home Consultations To avoid bedsores. Bedsores at stage II of development. Between the toes

To avoid bedsores. Bedsores at stage II of development. Between the toes

in bedridden patients this is a fairly common occurrence. They are formed due to decreased immunity, immobility of the patient and poor (insufficient) care for him. Bedsores are superficial necrosis of the integumentary tissues, which over time spreads to deeper areas (subcutaneous tissue, mucous membranes). Bedsores appear in places exposed to the greatest pressure from the body, in the area of the shoulder blades, sacrum, elbows and gluteal folds.

It is easier to prevent the occurrence of bedsores than to cure them later. Therefore, carefully examine the patient every day, and at the first suspicious symptoms, take decisive action. The occurrence of bedsores begins with blanching, and then redness of the skin, swelling, and peeling of the epidermis. Then blisters appear, followed by skin necrosis. If at this time a sick person catches some kind of infection, it can even lead to blood poisoning.

To prevent bedsores from occurring in a patient, use the following tips:

- if the patient’s physical condition allows, change his position several times a day;

- Shake your sheets and fluff your pillow several times a day. Make sure that the sheets do not bunch up and that wrinkles do not form on them or on the underwear;

- buy a rubber circle, inflate it, put on a pillowcase and periodically place it under the patient’s bottom part the back so that the sacrum is above the opening of the circle;

- if areas of the skin become pale or red, rub them with a dry towel and treat these areas quartz lamp, to improve blood circulation;

- wash suspicious areas daily with cold water and soap, wipe with alcohol and dust with baby powder;

- wipe the patient’s entire body with disinfectant solutions every day.

The following can be used as disinfectant solutions:

- camphor alcohol. Before use, warm the bottle under running hot water;

- composition: dissolve 2 tablespoons of cologne (vinegar or alcohol) in 0.5 liters of warm water.

You need to wipe your body as follows: wet one end of the towel in disinfectant solution, start with the neck, then thoroughly wipe behind the ears, then the back, chest, armpits and lower part. Pay attention Special attention places under the mammary glands, places in the folds of the skin. Dry your skin with a new towel in the same manner.

If the occurrence of bedsores could not be prevented, lubricate the affected area with brilliant green, apply a dry bandage, and cover the top with a sterile napkin soaked in a solution of potassium permanganate. Change the bandage 2-3 times a day. When the wounds are clean, switch to dressings with Vishnevsky ointment or syntomycin emulsion.

If the patient has diaper rash, spread a thin layer of baby cream on it.

Bedsores can also occur if the patient sweats excessively. Prepare herbal infusion: 20g root big burdock, 20g of the whole plant of fumaria vulgare, 20g of hazel leaves, 20g of plantain leaves, 50g of tricolor violet flowers. Mix all the ingredients, brew 50g of the collection in 1 liter of boiling water, let it brew for 15 minutes, strain. Let the patient drink 0.5 cups of tincture in the morning and at night.

It is also necessary to follow a diet and exclude refined carbohydrates, smoked meats, sausage, fried fat, and alcoholic beverages from the patient’s diet. Focus on freshly squeezed vegetable and fruit juices.

The use of a special inflatable rubberized mattress with electric heating and a corrugated surface helps prevent the occurrence of bedsores.

Be attentive to your loved ones, look after them carefully and carefully. Patience and strength to you!

An insidious disease that causes suffering in most cases to bedridden patients is bedsores. This is necrosis or death of soft tissue. The immobility of the patient leads to impaired blood circulation, as well as to nervous trophism. As a result, ulcers form on the body. Prevention of bedsores, started in a timely manner, can protect the patient from the occurrence of necrosis of areas, thereby saving the patient from severe suffering.

Causes

Human tissues and organs are saturated with oxygen through blood vessels called capillaries. They have very elastic walls. Their compression leads to a slowdown in blood flow, and sometimes to a complete cessation. Such processes are observed when the patient is forced to sit or lie down for long periods of time.

Patients whose blood circulation is impaired for more than two hours require bedsore prevention. This avoids tissue ischemia. Ignoring recommended procedures often leads to necrosis.

The situation may worsen Not proper care for the patient. If it is necessary to move the bedpan or change the bed, the patient is often pulled along the bed. There is a displacement of the skin in relation to the tissues located deep inside. Proper and attentive care is an important condition for the prevention of bedsores in bedridden patients to be carried out correctly.

Risk factors

However, not all bedridden patients develop necrosis. It has been noticed that some categories of people are more susceptible to the formation of such defects. Individuals are considered at risk if the following factors are present:

malnutrition, fluid deficiency;
overweight or underweight;
insufficient body hygiene;
uncontrolled bowel movements;
increased sweating (observed at elevated temperatures);
foreign objects in the bed (buttons, crumbs);
the presence of seams and folds on the bed or linen;
smoking;
allergies to hygiene products;
diabetes;
diseases (injuries) of the spinal cord and brain;
cardiovascular diseases.

If these signs are present, the most careful care for seriously ill patients is required. Preventing bedsores will help avoid unpleasant consequences. You should be aware that necrosis most often occurs in those places where bony protrusions exert the greatest pressure on the tissue. And also in areas with a minimal layer of fat.

In patients lying on their backs, the sacrum, back of the head, shoulder blades, buttocks, elbows, and heels are most susceptible to the formation of bedsores. When forced to lie on the side, necrosis forms on the surfaces of the ankles, knees, and in the area of the greater trochanter. Prevention of bedsores in seriously ill patients who are constantly on their stomachs is required in the area of the cheekbones and pubis. In sedentary patients, the buttocks, their closure area, sit bones, and tailbone may suffer.

Preventive measures

All procedures must be started from the first day of illness. Prevention of bedsores must be carried out with the utmost care and perseverance. After all, if tissue necrosis begins to form, it is very difficult to stop the progression of this pathology. So, what is the prevention of bedsores? The algorithm of actions is as follows:

Reducing pressure on tissue

This implies a change in the patient's position. In this case, the above-described tissue displacement should be carefully avoided.

If the patient is in a wheelchair and is able to change body position independently, it is recommended to do this every 15 minutes. If the patient cannot participate in this process, you should help him move every hour. Special wheelchairs can be used. They are equipped with various devices that allow you to apply alternating pressure to areas of the body. This allows you to achieve a change in position and reduce the impact on the most vulnerable areas. A variety of gaskets are effective. These can be devices filled with water, gel, air, foam. They make it possible to correctly place the patient in the chair.

Prevention of bedsores in bedridden patients should begin with changing position every two hours. If the patient has enough own strength, you can place a crossbar above it. By grasping it, a person will be able to perform a kind of “pull-up”. It is recommended to use support devices and special mattresses. They are aimed at protecting the skin from damage, giving the body the necessary position, and reducing pressure on vulnerable areas. If such mattresses are not available, pads can be used. They are placed in the most vulnerable places. It is possible to effectively reduce pressure on the skin by raising the head of the bed. However, you should know that it is allowed to raise it no higher than 30 degrees.

Nutritious food

The diet should consist of fruits, vegetables, fish, chicken bouillon, dairy products, cereals. It is important to consume enough fluid. It is recommended to drink at least 1.5 liters per day. Fatty, fried, spicy, smoked foods should be completely avoided.

Linen and clothing made only from soft fabrics

The sheets should be carefully stretched, avoiding wrinkles. Do not allow crumbs or other small objects to get into the bed. Monitor the cleanliness of linen. It is very important to prevent the patient from overheating. Because it provokes profuse sweating. And this, like urine, is a strong irritant for the skin.

Skin hygiene

This care and prevention of bedsores does not cause any great difficulties. It is only necessary to maintain cleanliness by promptly removing any contamination. It is important to maintain sufficient moisture of the skin to prevent it from drying out. In case of excess moisture, it is recommended to use talc. If you have dry skin, you can apply moisturizing lotions.

Washing is required. To do this, use a mild soap solution and warm water. After the procedure, the skin must be dried. Only after this can special products be applied to the compressed areas - creams or ointments for bedsores.

The surface of the skin should be carefully inspected daily. This will allow timely detection of the development of pathologies.

It is very important to immediately remove the patient's stool. Because they are the ones who expose the skin to severe bacteria and moisture. Therefore, diapers and diapers should be changed quite often.

However, there are cases where even ideal skin care and prevention of bedsores, carried out at a high level, could not protect the patient from the formation of necrosis.

Stages of pathology

So, above we discussed what such phenomena as bedsores are, causes, prevention. Treatment of pathology varies depending on the extent of the process occurring. That is why it is advisable to touch upon the main stages according to which bedsores develop.

Stage 1. Initial degree, which is characterized by the presence of the following symptoms:

The surface of the skin is not damaged.
There is redness. If the patient bright skin. When pressing on such an area, the color does not change.
In dark-skinned patients, redness is not visible. However, when pressed, the epidermis does not turn white. The surface may appear irritated, cyanotic, or purple.
Sometimes such areas are painful and especially sensitive. They may feel warmer or colder to the touch, softer than the rest of the skin.

Stage 2. Now the bedsore is an open wound. The following symptoms characterize degree 2:

The epidermis (top layer of skin) is damaged. Sometimes it may be completely absent.
A red-pink, swollen wound is visually observed. It reminds me of an ulcer.
In some cases, a bedsore is a blister filled with fluid. It may be intact or already burst.

Stage 3. Here we're talking about about a deep wound. The symptoms are as follows:

The bedsore reaches the fatty tissue.
The resulting ulcer looks like a crater.
There may be yellowish dead tissue at the bottom of the wound.
This damage spreads further, affecting layers of healthy skin.

Stage 4. This degree placed in case of extensive tissue necrosis. The signs of stage 4 are as follows:

Bones, tendons, and muscles may be visible in the wound.
The bottom of the ulcer is represented by hard dead tissue, dark in color.
The lesion is widespread far beyond the primary focus.

Treatment of bedsores 1st degree

It was previously noted that this is the initial stage of the development of pathology. What control measures do such pressure ulcers require? Prevention and treatment consist mainly of careful care, according to the algorithm described above.

If the patient begins to develop bedsores, the condition of the skin should be closely monitored. If the latter dries out, hypoallergenic creams are recommended for use. It is best to select "Children's".

At high humidity, drying ointments or solutions are recommended. It is also permissible to use talc or powder. Quite effective for drying the skin are manganese solution (1%), brilliant green, zinc ointment. However, the latter remedy is permissible for use only at stage 1. In the future, the use of ointments containing zinc is strictly prohibited.

Local treatment of bedsores is based on the following steps:

To cleanse the skin, preparations or products that do not have ion-exchange properties are used. One of the most popular medications is “Camphor Alcohol”.
The skin should be dried and treated with drugs that can improve local blood circulation. As a rule, the drugs “Solcoseryl” and “Actovegin” are used.
Applying a polyurethane film dressing. Such dressings are made in the form of an adhesive transparent plaster. They protect the surface of the skin from the penetration of bacteria. At the same time, they do not block the access of oxygen, as well as the evaporation of moisture. The transparent surface makes it possible to control the healing process.
Washing with cold water is effective. This method leads to contraction of blood vessels followed by dilation. The procedure stimulates improvement of local blood flow and increased tissue nutrition.

Treatment of stage 2 pathology

At this stage, superficial skin damage is observed. In this case it is already connected surgery(the very minimum). The doctor recommends measures to stop tissue necrosis and aimed at skin regeneration. The prevention of bedsores has changed somewhat. The algorithm for combating pathology is as follows:

In the dressing room, the dead epithelium is trimmed with surgical scissors. The wound is washed with “Hydrogen Peroxide” or “Saline Solution”. In the future, the dynamics of the process development is monitored.
If the pathology progresses and inflammation appears, the doctor initiates antibacterial therapy.
Applying antiseptic dressings to areas lacking epidermis. Only a doctor can recommend which one is best to use. In his appointment, he will take into account the stage, area of the lesion, absence or presence of necrosis. Transparent dressings “Tegaderm”, “Cosmopor”, “Blisterfilm”, “Gyrofilm” are considered quite effective. No less popular are wafer hydrocolloid ones - “Hydrocoll”, “Duoderm”.

Treatment 3-4 degrees

Treatment of bedsores and their prevention comes down to surgical intervention. This is the only way to clear the wound of necrosis. Expecting dead tissue to be rejected on its own is a wrong tactic. It should be understood that the pathological process spreads very quickly.

Best to produce surgery- necrectomy - before capillary bleeding occurs. After such an intervention, when the bedsores are cleared, prevention and treatment are based on the following groups of drugs:

Medicines with necrolytic action - “Trypsin”, “Collagenazine”, “Deoxyribonuclease”, “Chymotrypsin”, “Terrilitin”.
Preparations that stimulate tissue repair - “Kalanchoe ointment”, “Methyluracil”, “Curiosin”, “Bepanten”, “Vinilin”, “Vulnostimulin”.
Agents that improve blood circulation - Tribenoside, Pyricarbate.
Anti-inflammatory drugs - Algofin, Dexamethasone, Hydrocortisone, Vulnuzan.

Popular creams (ointments)

To prevent bedsores, it is necessary to take a comprehensive approach. Excellent drugs suitable for local treatment are the following:

Cream "Agrosulfan"

Main active substance is an antibiotic. It inhibits reproduction and growth pathogenic microorganisms. The cream provides an analgesic effect, moisturizes the wound and promotes its healing.

On bedsores, the cream can be applied openly or using an occlusive dressing. The medicine covers a wound 2-3 cm thick. The procedure should be repeated 2-3 times a day.

Ointment "Iruksol"

The action of the drug is aimed at cleansing the wound. Thus, the bacteria are deprived of a nutrient medium. In addition, the ointment provides rapid tissue granulation.

The drug should be applied to a wound that has been previously cleaned with saline solution. It is recommended to perform the procedure twice a day.

Levosin ointment

The drug has the highest hydration activity. This promotes rapid therapeutic results. The ointment cleanses the wound, removes pus and necrotic masses.

Apply daily. The damaged surface is filled with the drug. Superimposed on top dressing. Sometimes it is recommended to inject the ointment with a syringe into the purulent cavities.

Treatment at home

It is very difficult to fight this pathology on your own. If the stage is initial, then prevention of bedsores at home is carried out according to the algorithm described above. In more advanced case It is almost impossible to carry out complete cleansing of a purulent wound, to ensure normal conditions for drying, as well as tissue repair.

For such cases, modern pharmacology has produced special antiseptic dressings. When choosing such products, it is very important to take into account the degree of bedsore and the presence (or absence) of infection.

The most common dressings are the following:

"Proteox-TM" with mexidol and trypsin. Used for infected wounds on late stages. The bandage clears necrosis and pus, relieves inflammation, and stimulates tissue repair.
"Multiferm" - chitosan and enzyme complex. Intended for the treatment of stage 1 and stage 2 bedsores. Suitable in the presence or absence of infection in the wound.
"Biaten AG". Used for large wet surfaces with infection. The recommended change of dressings should occur once every 1-7 days.
"Comfil Plus". The drug is intended for large bedsores. However, completely uninfected.

Conclusion

Prevention of bedsores involves careful compliance with all rules for caring for patients. Strict adherence to the prescribed recommendations minimizes the likelihood of pathology occurring. Consequently, there is no need to cure necrosis.

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

Potential places for bedsores to form include any area over bony protrusions on the body that are compressed when lying or sitting. In these places, the subcutaneous fatty tissue is least pronounced, and the pressure of the bony protrusions is most pronounced.

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

Causes of bedsores

At a sedentary or recumbent person Compression of blood vessels and tissues occurs, as a result of which blood flow to the tissues is disrupted. If this continues long enough, tissue nutrition is disrupted, and then their necrosis occurs - a bedsore is formed.

The second cause of bedsores occurs when there is a displacement of the superficial layers of tissue relative to the deep layers, for example, when the patient is pulled along the bed, underwear is taken out from under him, or a bedpan is pushed under him.

Small blood vessels rupture and blood supply is disrupted. In addition, the occurrence of bedsores is influenced by such factors as:

dirty skin;
being overweight or malnourished;
urinary and fecal incontinence;
small objects in bed;
reduced nutrition and lack of fluids;
diabetes;
sweating;
diseases of the brain and spinal cord;
smoking;
cardiovascular diseases;
allergic reaction for skin care products.

Places of formation of bedsores

In the supine position, bedsores develop:

In the side position:

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 of medical or surgical treatment are prescribed.

Important: It is best when such sick people are cared for by a nurse. Their actions are based on special knowledge, which is collected in the table of stages of bedsores. It describes possible methods effects depending on the situation and condition of the patient.

Stage 1 bedsores

The initial stage of bedsores is accompanied by not always visually visible symptoms. Depending on the color of the skin, you may see redness of the epidermis, which does not change color when you press on it.

Most often, the affected area has a red-purple tint. With tactile contact, it can be noted that this zone 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. In this way, it is possible to completely heal blemishes without leaving any residue.

The main treatment is to change body position regularly, if possible. Special inflatable cushions should be placed every two hours to provide space for air circulation. In addition, it is necessary to carry out hygiene procedures using disinfectants.

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

Stage 2 bedsores

At the second stage of bedsores, visible damage epidermis. The integrity of the cover is compromised and peeling may begin. Initially, isolated 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 stage.

When treating more deep damage you will need special wipes with sterile powder. Wounds can be washed with saline or chlorophyllipt solution. You should not use iodine and brilliant green to cauterize ulcers. You need to apply ointments prescribed by your doctor. As additional measures, applications with enzymes are applied. They accelerate the process of wound healing and skin regeneration.

Stage 3 bedsores

The damage begins to reach the fatty 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 may be damaged.

Treatment of third degree lesions means surgical intervention. During surgery, dead tissue is exposed. They are cleaned and disinfected. Next, medications are prescribed that help activate the regenerative functions of the epidermis, and bandages are applied, which should be changed regularly.

Stage 4 bedsores

At this stage of development of pressure ulcers, all soft tissues die. Bones and tendons are visible. Such manifestations cannot be treated with medication. The surgeon performs an operation during which dead tissue remains are removed and all remaining layers are sanitized. Then artificial skin or a whole healthy covering can be transplanted.

Prevention of bedsores

Patients who use a wheelchair, who are bedridden, who suffer from partial immobility, urinary and/or fecal incontinence, who are malnourished or obese, who suffer from diabetes mellitus or after a stroke. The basic principles of pressure ulcer prevention are:

decreased tightness, shear, or friction;
reduction of skin irritants;
decreased skin moisture;
personal hygiene;
good nutrition;
correct excretion 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 if there is insufficient attention to other preventive measures, the patient may still develop bedsores.

It is necessary to examine the patient’s skin every day in places where bones protrude, since this is where bedsores most often appear. The patient's body position should be changed 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 soft fabrics body, blood circulation improves and the risk of bedsores is reduced.

Important: It should be remembered that the patient must first be raised, and only then moved or something placed under him. The patient should not be left in an uncomfortable position.

To prevent bedsores, the patient’s diet must contain at least 20% protein, contain enough microelements, zinc, iron and vitamin C. The diet should include fruits, herbs, 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, unless there are medical restrictions.

To reduce skin irritation, underwear should be soft, without rough seams, patches or buttons. You should straighten your bed regularly to ensure there are no wrinkles. For skin care it is necessary to use proven, non- causing allergies facilities. In addition, you should perform perineal hygiene more often, since 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, since overheating increases sweating.

Skin care rules for preventing the occurrence of bedsores are quite simple:

Wet skin should be dried, dry skin should be moisturized. Do not use antibacterial soap as it may harmful microorganisms it also 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 bedpan more often. For urinary incontinence in men, a urinal bag can be used.

Treatment of bedsores

Treatment of bedsores consists of observing three principles: blood circulation at the site of injury should be restored as much as possible, it is necessary to promote the rejection of dead tissue, and it is necessary to help the wound heal.

To restore blood circulation in tissues, it is necessary to follow the rules of prevention. Used to remove dead tissue mechanical removal surgically or use medications that accelerate rejection, for example, Iruksol ointment.

In addition, you can use the following home remedy: dressings with a salt solution in cognac (150 ml of cognac and 30 g of salt), which should be applied under compress paper and replace as necessary. Before applying a new dressing, 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-area bedsores can only be cured surgically - by tissue transplantation.

When treating bedsores, bandages should be used. To secure them, use a bandage or plaster. It is necessary to use a paper-based patch, since the skin under it breathes, and the glue secures the bandage well. When applying the patch, avoid the formation of skin folds.

Folk remedies for treating bedsores at home

It must be remembered that when using folk remedies to treat bedsores at home, you should consult with your doctor.

Boil 100 g vegetable oil and add a piece there beeswax. 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 are well treated by Kalanchoe. Cut the Kalanchoe leaves and apply the side where the juice flows as a sticker and secure. The wound will heal overnight.

2 heads finely chopped onions and 2 tablespoons of vegetable oil, simmer in an enamel 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. Apply pressure sores twice a day until they disappear.

Place the patient on a mattress filled with straw. It is better to take oat straw or any other straw 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).

Folk remedy for bedsores and others skin diseases- This is calendula ointment. It is necessary to grind a tablespoon of dried calendula flowers in a coffee grinder and mix with 50 g of Vaseline. The mixture is applied to sore spot 1-2 times a day until complete recovery.

Ointment for bedsores and fistulas: mix in equal quantities olive oil and vodka. Wipe the sore spot with this mixture 2-3 times a day.

Bedsores due to hip fracture

A hip fracture is the most common injury in women who have entered menopause. Pathology occurs due to some kind of impact (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 feel uncomfortable and they become irritable. Treatment of such people is complicated by the lack of psychological contact with them.

As a rule, at the onset 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 of time the problem disappears (provided normal functioning Bladder and defecation).

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

Most efficient algorithm prevention for bedridden patients – permanent shift provisions. But turning to the healthy side causes unbearable pain in the area of the femoral neck fracture. This often makes it difficult to move the patient to the desired position.

In the sacrum area, it is necessary to carefully examine and treat the skin, and change linen frequently. 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 preventing tissue necrosis in such bedridden patients.

Skin ulcerations can be caused by dirt, urine, feces, or high humidity. Skin care should be gentle and non-aggressive. Wet skin should be carefully dried, and if it is dry, then moisturized.

If inflammation cannot be avoided, then the wound must be cleaned to restore blood circulation. Necrosis can be removed surgically or using a special ointment.

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

Light stroking massage movements eliminate blood stagnation 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 "Bedsores"

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

Question:Is it possible to prevent the occurrence of bedsores?

Answer: There are special anti-decubitus mattresses with a special coating and an air compressor, which 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 his 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? Is Levomikol ointment necessary in such cases? What is better to dry or, conversely, to maintain a humid environment? And most importantly: is it possible to wash in the shower? The patient walks poorly, but is mobile.

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

Question:My mother (78 years old), after three weeks of intensive care with a massive heart attack, developed a bedsore on her heel. 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 bedsore is very deep. Recommend something more effective.

Answer: Hello. In general, there is nothing more effective than time and the drugs you use. But I think that since the healing of a bedsore takes so long, then there may already be chronic osteomyelitis there calcaneus, maintaining the existence of this bedsore. 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 consult a surgeon.

Question:Hello. My husband (age 43 years old) suffered a fracture of the femoral neck while he was in the hospital and developed a bedsore on his sacrum. At the moment I treat my home with chlorhexine, then apply sterile bandage with argosulfan. I don't know how often the bandage needs to be changed. The partially formed crust is now 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 get well soon. It is clear that this is a long process, please tell me your forecast. Thank you in advance.

Answer: Dressings should be done once a day without fail, you should also invite the surgeon of the clinic to which you are assigned - to monitor wound healing and timely change of medications or the possibility of using an urgo dressing.

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

Hello. “Dry” the bedsore with brilliant green, fresh air, turn (or let him turn more actively), regularly rearrange, acquire (receive?) anti-decubitus mattress. After greening, you can apply dry sterile wipes once a day to “protect” the crust.

Question:Hello! Help me please! I am caring for my mother-in-law, she has been lying in the hemodialysis department for 4 months and has not gotten up. Bedsores give no rest. I try, process it every day, but without results. I treat the bedsore on the spine with chlorhexidine and apply Ebermin ointment. It's been 2 months and no improvement. Please tell me 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 it correctly. The main thing in preventing the occurrence of bedsores is frequent changes in body position.

Question:Please tell me how to treat athlete's foot and bedsores on the buttocks. My husband is paralyzed, stage 4 kidney cancer.

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

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

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 do not yet exist; but in your case it will not hurt either). Ideally (they write in all textbooks) - turn from side to side every two hours, but this is not feasible and probably not so much is necessary if you have a mattress. 3. Bedsores should be “dried” around the edges, with brilliant green, for example. If “inside” it festers, then levomekol, if it hardly “festers” or even slowly “overgrows” - you can use panthenol and solcoseryl. Cover the bedsore with just clean napkins after treating it. The most important thing: you don’t need to “lie” on the bedsore; you need to “dry” and “ventilate” it. Time will do the rest.

Bedsores are ulcers that are signs serious complications many diseases that develop due to impaired blood supply to tissues or due to their compression with subsequent displacement. Pathologies are typical not only for bedridden patients; bedsores can occur with any external pressure on the skin. They form especially often in areas of bony protrusions. Patients suffering from impaired innervation (supply of nerves) of the skin due to diseases of the spinal cord are susceptible to bedsores. In patients, such ulcers often appear on the head, buttocks, and heels.

Stages of bedsores and features of their treatment

In search of effective methods for treating bedsores, doctors have tried many remedies, but so far the optimal way to combat them has not been found. Each medical institution uses its own methods, which it considers to be most effective. The difficulty of treating bedsores lies in the passive blood supply in places of tissue compression during prolonged immobility of a bedridden patient.

Stages of pathology:

Minor skin damage.
Damage to skin and fatty tissue.
Muscle damage.
Deep wounds to the bones.

There are two types of treatment for pressure ulcers – surgical and conservative. The first is used exclusively for severe stages of pathology, which are difficult to treat and do not heal for a long time. Conservative measures are aimed at activating the blood supply to damaged tissues, cleansing wounds of dead mass, healing skin lesions. How to treat bedsores in a bedridden patient is determined by the doctor, depending on the degree of development of the pathology.

Treatment of bedsores 1st and 2nd degree

At the initial stage of development of diaper rash, preventive measures for the progression of tissue cell death should be actively carried out, since at this stage only skin hyperemia occurs and compactions appear. The doctor assesses the patient's condition to identify or exclude external and internal factors risk of ulcer progression. Next, treatment is prescribed for all existing pathologies and associated syndromes that aggravate the situation. The specialist may prescribe:

Detoxification of the body (hemodesis, blood transfusion).
Immunostimulating therapy (vitamins).
Elimination of constant pressure (turning the patient over every 2 hours).
Reducing pressure on tissue with special means– plastic tires, anti-decubitus mattresses, pillows, pads, etc.

How to treat deep bedsores stages 3 and 4

At the third stage, active death of the skin and subcutaneous fat layer occurs. Treatment of bedsores in bedridden patients, as a rule, involves surgical intervention (cleaning the ulcer from pus and necrosis, absorption of the discharged wound with protection from drying out). At stage 3, the pathological process quickly spreads to adjacent areas of the skin, where the blood supply is also impaired. At this time, you cannot remain idle; the skin can no longer regenerate on its own. Removal of dead tissue (necrectomy) must be carried out before capillary bleeding occurs.

Then the doctor cleanses the bedsores using local antiseptics. In the treatment of this kind of ulcers, necrolytic drugs (Collagensin, Chymotrypsin, Trypsin), anti-inflammatory drugs (Alfogin, Vulnuzan, Hydrocortisone), stimulators of tissue repair (Vinilin, Bepanten, Methyluracil), drugs for normalizing lymph microcirculation (Tribenoside, Pyricarbate) are used.

The fourth stage is characterized by deep necrosis with damage to muscle tissue, tendons and bones. Treatment involves excision of dead tissue, absorption of the pressure sore, and hydration of the healing wound. After termination acute phase process of necrosis, the doctor raises the question of surgical treatment. This cleaning of the ulcer is carried out to preserve the maximum amount of living tissue. At the same time, physiotherapeutic treatment of ulcers is carried out, a course of antibiotics and antiseptics is prescribed.

Treatment of the disease depending on location

Bedsores form in bedridden patients due to compression of blood vessels and skin, as a result of which blood supply is disrupted and tissue cells die in the areas maximum pressure on the body. So, when lying on your side, ulcers form on the thigh, ankle, and knee. If the patient lies on his stomach for a long time, wounds appear on the cheekbones and pubis. When lying on your back, wounds can open on the heels, sacrum, elbows, back of the head, tailbone, and shoulder blades. Care for bedsores and their treatment is carried out depending on the location of formation.

How to treat bedsores on the heels

To treat heel ulcers, it is advisable to use special “Comfil” (Denmark) bandages; they are glued to the damaged areas of the skin. The bandage renders antiseptic effect and prevents further infection. If the wound is contaminated or pus forms in it, the ulcer is first cleaned and then disinfected with Proteox or similar means - hydrogen peroxide, tea tree oil, chlorhexidine spray, brilliant green solution.

Bedsores on the buttocks

To cure bedsores and restore blood supply to tissues, it is necessary to stop negative impact damaging force. Until you relieve the affected areas of pressure, no ointments or powders will help. Further, with proper treatment, dead tissue will be rejected, and the wound will gradually heal. Thus, the treatment of ulcers on the buttocks is based on 3 main stages:

Restoring blood circulation in areas of skin damage.
Assisting tissues in the rejection of necrosis.
Cleansing the wound and applying healing agents.

Bedsores on the buttocks are often treated with medications containing silver. Such means have antiseptic properties and reduce painful sensations. Creams and ointments that contain silver help fast healing wound Alcohol-based medications are often not recommended because they can dry out the skin.

On the tailbone

To treat wounds formed on the tailbone, use bandages soaked in a solution of cognac and salt (in a ratio of 30 g of salt per 150 g of cognac). It is better to apply bandages under compress paper, changing it as necessary. Before changing the dressing to a new one, be sure to wash off the salt from the bedsores. To heal wounds, you can use products such as Levosin, sea buckthorn oil, Solcoserine. If the ulcers fester, it is necessary to use antiseptic or antibacterial agents (streptocide powder, boric acid).

Methods for treating the disease at home

Treatment of bedsores in patients who are at home presents certain difficulties. At home, it is difficult to carry out high-quality cleaning of a festering wound and ensure good gas exchange necessary for tissue restoration. Along with folk remedies and medications, be sure to use it to treat ulcers. modern means, for example, a convenient antiseptic patch made from the latest materials, or anti-bedsore mattresses.

Medications

To quickly remove dead tissue from the damaged area of skin and begin the healing process, use special medications(for example, Iruksol). If necessary, during primary processing bedsores, remove necrosis using special instruments. When the ulcer is cleared of dead tissue, it is bandaged with bandages with analgesics, covered with hydrocolloid dressings (Hydrosorb, Hydrocol) or a compress is made with a wound-healing drug. When bedsores become infected, local antibacterial agents are used.

External treatment: ointments and creams

To treat wounds, you cannot use softening ointments or apply blind bandages that block the access of oxygen. On initial stages and in case of dry tissue death, refrain from wet dressings. All of these actions can lead to the formation of wet necrosis and active cell death. Antibacterial agents are prescribed in case of formation of a wet wound with pus or when wet necrosis skin tissues. To alleviate the patient's condition, it is permissible to use:

Vishnevsky ointment;
"Boro-Plus";
Bepanthena;
Autenrita ointment.

Anti-decubitus mattresses

One of the most effective means of preventing the formation of bedsores is an anti-bedsore mattress. Such products constantly change the pressure exerted on them. different areas body, through frequent inflation and deflation of air in special chambers of the mattress. Alternately changing pressure points guarantees the elimination of the causes of bedsores and maintains the normal activity of blood circulation in the compressed tissues.

Folk remedies

Treatment with folk remedies is an auxiliary measure to combat bedsores. Almost everything traditional methods treatments are based on the use medicinal plants, due to which the patient may experience an allergic reaction. The relevance of using folk remedies depends on the degree of the disease, so before using them you should consult your doctor about the advisability of such treatment. Here are some methods alternative medicine that help in the fight against bedsores:

Lubricate the wounds several times a day fresh juice lungworts.
Scald 1 tablespoon of crushed young elderberry leaves with boiling milk and apply it to the ulcer twice a day.
Cut the Kalanchoe leaves lengthwise, apply a fresh cut to the wounds, secure with a plaster or bandage and leave overnight.
If bedsores have formed on the head, mix vodka with shampoo (1:1) and wash your hair with this solution.
Make a mixture of a tablespoon of crushed calendula flowers and 50 g of petroleum jelly, apply it to the ulcers twice a day.
Make lotions from fresh potatoes 1-2 times a day. To do this, pass it through a meat grinder (or use a food processor) and mix the pulp with honey (1:1). Place the mixture on a thin cloth and apply it to the ulcer.
At night, make a compress with fish or bear fat using a sterile bandage.
To make a wet bedsore dry out faster, sprinkle it with starch once a day.
Systematically tie fresh cabbage leaves to the wounds at night. After 10-14 days, red spots should appear around the bedsores - this indicates the healing process of the ulcers.
Treat bedsores daily with a strong solution of potassium permanganate (add enough powder to the water so that it turns bright pink).

Surgery

Surgical intervention occurs only after a doctor’s prescription and according to strict indications. Incorrect or inappropriate surgical treatment can aggravate the disease, for example, increase the area of bedsores. First of all, doctors assess the likely effectiveness surgical methods treatment, and only if the prognosis is positive, one of the treatment methods is used: free skin plasty, plasty with local tissues, excision of the ulcer with comparison of the edges of the bedsore.

Surgical treatment does not always give the expected results. It happens that the transplanted skin tissue does not take root well in the affected area of the body due to its insufficient blood supply. Early complications after surgery they appear as accumulation of fluid under the skin tissue, suture dehiscence, necrosis of the wound or skin, bleeding. In the future, an ulcer may form, which often leads to a relapse of the bedsore.

Prevention of bedsores

The basic rule for preventing bedsores is proper patient care. It is necessary to ensure that the patient has normal blood supply to all areas of the skin. It is impossible for the patient to lie in one position for a long time, so turn him over every couple of hours, even despite the pain of this process. Otherwise, the ulcers will appear constantly and worsen to such an extent that the damage reaches the bone. To take preventive measures, it is necessary to take into account the provoking circumstances and risk factors for the development of bedsores:

insufficient hygiene of the patient's skin;
the presence of folds, protruding seams, buttons on clothes or in bed;
enuresis, fecal incontinence;
an allergic reaction in a patient to care and treatment products;
active sweating, diabetes, obesity;
poor nutrition, lack of fluid in the body;
Parkinson's disease;
diseases of the vascular system or spinal cord;
smoking or alcohol abuse;
physical inactivity, bone fractures;
anemia;
Availability malignant tumors;
swelling, dry skin.

Preventive measures to prevent the appearance of bedsores, they should be carried out from the first day of illness or placing the patient in a supine position. As practice shows, once the process of ulcer formation has begun, it is almost impossible to prevent its further development, which is why prevention is so important. With each subsequent stage of development of pressure ulcers, the likelihood of prompt treatment of the pathology decreases. Prevention includes the following measures:

Systematic cleansing of the skin, non-contact drying (without using towels or napkins) and disinfection using antiseptics.
Frequent change bed linen patient, straightening folds on clothes and bed.
Purchase of a special mattress (anti-decubitus, pneumatic, water, vibration).
Frequent changes in the patient's position.
The right diet nutrition and drinking regime.
Stimulation of the patient's muscle activity (electric underwear, massage).

If a person is forced to be in bed rest, then the first thing you need to remember is that there is a danger of appearance. It is easier to prevent this misfortune than to overcome it later.

It is useful for people caring for a bedridden patient to become familiar with the topic of what to do if bedsores do occur. This article is intended to tell you how to deal with bedsores in a bedridden patient, how to treat them, and how to avoid such a problem.

Stages of pathology

Bedsores can appear on the patient’s body within two hours of lying in one position. Pressing body tissues with body weight against the surface of the bed causes them poor nutrition and is the cause of disruption of normal life processes in them, up to necrosis.

Negative processes occur sequentially from small to serious purulent wounds. Experts have divided the transformations that occur with tissues during bedsores into four stages.

First stage is the initial and easiest. If you provide help at this stage, you can achieve success with little effort. Signs of the first stage of the lesion are red spots on protruding parts of the body that come into contact with the bed when lying down. The redness does not go away for some time, and when pressed with a finger, a pale mark does not remain in this area. A reddened part of the body may also be observed.
That the negative process has passed to second stage indicates the appearance or on a reddened surface.
On third stage occurs at the site of skin damage. It might work out open wound filled with pus. During this period of progression of bedsores, the skin on the inflamed lesion completely disappears from the necrotic processes occurring in it. Pathological process covers muscle tissue and fat layer.
Fourth stage has the same problems as the third, but with distribution to deeper layers. The tendons are already damaged, and it may inflammatory process cover the adjacent bones.

Now let's find out how to get rid of bedsores in a bedridden patient.

Stages of bedsores

How and with what to treat bedsores in bedridden patients

Modern medicine instructs people caring for bedridden patients to perform preventive actions to prevent the occurrence of bedsores. It is important to notice a developing bedsore as early as possible in order to take measures to localize and stop the pathological process.

Treatment of bedsores is prescribed depending on the stage at which the pathology is located. And at each stage, helping a patient has its own characteristics. So, how to apply bedsores to a bedridden patient, what effective treatment should you choose?

This video will tell you how to treat bedsores in a bedridden patient at home:

At home

To begin with, we will tell you about the actions and the best medications for bedsores in bedridden patients at the first stage of the disease.

First stage

When the disease has not progressed beyond the second stage, help can easily be provided at home. If redness is detected, the patient is turned so that the place where the problem appears does not experience pressure on its surface.

They try to position the problem area by turning the patient so that there is no contact with the bed or clothing. If necessary, special anti-bedsore pads in the form of circles are used, in which case it is possible to ensure that the affected area is supported.
It is allowed to knead the areas around the redness area, but massaging the surface of the hyperemic skin is prohibited. At this stage, with a little effort you can prevent the development of more severe forms bedsores.
Therefore, it is important to help maintain the integrity of the skin to prevent the appearance of a wound.

If there is a need to carry out activities with the use of medications, this is possible only as prescribed by a doctor. This also applies to traditional methods.

The affected area should be kept dry; you can lubricate it approximately once every two hours with the following products:

sea buckthorn oil,
tincture of Sophora japonica.

Read below about the names and prices of creams, sprays, ointments and other medicines for bedsores for bedridden patients of the second stage.

Second stage

At the second stage, caring for the affected area consists of the following actions:

the bedsore is washed with hydrogen peroxide or chlorhexidine,
apply a bandage made of the following materials:
- Apply one of the ointments to the gauze:
- use special self-adhesive dressings (they do not stick to the wound and collect discharge from it):
  - Cosmopore
  - or Tegaderm,
- you can use applications, they will require some material costs, but the substances with wound-healing properties included in their composition will significantly accelerate the healing of affected tissues, an example of such a product is Multiferm;
- It is good to use hydrogel dressings, for example, Hydrosorb; such products maintain the required moisture in the wound surface, have a healing effect and create a gentle regime for the sore spot;
A common way to prevent bedsores and alleviate the condition when they appear is to use a mattress for bedridden patients against bedsores.

If folk remedies and medicines for bedsores for bedridden patients do not help, then you should immediately consult a doctor.

This video will tell you what actions a nurse takes when treating a bedsore in a bedridden patient:

In the hospital

If the negative processes in a bedsore have reached the third stage, then from this period they need the help of a surgeon to heal, so it is advisable to stay in a hospital. The third and fourth stages of bedsores differ in the depth of the lesion.

The specialist carries out the following activities:

the wound is cleaned of dead tissue; such actions are necessary to stop the spread of the necrosis process to neighboring areas;
Bandages are applied to the cleaned wound, which are required for a specific case:
- absorbent dressings (Biaten) - if there is a need to draw out moisture and necrotic masses from the wound;
- wound healing dressings (Proteox-TM).

Another reason for hospital treatment is when bedsores cause complications. It could be:

infection in the subcutaneous tissue,
sepsis,
inflammatory infectious process in the bones.

All these conditions are very dangerous and require special treatment in a hospital setting. Sepsis is a lesion of the entire body. The disease occurs when purulent bacteria enter the blood.

The cause of sepsis is mistakes made when caring for purulent wounds. The problem may lead to fatal outcome. To treat sepsis, specialists use complex techniques using broad-spectrum antibiotics.

At the stage of infection entering the subcutaneous tissue, surgery is prescribed to prevent or sepsis.
We also advise you to ask your doctors about the algorithm for preventing bedsores in bedridden patients. This could be very useful.

This video explains in detail the prevention of bedsores in bedridden patients and their treatment: