression, and each subsequent stage of the pressure sore increasingly reduces the chance of a spontaneous resolution of the pathological process.

Prevention includes the following activities:

  • Thorough skin care - cleansing, non-contact drying and disinfection.
  • Regular change of bed linen, even stretching of the sheet without folds.
  • The use of special mattresses (water, pneumatic, vibration), circles and pads.
  • Constant change of position of the patient (after 2 hours).
  • Rational nutrition in compliance with the drinking regimen.
  • Imitation of muscle work - massage, special electric underwear.

bedsores- these are parts of the body of a bedridden patient that appear as a result of bleeding and necrosis of tissues due to prolonged compression or displacement between the skeleton and the bed.

Potential bedsores are all over bony protrusions on the body that are compressed when lying or sitting. In these places, the subcutaneous fat is the least pronounced, the pressure of the bone protrusions is most pronounced.

If the patient lies on his back - these places are the sacrum, heels, ischial tubercles, elbows, shoulder blades, occiput. If on the side - on the side of the thigh (greater trochanter area), on the sides of the ankles and knees. If the patient lies on his stomach - the pubic area and cheekbones.

Causes of bedsores

In a sitting or lying person, compression of blood vessels and tissues occurs, as a result of which blood flow to the tissues is disturbed. If this continues long enough, there is a malnutrition of the tissues, and then their necrosis - a bedsore is formed.

The second cause of a bedsore occurs when the surface layers of tissues are displaced relative to the deep layers, for example, when the patient is pulled along the bed, linen is taken out from under him or a vessel is pushed under him.

Small blood vessels rupture and the blood supply is interrupted. In addition, factors such as:

  • dirty skin;
  • overweight or wasting;
  • incontinence of urine and feces;
  • small items in bed;
  • reduced nutrition and lack of drinking;
  • diabetes;
  • sweating;
  • diseases of the brain and spinal cord;
  • smoking;
  • cardiovascular diseases;
  • allergic reaction to skin care products.

Places of bedsore formation

In the “on the back” position, bedsores develop:

  • in the back of the head,
  • shoulder blades
  • on the elbows
  • sacrum,
  • ischial tuberosities,
  • heels.

In the side position:

  • in the region of the auricle,
  • shoulder,
  • elbow joints,
  • femoral
  • knee joints,
  • at the ankle.

In the sitting position:

  • in the area of ​​the shoulder blades
  • sacrum,
  • heels,
  • toes.

Stages of bedsores

There are 4 stages of bedsores, each of which develops in connection with the dynamic progress of the previous stage of the disease. All 4 stages of skin cell death can be treated. Depending on the degree of damage, appropriate measures for medical or surgical treatment are prescribed.

Important: it is best when a nurse takes care of such sick people. Their actions are based on the special knowledge that the table of stages of bedsores has collected. It describes possible methods of influence depending on the situation and the patient's condition.

1 stage bedsores

The initial stage of bedsores is accompanied by symptoms that are not always visible visually. Depending on the color of the skin, reddening of the epidermis can be seen, which does not change in color when pressed.

Most often, the affected area has a red-purple hue. With tactile contact, it can be noted that this area is hotter or cooler compared to the rest of the body surface. If the patient is able to speak, he may complain of tingling or numbness in these parts.

No other damage is noted, so it is very important that the initial stage is detected in time. Thus, it is possible to completely heal flaws without residue.

The main treatment is to change body position regularly, if possible. Every two hours, special inflatable pillows should be placed so that there is room for air circulation. In addition, it is necessary to carry out hygiene procedures using disinfectants.

You can rinse with chlorhexidine so as not to additionally dry out the skin. After that, it is necessary to apply restorative ointments that will help activate blood circulation. For this purpose, drugs Levomekol or Solcoseryl are suitable.

2nd stage bedsores

In the second stage of bedsores, visible damage to the epidermis is noted. The integrity of the cover is broken, delamination may begin. Initially, single wounds or blisters may appear. This indicates that the process of death has begun, which affects the subcutaneous tissue. The surface swells. At this stage, recovery is possible, but it will be much longer and more difficult than in the previous degree.

In the treatment of deeper damage, special wipes with sterile powder will be required. You can wash the wounds with saline or chlorophyllipt solution. Do not use iodine and brilliant green to cauterize ulcers. It is necessary to apply ointments prescribed by the attending physician. As additional measures, applications with enzymes are applied. They accelerate the process of wound healing and skin regeneration.

3rd stage bedsores

Damage begins to reach adipose tissue. The surface is completely affected, and the skin is missing. The ulcer resembles a crater, and its bottom is filled with dead tissue of a yellow-brown hue. The main danger during this period is that healthy areas of the skin can also be damaged.

Under the treatment of the third degree of damage, surgical intervention is meant. During the operation, dead tissue is opened. They are cleaned and disinfected. Next, drugs are prescribed that help activate the regenerative functions of the epidermis, dressings are applied, which should be changed regularly.

4 stage bedsores

At this stage in the development of bedsores, all soft tissues die off. Bones and tendons are visible. Such manifestations are not treated with medication. The surgeon performs an operation during which dead tissue remains are removed, and all surviving layers are sanitized. Then artificial skin or a whole healthy cover can be transplanted.

Prevention of bedsores

Pressure ulcer prevention is needed in patients who use a wheelchair, who are recumbent, who suffer from partial immobility, urinary and / or fecal incontinence, malnourished or obese, suffering from diabetes mellitus or after a stroke. The main principles for the prevention of bedsores are:

  • reduction of pressure, shear or friction;
  • reduction of skin irritants;
  • decrease in skin moisture;
  • personal hygiene;
  • complete nutrition;
  • correct delivery of urine and feces.

To reduce compression, a soft, elastic mattress is needed, for example, made of foam rubber with a thickness of at least 15 cm. There are special mattresses for bedsores on sale, but it should be remembered that with insufficient attention to other preventive measures, the patient may still experience bedsores.

It is necessary to examine the patient's skin every day in places where the bones protrude, since it is there that bedsores most often appear. It is necessary to change the position of the patient's body more often - at least every 2-3 hours, including at night.

Rollers or soft pillows should be placed under the bony protrusions, which increase the area of ​​contact between the patient's body and the surface of the bed. This reduces the pressure on the soft tissues of the body, improves blood circulation and reduces the risk of pressure sores.

Important: it should be remembered that the patient must first be lifted, and only then should he be moved or something should be placed under him. Do not leave the patient in an uncomfortable position.

For the prevention of bedsores, the patient's diet should contain at least 20% protein, contain enough trace elements, zinc, iron and vitamin C. The diet should include fruits, greens, vegetables, dairy products. Fish, chicken broth, cereals, and dairy products should be used to meet the patient's protein needs. Drinking - at least 1.5 liters, if there are no medical restrictions.

To reduce skin irritation, underwear should be soft, without coarse seams, patches and buttons. The bed should be straightened regularly so that there are no wrinkles on it. For skin care, it is necessary to use proven, non-allergic products. In addition, perineal hygiene should be performed more frequently, as urine and feces are strong irritants.

It is necessary to ensure that the patient is covered with a blanket and dressed in accordance with the temperature of the room, as sweating increases with overheating.

The rules for skin care to prevent the occurrence of bedsores are quite simple:

  • skin must not be contaminated
  • excessive moisture or dryness,
  • use plain water
  • soap,
  • cotton washcloth,
  • natural sponges,
  • moisturizing and nourishing creams,
  • drying ointments and powders.

Wet skin should be dried, dry skin should be moisturized. Do not use antibacterial soap, as along with harmful microorganisms, it destroys beneficial ones, which reduces the skin's resistance to infections.

In addition, it is necessary to do air baths for the skin. For urinary incontinence, it is better to use diapers or pads, although for some patients it is enough to give a vessel more often. For urinary incontinence in men, a urinal can be used.

Treatment of bedsores

The treatment of bedsores is based on three principles: it is necessary to restore blood circulation at the site of injury as much as possible, it is necessary to promote the rejection of dead tissues, and it is necessary to help the wound heal.

To restore blood circulation in the tissues, it is necessary to follow the rules of prevention. For rejection of dead tissues, mechanical surgical removal is used or drugs are used that accelerate rejection, for example, Iruksol ointment.

In addition, you can use such a home remedy: dressings with a solution of salt in cognac (150 ml of cognac and 30 g of salt), which should be applied under compress paper and replaced as necessary. Before applying a new bandage, it is necessary to wash the wound.

Various healing agents can be used to heal a wound:

  • sea ​​buckthorn oil,
  • ointment "Actovegin",
  • "Levomikol",
  • "Levosin",
  • "Solcoseryl" and others.

Often, bedsores are complicated by a secondary infection, then antibacterial and antiseptic agents should be used to treat them:

  • 3% hydrogen peroxide solution,
  • boric acid,
  • furacillin solution,
  • white streptocide powder,
  • ointments "Levomikol" and "Levosin".

Hard-to-heal or large bedsores can only be cured surgically - tissue grafting.

In the treatment of bedsores, dressings should be used. To secure them, use a bandage or plaster. You need to use a paper-based patch, as the skin under it breathes, and the glue fixes the bandage well. When applying the patch, the formation of skin folds should be avoided.

Folk remedies for the treatment of bedsores at home

It must be remembered that when using folk remedies for the treatment of bedsores at home, you should consult with your doctor.

Boil 100 g of vegetable oil and add a piece of beeswax there. Stir and cool - you will get a mass similar to vaseline. Bedsores, ulcers or wounds should be lubricated with this ointment.
To prevent bedsores, mix water with vodka or alcohol, add a few drops of shampoo or shower gel and wipe the body. Finish wiping with a dry cloth.
Bedsores well treats Kalanchoe. Cut the leaves of Kalanchoe and the side where the juice flows, attach as a sticker and secure. The wound will heal overnight.
Simmer 2 finely chopped onions and 2 tablespoons of vegetable oil in an enameled pan over low heat for about 20 minutes. When the onion turns golden, remove it with a slotted spoon. Melt 1/4 of the church candle in the remaining oil. Place the resulting mixture in a jar and store in the refrigerator. Lubricate bedsores twice a day until they disappear.
Place the patient on a mattress stuffed with straw. Straw is better to take oatmeal or any other, except barley. Through such a mattress, the skin breathes and is ventilated. Buy 15 kg of millet, put it in a pillowcase and sew it up. Place this pillowcase under the patient. There will be no bedsores. And if bedsores have already appeared, treat them with a strong solution of potassium permanganate (dark pink).
A folk remedy for bedsores and other skin diseases is calendula ointment. It is necessary to grind a tablespoon of dried calendula flowers in a coffee grinder and mix with 50 g of petroleum jelly. The mixture is applied to the sore spot 1-2 times a day until complete recovery.
Ointment for bedsores and fistulas: mix equal amounts of olive oil and vodka. Rub this mixture on the affected area 2-3 times a day.

Bedsores with hip fracture

A hip fracture is the most common injury in women who have entered menopause. Pathology occurs due to any blow (fall). With a pathology such as osteoporosis, fractures occur very often.

After a fracture, patients experience minor but constant pain in the groin. It makes them uncomfortable, they become irritable. The treatment of such people is complicated by the lack of psychological contact with them.

As a rule, at the beginning of the disease, patients experience urinary and fecal incontinence. To solve the problem, they need adequate care and treatment, some help. After a short period, the problem disappears (subject to the normal functioning of the bladder and defecation).

But the biggest threat is bedsores. The main areas of inflammation are the sacrum and heel of the broken leg. Such patients require preventive measures.

The most effective prevention algorithm for bedridden patients is a constant change of position. But turning to the healthy side causes unbearable pain in the region of the hip fracture. Often because of this, it is difficult to perform the movements of the patient to the desired position.

In the area of ​​the sacrum, it is necessary to carefully examine and process the skin, to make a frequent change of linen. At the first signs of tissue necrosis, use drying ointments, powders, and carry out appropriate treatment.

Important: Patients with a hip fracture are seriously ill, and professional medical care plays a huge role in the prevention of tissue necrosis in such bedridden patients.

Skin ulcerations can be caused by pollution, urine, feces, and high humidity. Skin care should be soft, non-aggressive. Wet skin should be gently dried, and if it is dry, then moisturize.

If it was not possible to avoid inflammation, then the wound must be cleaned to restore blood circulation. Necrosis can be removed surgically or a special ointment can be used.

Painkillers are used to turn patients with a hip fracture. They are used in the form of injections, tablets, or in combination. Massage is used as a preventive measure.

Light stroking massage movements eliminate blood stasis in a broken leg, improve tissue trophism, and reduce the risk of inflammation. Care and treatment of patients with a fracture should begin from the first days.

Questions and answers on the topic "Decubituses"

Question:Hello, my father is lying with a fracture of the femoral neck, the leg is fixed and there is no possibility to roll over or change position, how to prevent bedsores, how to treat the skin and in general what measures to take?

Question:Can pressure ulcers be prevented?

Answer: There are special anti-decubitus mattresses with a special coating and an air compressor that partially solve the problem of static and restore blood circulation. However, skin examination and timely action are still necessary.

Question:Hello. A relative of mine developed a bedsore on the lower part of the buttock. I did applications with Solcoseryl gel. Now the dense central part has opened, there is a serous discharge with inclusions. I washed it with hydrogen peroxide and applied the gel. Please tell us how to treat such bedsores with drugs sold in pharmacies? Do I need ointment "levomikol" in such cases? What is better to dry or vice versa to keep the environment moist? And most importantly: is it possible to wash in the shower? The patient does not walk well, but is mobile.

Answer: Hello. Need to wash. Then dry, then lubricate (you can use the same levomekol). Humid environment is not needed. If possible - air baths (within reason, that is, so that your relative does not freeze). To prevent bedsores in other places, the patient should roll over more often, i.e. do not lie in one position. Massage helps a lot (only with intact skin in the area being massaged).

Question:My mother (78 years old) developed a decubitus on her heel after three weeks of resuscitation with a massive heart attack. Now she is moving around the apartment. But 7 months have already passed since the formation of the bedsore. I treat with ointments - argosulfan, levomikol, treat with a solution of chlorhexadine, make wet compresses with malavit and ointment. The healing process is very slow. The bed sore is very deep. Recommend something more efficient.

Answer: Hello. In general, there is no more effective than time and the drugs you use. But I think that since it takes so long for a pressure sore to heal, there may already be chronic osteomyelitis of the calcaneus supporting the existence of this pressure sore. In this case, as well as if the wound is simply large and does not heal because of this, surgical treatment may be required. I advise you to see a surgeon.

Question:Hello. My husband (age 43) had a fracture of the femoral neck, while he was in the hospital, he developed a bedsore on the sacrum. At the moment, I treat at home with chlorhexine, then apply a sterile dressing with argosulfan. I don't know how often to change the bandage. Now the partially formed crust is coming off. Please tell me how to properly treat the wound so that there are no complications, maybe something else needs to be done for a speedy recovery. It is clear that this is a long process, please tell us your forecast. Thank you in advance.

Answer: Dressings should be done once a day, be sure to invite the surgeon of the clinic to which they are assigned - to control wound healing and timely change of drugs or the possibility of using the urgo dressing.

Question:My husband developed a bedsore in the coccyx area (MTS in the pelvis and spine after a melanoma of the back removed 5 years ago). I tried to treat him myself (levomikol, argosulfan), a blood crust formed 2 by 3 cm in size. But, since he lies, fidgets on his back, ichor oozes from under the crust. What to do next? Thank you in advance for your response. Husband is 67 years old.

Hello. "Dry" the bed sore with green paint, fresh air, turn it (or let it turn more actively), re-lay it regularly, purchase (get?) an anti-decubitus mattress. You can apply dry sterile wipes once a day after brilliant green to “protect” the crust.

Question:Hello! Help me please! I take care of my mother-in-law, she has been lying and not getting up for 4 months in the hemodialysis unit. Bedsores do not give rest. I try, I process every day, but without results. I treat the bedsore on the spine with chlorhexidine and apply Ebermin ointment. It's been 2 months with no improvement. Please suggest an effective remedy. I beg you, please help!

Answer: The best option is an anti-decubitus mattress, and a change in body position. You are processing correctly. The main thing in preventing the appearance of bedsores is a frequent change in body position.

Question:Please tell me how to treat epidermophytosis inguinal and bedsores on the buttocks. The husband is paralyzed, kidney cancer 4 tbsp.

Answer: If this is really inguinal erythroderma, treat the skin in this place with a solution of chlorhexidine and apply Triderm cream, later you can switch to Clotrimazole or Nizoral and Candide powder, inflammation sites can be treated with Fucorcin. Concerning decubituses consult internally to the surgeon, all depends on a stage of process.

Question:Hello! Prompt please, than and how to treat decubituses. We have a boy, 19 years old, after an accident, a fracture of the 6th vertebra and a contusion of the spinal cord, the operation was performed only on the third day. She did not give any results, now he is lying, there is no sensitivity below the belt. It took almost six months, bedsores began to appear. We don’t know how to treat, we’ve already tried everything, it seems to help, then again everything is the same. There is a deep bedsore on the sacrum and on the thighs, superficial. They smeared it with levomekol, panthenol, now we smear it on the thighs with solcoseryl, and on the sacrum with agrosulfan.

Answer: Hello. 1. Anti-decubitus mattress. 2. Periodic turning over (this is no longer needed for treatment, but for the prevention of bedsores, when they are not there yet, but in your case it will not hurt either). Ideally (in all textbooks they write) - coups from side to side every two hours, but this is not feasible and probably so much is not needed if you have a mattress. 3. Bedsores should be "dry" around the edges, with green paint, for example. If "inside" fester - then levomekol, if it almost does not "fester" or even slowly "overgrows" - you can use panthenol and solcoseryl. Close the bed sore with just clean napkins after it has been treated. The most important thing: you don’t have to “lie” on a bedsore, it needs to be “dryed” and “ventilated”. Time will do the rest.

Reading 6 min. Views 7.8k. Published on 05.04.2018

Bedsores are a common problem associated with tissue necrosis as a result of prolonged squeezing of certain parts of the body. They occur in people who, due to illness, are limited in movement.

If not properly cared for, bedsores can penetrate deeply into soft tissue, resulting in deep wounds. Most often, this problem occurs in older people, since blood circulation at this age worsens, so it is more difficult for tissues to recover.

Causes of bedsores

The main factor is the pressure of a hard surface on the protruding parts of the body. The most commonly affected areas are:

  • sacrum;
  • thoracic;
  • shoulder blades;
  • back of the head.

The vulnerability of these areas is due to the fact that there is a weak layer of muscle and adipose tissue between the bone and the skin.

Note! When positioned on the side, the main part of the mass presses on the region of the femur and ilium. Frequent position on the stomach is dangerous for the chest area. Sedentary patients are prone to the formation of bedsores in the buttocks, sacrum, feet, heels, shoulder blades and fingers.

Another cause of bedsores is friction and sliding. It occurs when the skin interacts with the sheet, when the patient changes position himself, or he is turned over or transplanted.

The main risk group for the occurrence of the disease includes people whose limited movement is associated with:

  • operations;
  • diseases and injuries requiring bed rest, or being in a wheelchair;
  • paralysis;
  • coma.

Other factors include:

  • sensory impairment associated with neurological diseases. In this case, the patient does not feel discomfort and squeezing of soft tissues;
  • elderly age. The older the person, the thinner the skin becomes, we lose elasticity and the ability to heal quickly;
  • poor nutrition and insufficient fluid intake;
  • muscle atrophy and low weight. Adipose tissue, together with muscles, creates a layer that normally protects bone protrusions and skin;
  • increased moisture on the skin, or its dryness;
  • urinary or fecal incontinence. In patients with this problem, the skin is often wet, which creates a breeding ground for bacteria;
  • muscle spasms. They lead to involuntary movements, the skin suffers from rubbing against the bed or clothes;
  • bad habits. Smoking leads to narrowing of the blood vessels, hence the lack of oxygen.

All this leads to delayed wound healing processes.

Stages and photos of bedsores in bedridden patients

There are four stages in the development of bedsores.

Stage 1 - initial

It is formed as a result of circulatory disorders in the skin. There are no significant external signs, since cell death has not yet occurred.

First, the affected area turns pale, then redness appears, which develops into a bluish or bluish edema.

2 stage

It is characterized by the formation of the first signs of cell death. The process takes place on the surface of the skin, without affecting the muscle tissue.

At this stage, the appearance of bubbles with liquid and peeling is possible.

3 stage

The development of necrosis descends to the depth of the dermis and touches the subcutaneous fatty tissue.

In areas of thinned skin, deeper bubbles continue to form. With improper treatment, infection and the formation of purulent foci are possible.

4 stage

The most difficult and neglected stage. All layers of tissue are affected, down to the bones. At this stage, the bedsore looks like a deep wound through which you can see the tendons and bone tissue.

In case of infection, bones and joints can be affected.

Complications of bedsores

Improper care and untimely treatment of bedsores in patients can lead to serious consequences.

Such as:

  • circulatory disorders;
  • the formation of gangrene;
  • sepsis;
  • cancerous diseases;

Note! Of course, such cases are extremely rare. But it must be remembered that there is still a risk, therefore, maximum efforts should be made in order to overcome bedsores in the early stages of development.

Treatment of bedsores

Treatment is prescribed depending on the degree of damage to the body. Treatment of bedsores 1 and 2 stages can be done at home. More complex cases with deep and purulent lesions require surgical intervention.

At the 1st stage of bedsores it is necessary:

  • every couple of hours, cleanse with camphor alcohol;
  • treat the skin several times a day with sea buckthorn oil;
  • keep the affected area clean and dry

It is important not to massage sore spots, even when processing it is not recommended to use any force. The skin in such places is very thin and easily injured, which can lead to infections.

2 stage. At this stage, alcohol and oil alone will not help. It is necessary to add special drugs.

  • treat the wound with chlorhexidine several times a day, it has an antiseptic effect;
  • after treatment, immediately apply a special ointment;
  • apply hydrogel dressings to sore spots;
  • use special applications that promote rapid healing of wounds. Hydrogel dressings and applications are expensive products, but their use significantly speeds up the healing process.

3 and 4 stage. In these stages, as a rule, there are significant wounds that require surgical intervention.

Thus is carried out:

  • cleansing the wound and body area;
  • applying dressings with a healing effect;
  • if there is a large amount of pus in the wound, a special type of bandage is used, such as Biaten. After the wound has dried, special medications can be applied to it.

Treatment at home

It should be remembered that it is necessary to treat bedsores at home with extreme caution. At stages 1 and 2, wound treatment with Kalanchoe is allowed. The sheet is cut and tied to the wound. The juice of this plant removes harmful fluids from the wound, dries it and accelerates the healing process. Agave juice will also be a good helper. Compresses from it are applied to bedsores for 20-25 minutes.

Note! potato starch is also used as a prophylaxis. It removes excess moisture from the surface. Experts recommend treating the affected areas with sea buckthorn oil, since among all the listed drugs it has the best effect.

Prevention measures

When caring for bedridden patients, checking the condition of the skin is a mandatory procedure.

Particular attention should be paid to places that are prone to the formation of bedsores:

  • to prevent the formation of wounds, it is necessary to change the position of the patient every 2-3 hours, and it is important to do this with extreme caution in order to avoid unnecessary friction and stretching of the skin;
  • choose bed linen and clothes from natural fabrics, it is desirable that there are no buttons and other elements on it that can create a risk of skin damage;
  • maintaining the optimal temperature in the room with the patient. It should not be low, and not high;
  • the bed should be clean and dry. If necessary, use diapers or diapers.

Important to remember: that it is easier to prevent the disease than to deal with its complications later. Therefore, when caring for bedridden patients, it is necessary to pay attention to creating comfortable conditions for their life, to follow the rules of hygiene, so as not to suffer from complications later.

A terrible complication that bedridden patients suffer from is the formation of skin necrosis in places of prolonged compression. Such necrotic wounds are called and significantly worsen the patient's condition. Depending on the nature of the disease, bedsores are accompanied by general intoxication, severe pain syndrome, deterioration of the general condition.

Classification of necrotic changes

The influence of local necrotic changes on the general condition of the organism depends on the type and.

Depth of damage

  • Stage 1 - the formation of a site of hyperemia on the skin;
  • Stage 2 - erosions affecting the upper layer of the epidermis join hyperemia;
  • Stage 3 - necrotic lesion passes to the subcutaneous fat;
  • Stage 4 - the process affects the muscle tissue and underlying bones.

The temperature during bedsores rises by , the initial degrees of damage proceed without serious changes on the part of the body as a whole.

According to the nature of development

There are two types of necrosis: dry and wet.

Dry bedsores are characterized by a sluggish course without pronounced signs of intoxication from the body. Wound with scanty exudate or without it, the affected area is mummified. The healing process is slow.

Wet necrosis is characterized by the rapid progression of the disease and the presence of a wound with profuse discharge. The underlying layers and surrounding tissues are intensively involved in the process. There is a pronounced reaction from the body: signs of intoxication and inflammation, pain and hyperthermia.

Causes of hyperthermia

The main feature of weeping necrosis is the infection of the wound with pathogens. In this regard, putrefactive processes develop in the wound, which affect the state of the whole organism as a whole. Their toxins, getting into the blood, cause an increase in the activity of the hypothalamus and the temperature curve creeps up.

Erysipelatous inflammation in bedsores

The process develops rapidly, in the area of ​​the bedsore is accompanied by the growth of pathogenic flora. Patients report severe weakness, headache. With such a course of the disease, the temperature from bedsores rises to 39 degrees, the patient's condition deteriorates rapidly, signs of severe intoxication are observed.

Phlegmonous inflammation in bedsores

This process is also accompanied by signs of intoxication and an increase in temperature up to 40 degrees. A complication in the form of phlegmon occurs when the wound is infected with staphylococcus aureus, Escherichia coli and other types of pyogenic microorganisms.

High temperature in this case can cause a severe headache, confusion, disruption of the internal organs.

Septic inflammation in bedsores

An erysipelatous and phlegmonous lesion with bedsores quickly turns into sepsis. Septic inflammation in bedsores is characterized by an increase in body temperature up to 40 degrees, severe intoxication and a severe general condition of the patient. With the development of shock, the temperature drops to 35-36 degrees, depression of cardiac and respiratory activity, and a decrease in blood pressure are noted.

In all these cases, the spread of pathogenic microflora from bedsores leads to a significant increase in body temperature and requires immediate therapy.

Types of hyperthermia

Depending on the effect on the body's immune system, several types of pathological body temperature are distinguished.

With a further increase in temperature, a person dies. Subfebrile temperature with bedsores means that the body resists infection. Body temperature up to 38 degrees is immunostimulating, and it is not necessary to reduce it. If the fever intensifies and reaches 38.5 degrees, urgent action must be taken.

Antipyretic drugs and folk remedies

To reduce blood viscosity and eliminate signs of dehydration, as well as to reduce the concentration of toxins, droppers with saline are prescribed.

Important! In the treatment of pressure sores, antipyretic drugs should be taken only at febrile and high temperatures. You can not use them for the purpose of hyperthermia.

If the temperature from bedsores has risen suddenly, and there is no way to reduce it with medication, you should use:

  • Fresh potatoes, white cabbage, sauerkraut, pickles have antipyretic properties - they are used for compresses on the forehead, calves of the legs.
  • Fresh or dried raspberry tea - brew and drink a little warm. You can use dried apples for the same purpose.
  • Herbal collection: 25 grams of lime blossom, 20 grams of plantain, chamomile, wild rose, coltsfoot 10 grams each - pour 4 teaspoons of dry matter with a glass of boiling water, leave for 10 minutes and drink 3-4 times a day.

An increase in temperature with bedsores from 38.5 degrees and above leads to an increased load on the heart muscle, which can cause a microinfarction. The functioning of the cerebral cortex is disrupted - hence the clouding of consciousness, delusional states.

Dehydration of the body leads to an increase in general intoxication, which affects the state of all organs. Hypertension can exacerbate chronic diseases.

At high temperatures, protein coagulation occurs, convulsions are observed, maybe. Therefore, antipyretics should always be on hand.

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Formation of bedsores on the buttocks, coccyx, etc. is a serious problem for a bedridden patient, whose condition is already weakened. We must remember that the treatment of ulcers is much more difficult than prevention, so you need to apply ointments, change your posture and have an anti-decubitus mattress. If a bedsore has nevertheless arisen, then you need to know how and with what to treat it, avoiding complications and the transition to a difficult stage.


What are bedsores

This is the name given to ulcers on the torso and limbs of a person, indicating serious complications and diseases arising from insufficient blood circulation of tissues, pressure on them and displacement. Contrary to stereotypes, the formation of bedsores occurs not only in patients with bed rest, while the places of anatomical protrusions of the bones are most susceptible to them. They also occur after prolonged external pressure on the skin.


Photo 1. Scheme of bedsores in bedridden patients

The disease is characteristic of people with disturbed innervation when the nerve tissue is not sufficiently supplied with blood. A common cause of this is diseases of the spinal cord. Bed sores can be treated in a variety of ways. What specific treatment to prescribe will depend on the factors that led to the pathology. In the general case, therapy is carried out at home by treating problem areas with ointment, selecting an orthopedic mattress, etc. The most common places with bedsores are the buttocks, coccyx, and heels.

Stages of bedsores

Medicine has invented many means of treating the disease, but it is impossible to single out any universal and effective one today. Many medical institutions dealing with this problem apply their proven methods, which have shown the maximum result.

The main difficulty in choosing how and with what to treat a bedsore lies in the presence of only passive blood supply in areas where tissues are subjected to prolonged compression or immobility. For the optimal selection of the treatment method, the disease was divided into series of stages. Based on the degree of structural changes, bedsores are characterized by:

  1. Light skin lesions
  2. Penetration of the pathological process into the fatty subcutaneous tissue
  3. Damage to muscle structures
  4. Deep ulceration affecting the bones

Pressure ulcer treatment based on stage

The presented classification at the stage includes the entire range of injuries, from the lightest to the most severe. Depending on the degree of damage to a bedridden patient, conservative or surgical therapy is indicated.

In most cases, conservative methods that use ointment, a special mattress, etc. are applicable for the first two stages. Surgical intervention, respectively, is indicated for stages 3 and 4.

By measures of conservative therapy, the process of blood supply is activated, the place with a bedsore is cleared of dead areas, measures are taken to heal wounds. How to treat a bedridden patient is decided by the attending physician.

How to treat bedsores at 1, 2 stages

At an early stage, the disease can be actively stopped by prophylaxis by special treatment of diaper rash, which can also be done at home. Thanks to this work, it is possible to stop the process of cell death, since a bedridden patient suffers only from compaction and redness of the skin.


Photo 2. Treatment with a relief dressing

At the same time, it is necessary that the doctor conduct the necessary diagnostics to identify the causes of an external and internal nature, leading to ulcers in the future.

Bedsores of 1 and 2 degrees in a bedridden patient are treated by eliminating the diseases that caused and aggravate his condition. To do this, carry out:

  • Elimination of intoxication with the help of blood transfusion, gemodez.
  • Activation of the immune system by taking stimulants and vitamin complexes.
  • Prevention of staying in one lying position, when the body with its mass all the time presses on one area.
  • Reducing pressure through the use of devices. Treatment is carried out with special supporting splints, pillows, mattresses.
  • Treatment of bedsores with ointments and other means against blood stasis.

Treatment and anesthesia of deep bedsores of 3-4 degrees

The third stage is characterized by the active death of skin and subcutaneous fat elements. Under such conditions, it is impossible to avoid surgical intervention in order to remove necrotic areas, clean out purulent secretions, etc. If this is not done, then stage 3 will inevitably be aggravated due to the involvement of neighboring areas of partially affected skin that is not capable of self-regeneration.

In order to ensure the elimination of a pressure sore of stage 3, 4, dead tissue is removed until capillary bleeding appears. After that, treatment and cleaning with broad-spectrum antibiotics and antiseptics is indicated. In addition, drugs with a necrolytic effect, drugs with an anti-inflammatory effect, drugs that stimulate tissue structures to recover, and improve lymph microcirculation are used in therapy.

The most severe stage of bedsores in bedridden patients is the fourth. It is characterized deep necrosis when muscles, tendons and bones are affected. There can be no talk of any home treatment at stage 4. For effective therapy, it is necessary to extensively excise the dead area, and then actively absorb the bedsore and moisten the healing wound.

When the acute phase of the disease is overcome, the ulcer is treated physiotherapy, as well as prescribe the necessary antibiotics and antiseptics for periodic treatment.

Treatment of bedsores depending on the location

Most often, due to impaired blood supply, bedsores are formed in patients with bed rest, since the skin surface and blood vessels are compressed in places of strong and constant pressure. Thus, places of frequent formation of ulcers are distinguished.

If the patient constantly lies on his side, then the lesion appears in the area of ​​the thigh, knee joint. In the “on the stomach” position, the pubis and cheekbones are subject to compression. A person lying on his back will suffer from ulceration of the heels, the coccyx of the elbow joints, the back of the head, and the shoulder blades.

Despite a single mechanism of formation, there are some differences in the treatment and prevention in different parts of the body.

How to treat heel bedsores

Treatment of heel ulcers is carried out by gluing Komfilyu bandages in places of damage. The main effect of this is antiseptic, which prevents the process of further infection. If the wound is still contaminated or pus forms in it, then it should be cleaned and disinfected with Troteox or its analogues, including hydrogen peroxide, Chlorhexidine, and ordinary brilliant green.


Photo 3. Heel lesion

What to do with pressure sores on the buttocks

To normalize the skin in the buttocks area, it is necessary to exclude the cause of its degradation. Without this, it is impossible to get rid of gluteal bedsores by applying even the most expensive ointment or powder. Further, an individually prescribed treatment of the patient is carried out, leading to the rejection of dead structures and healing of wounds. The therapy includes three stages:

  • Normalization of blood supply
  • Activation of rejection of necrotic elements
  • Cleaning the pressure sore and taking steps to heal as soon as possible


Photo 4. Deep bedsore on the buttock

The list of medicines that treat bedsores on the buttocks includes preparations with silver, which has a strong disinfecting and analgesic effect. Additional application of cream and ointment with silver leads to an acceleration of wound healing. At the same time, drugs with alcohol are not recommended, as they greatly dry the skin.

Treatment of bedsores on the coccyx

How and how ulcers formed on the coccyx are treated, we will consider below. In this case, tying bandages is effective, for soaking which cognac with salt is suitable. The bandage is covered with compress paper, periodically changed. When changing the dressing, the coccyx must be thoroughly rinsed to remove any salt residue.

Additionally, treatment with sea buckthorn oil, Solcoserine, Levosin is shown. In case of suppuration, actively rinse with antiseptic and antibacterial substances, for example, boric acid, streptocide.

Treatment at home

There are a number of difficulties in the implementation of medical procedures at home. High-quality cleaning of suppuration is difficult, plus it is difficult to create conditions for normal gas exchange leading to recovery. When treating at home, it is necessary to use not only prescribed medicines and folk remedies approved by the doctor, but also aseptic plasters and anti-decubitus mattresses. Let's figure out how to treat bedsores at home.

Medicines

To activate the process of rejection of dead tissues and general healing, it is necessary, according to the appointment of a specialist, to treat the affected areas with special medications, for example, Iruxol. Primary treatment with a special tool allows you to get rid of dead skin and internal tissue.

After cleaning the bedsores of a bedridden patient, they are bandaged with soaking in an analgesic, covering them with a hydrocolloid dressing such as Hydrosorb, Hydrocol. Alternatively, you can make a wound healing compress. If an infection is diagnosed, then treatment with antibacterial substances is mandatory.

Ointment and cream

It is forbidden to use softening ointments and deaf bandages that completely isolate pressure sores from air access. In addition, at an early stage of the disease, both the walking and the lying patient should not be given wet dressings, which can lead to the development of rapidly progressive wet necrosis. If there is pus or a wet necrotic process, then drugs with antibacterial properties are required.

The most popular ointments and creams:

  1. Vishnevsky ointment
  2. Bepanthena
  3. Autenrite

Mattress

In situations where the patient is lying down, a mattress of a special design is very effective. It is called anti-decubitus, its essence lies in the continuous change of pressure formed by its own weight on different zones of the trunk, arms and legs. This is achieved by deflating and inflating the insulated chambers of the mattress using a programmed pump. Mattresses can also be water, vibration and others.


Photo 5. Anti-decubitus mattress

As a result, the pressure application points are constantly changing and there are no conditions for the formation of a bedsore. In addition, blood circulation improves and the tone of the skin surface is maintained.

Surgery

The operation to remove necrotic elements is not always useful, so its purpose must be carefully weighed. With inappropriate surgical intervention, the pressure sore area will only increase, and the patient's condition will become more severe. Therefore, before cutting, an analysis of the possible consequences and effectiveness of surgery is first carried out.

If there is no doubt about the operation, then it is carried out by the method:

  • Free skin grafting
  • Plastic manipulations with local tissue
  • Excision of a bedsore

In some cases, the result is not as expected. The main problems are poor survival of transplanted skin when it is not possible to achieve sufficient blood supply in the operated area.

The consequences of poor-quality surgical treatment will be subcutaneous accumulation of moisture, open sutures, necrosis, bleeding, which in the end often results in a relapse of the underlying disease.

Prevention

If there is already a bedsore, then the importance of what kind of care is provided to the patient is great. This is especially important for bedridden people who are not able to fully serve themselves. The progression of the pathology can be avoided if the patient maintains a normal blood supply to problem areas. To do this, it is important not to allow one position of the body and periodically, every 1.5-2 hours, turn the person over, even despite the inconvenience caused to him.

If this is not done, then the disease will be aggravated by more and more bedsores, and those that already exist will expand in breadth and depth to the bones.

Other important aspects of preventive measures:

  • Insufficient hygiene, which is a common occurrence when lying down
  • Creases, protruding seams of clothes, beds, mattresses
  • Ensuring regular bowel and bladder emptying
  • Local allergies to medicines and hygiene products
  • excessive sweating
  • Unhealthy food, insufficient fluid intake
  • Cigarettes and alcohol
  • Poor mobility in bed
  • anemia
  • Edema
Prevention against bedsores is carried out from the very beginning of the patient's bedside treatment. If ulceration appears, then reversing it will be many times more difficult than methodically implementing preventive measures. This is very important for long term treatment. The formation of a bedsore can slow down the process of the main therapy with which the patient was admitted.

We list effective measures to avoid bedsores:

  • Regular cleaning of the skin, subsequent drying by a non-contact method (without a towel), treatment with an antiseptic.
  • Bed linen should be changed more often for fresh ones, the folds of the bed and clothes should be straightened out.
  • Ideally, buy an anti-decubitus mattress.
  • The patient should change his position from time to time.
  • You need to eat in compliance with the diet and the necessary diet, drink more.
  • It is important to stimulate muscle activity, avoiding complete hypodynamia.

ethnoscience

It is possible to treat bedsores and ulcers with alternative methods at home only additionally, when the main therapy is traditional, prescribed by a doctor. The basis of any folk remedy is a variety of plants, the application of which to areas with lesions often causes an allergic reaction and aggravates the situation.

Apply compresses and herbal ointments is allowed only with the permission of the attending physician and under his supervision. Here are some popular recipes:

  • Treatment of ulceration with lungwort juice
  • Applying cut in half along the sheet of Kalanchoe
  • If the head is damaged, it is recommended to add ethyl alcohol to the shampoo and wash your hair.
  • Fresh potatoes are wound in a meat grinder, mixed with honey 50/50. The resulting mass is applied to the bed sore, covering with a cloth.
  • To speed up drying (if there is such a task), starch is applied.
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