home Audience 12 How and how to treat bedsores? Ointments for bedsores, folk remedies at home. Treatment of bedsores with medicines. Nurse care for patients with bedsores will help in severe cases

How and how to treat bedsores? Ointments for bedsores, folk remedies at home. Treatment of bedsores with medicines. Nurse care for patients with bedsores will help in severe cases

Pathologies are characteristic not only for bedridden patients, bedsores can occur with any external pressure on the skin. Especially often they are formed in the areas of bone protrusions. Bedsores are prone to patients suffering from a violation of the innervation (supply of nerves) of the skin due to diseases of the spinal cord. In patients, such ulcers often occur on the head, buttocks, and heels.

Stages of bedsores and features of their treatment

Looking for effective methods Doctors have tried many means to treat pressure ulcers, but so far the best way to deal with them has not been found. Each medical institution uses its own methods, which it considers to be the most effective. The complexity of the treatment of bedsores lies in the passive blood supply in places of tissue compression during prolonged immobility of a bedridden patient.

Light skin lesions.
Damage to the skin, fatty tissue.
Muscle damage.
Deep wounds to the bone.

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

Treatment of bedsores 1 and 2 degrees

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

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Detoxification of the body (hemodez, blood transfusion).
Immunostimulating therapy (taking immunostimulants, vitamins).
Elimination of constant pressure (turning the patient every 2 hours).
Reducing pressure on tissues with the help of special means - plastic splints, anti-decubitus mattresses, pillows, pads, etc.

How to treat deep bedsores 3 and 4 stages

In 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 (clearing the ulcer from pus and necrosis, absorption of the detachable wound with protection from drying out). At 3 stages pathological process quickly spreads to neighboring areas of the skin, where blood supply is also impaired. At this time, you can not be inactive, the skin can no longer regenerate itself. Removal of dead tissue (necrectomy) must be performed before capillary bleeding occurs.

Then the doctor cleans the bedsores with antibiotics. a wide range action, local antiseptics. In the treatment of such ulcers, necrolytic drugs (Collagenzine, Chymotrypsin, Trypsin), anti-inflammatory drugs (Alfogin, Vulnuzan, Hydrocortisone), tissue repair stimulants (Vinilin, Bepanten, Methyluracil), drugs for normalizing lymph microcirculation (Tribenozid, Pyricarbate) are used.

The fourth stage is characterized by deep necrosis with damage to muscle tissues, tendons and bones. Treatment consists of excising the dead tissue, absorbing the pressure sore, and moisturizing the healing wound. After the termination acute phase process of necrosis, the doctor raises the question of surgical treatment. Such cleaning of the ulcer is carried out in order 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 the location

Bedsores are formed in bedridden patients due to squeezing of blood vessels and skin, as a result of which blood supply is disturbed and tissue cells die in areas maximum pressure on the body. So, when lying on your side, ulcers form on the thigh, ankle, knee. If the patient lies on his stomach for a long time, wounds appear on the cheekbones, pubis. When lying on your back, wounds can open on the heels, sacrum, elbows, nape, coccyx, shoulder blades. Pressure sores are cared for and treated depending on the site of formation.

How to treat bedsores on the heels

Bedsores on the buttocks

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

Restoration of blood circulation in places of skin damage.
Assistance to tissues in the rejection of necrosis.
Wound cleansing and application of healing agents.

Pressure ulcers on the buttocks are often treated with medications containing silver. Such funds have antiseptic properties and reduce pain. Creams and ointments containing silver contribute to rapid healing wounds. Alcohol-based medicines are often not recommended because they can dry out the skin.

Tailbone

For the treatment of wounds formed on the coccyx, use dressings soaked in a solution of cognac and salt (in the ratio of 30 g of salt to 150 g of cognac). Bandages are best applied under compress paper, changing it as necessary. Before changing the bandage to a new one, be sure to rinse the bedsores from salt. For wound healing, you can use remedies such as Levosin, sea buckthorn oil, Solkoserin. If the ulcers fester, it is necessary to use antiseptic or antibacterial agents (streptocid powder, boric acid).

Ways to treat 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, which is necessary for tissue restoration. Along with folk remedies and medicines, be sure to use for the treatment of ulcers modern facilities, for example, a handy antiseptic patch made from latest materials, or anti-decubitus mattresses.

Medications

In order for dead tissue to be rejected faster on the damaged area of the skin, and the healing process to begin, use special medications (for example, Iruksol). If necessary, during the initial treatment of bedsores, remove necrosis with special tools. 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 infection of pressure ulcers, local antibacterial agents are used.

External treatment: ointments and creams

For the treatment of wounds, softening ointments should not be used or deaf bandages should be applied that block the access of oxygen. In the initial stages and with dry tissue death, refrain from wet dressings. All of the above actions can lead to the formation wet necrosis and active cell death. Antibacterial agents are prescribed in case of formation of a wet wound with pus or with wet necrosis of skin tissues. To alleviate the patient's condition, the use of:

Anti-decubitus mattresses

One of the most effective means that prevent the formation of bedsores, is considered anti-decubitus mattress. Such products constantly change the pressure exerted on different areas body, by means of frequent inflating and deflating air in special chambers of the mattress. Alternate change of 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 pressure sores. Almost all folk methods treatments are based on the use medicinal plants, due to which the patient may experience an allergic reaction. The relevance of the use of folk remedies depends on the degree of the disease, therefore, before using them, you should consult your doctor about the advisability of such treatment. Here are some alternative medicine methods that help in the fight against pressure ulcers:

Apply to wounds several times a day fresh juice lungwort.
Scald 1 tablespoon of crushed young elderberry leaves with boiling milk and apply them 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 marigold 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 combine) and mix the gruel with honey (1: 1). Place the mixture on a thin washcloth and apply it to the ulcer.
At night, make a compress with fish or bear oil using a sterile bandage.
To make a wet bed sore dry out faster, sprinkle it with starch once a day.
Systematically tie fresh to wounds at night cabbage leaves. The next day, 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 yellow). pink color).

Surgery

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

Not always surgical treatment gives the expected results. It happens that the transplanted skin tissue does not take root well on the affected area of the body due to its insufficient blood supply. Early complications after surgery have the form of accumulation of fluid under the skin tissue, divergence of sutures, necrosis of the wound or skin, bleeding. In the future, an ulcer may form, which often leads to a recurrence of the bedsore.

Prevention of bedsores

The basic rule for the prevention of bedsores is proper patient care. It is necessary to ensure that the patient has a 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, ulcers will appear constantly and worsen to such an extent that damage will reach the bone. To take preventive measures, it is necessary to take into account the provoking circumstances and risk factors for the appearance of bedsores:

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

Preventive measures to prevent the occurrence of bedsores should be carried out from the first day of the disease or the patient's placement in lying position. As practice shows, if 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 in the development of bedsores, the likelihood of a quick treatment of the pathology decreases. Prevention includes the following measures:

Systematic cleansing of the skin, non-contact drying (without the use of towels or napkins) and disinfection with antiseptics.
Frequent change bed linen the patient, straightening the folds on clothes and beds.
Acquisition of a special mattress (anti-decubitus, pneumatic, water, vibration).
Frequent change of position of the patient.
Proper Diet nutrition and compliance drinking regime.
Stimulation of the patient's muscle activity (electric underwear, massage).

The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on individual features specific patient.

How to treat and treat bedsores with folk remedies at home

Treatment of bedsores involves procedures aimed at restoring the skin. Most often, bedsores appear along the line of the ribs, in the area of the ischium, on the elbows, heels, shoulder blades and sacrum. Homeostasis in the human body is maintained at the proper level thanks to the blood that saturates the body nutrients and oxygen. Bedsores are formed due to a violation of its circulation. The process of tissue necrosis is accompanied by nervous atrophy; as there is no blood circulation, the lesions increase.

What are bedsores?

Bedsores (ulcers) are a serious complication resulting from compression and malnutrition of tissues. Most often, ulcers form at the sites of bony prominences. Patients with pathologies and injuries of the spinal cord, which are accompanied by impaired tissue innervation, are predisposed to the formation of bedsores. Such people need treatment for bedsores on the buttocks, heels and other places subject to great pressure. Ulcers form quickly, and their treatment is not always effective. Fabrics die off in those places where there is maximum contact of the body with the solid elements of the bed and bed linen.

Bedsores appear depending on the position of the body:

when a person lies on his back, the back of the head, shoulder blades, elbows, ischial tuberosity, sacrum, heels are affected;
when positioned on the side, the ankles, hips, knees are affected;
if the patient lies on his stomach, the cheekbones and pubis are affected.

Symptoms of pressure ulcers, their causes

Symptoms of bedsores depend on the degree of tissue damage:

the first degree - there is a persistent reddening of the skin, which does not disappear even after a decrease in the total pressure;
the second degree - hyperemia, a violation of the skin, accompanied by the formation of a bubble or detachment of the epidermis, are noted;
the third stage - muscle tissue is affected, appear liquid discharge, necrosis is formed;
the fourth stage - as a result of necrosis, bones and tendons are exposed, deep cavities are formed.

On initial stages sparing treatment of bedsores in bedridden patients is usually performed, ulcers of the last stages require surgical intervention.

The main reason for the formation of bedsores is a violation of blood circulation due to lack of movement. Other reasons include:

big weight;
constant high or low temperature body;
dry or damp skin;
severe iron deficiency anemia;
poor nutrition(insufficient amounts of nutrients and proteins in the diet);
improper care for bedridden patients;
accompanying illnesses endocrine system(goiter, diabetes, etc.);
urinary incontinence, problem realization of natural needs.
With increased dryness of the skin, the layer that performs a protective function exfoliates, and with excessive moisture, infection of the affected areas occurs. The problem is exacerbated by impaired blood circulation in places of compression.

Development of the pathological process

First, the skin in places where a person often lies, turns red and swells. On this stage need to provide initial care. If, upon detection of the first symptoms, no necessary actions, skin covering is disturbed, over time it exfoliates in thin films, layers of the skin located more deeply are gradually exposed, it becomes moist, the formation of a sanious fluid is possible. The process, which is not stopped in time, contributes to the multiplication of harmful bacteria, as a result of which ulcers filled with pus appear on the skin, sometimes quite deep. A person does not experience a strong pain sensation, but in the future, irreversible destruction of the affected skin areas is possible.

Pressure sores: treatment according to the stage of their development

Methods and means of treatment are selected taking into account the severity of the pathological process. Great importance has proper care for bedsores. After the discovery of the first signs of a disease that contributes to the development of complications, it is necessary to begin prevention. In the presence of bedsores, conservative and surgical treatment is used. The latter is shown at severe lesions that do not heal and are difficult to treat. Conservative measures are aimed at healing bedsores, they allow you to remove necrotic masses and improve the blood supply to tissues.

Treatment of bedsores is based on the following principles:

implementation of preventive measures, regardless of the degree of development of pathology;
the inadmissibility of the use of softening ointments, wet (at the initial stage, with dry necrosis) and deaf bandages (prevent the evaporation of moisture and oxygen access) - such actions can provoke the development of wet necrosis and tissue death;
the appointment of ointments that have an antibacterial effect, in the presence of wet purulent wounds and wet tissue necrosis;
general antibiotic therapy with the determination of the sensitivity of pathogenic flora.

Pressure sores of the first degree

Active prophylaxis is needed to prevent the progression of bedsores, because. at the initial stage, only hyperemia of the skin, its compaction are noted:

checking the state of health, which allows to exclude factors for the development of bedsores, their progression;
elimination of pathologies and syndromes that aggravate bedsores;
detoxification of the body (hemodez, reopoliglyukin, blood transfusion);
immunostimulating therapy (the use of immunostimulants, immunomodulators and vitamins);
reduction of pressure on tissues (achieved through the use of special tools - systems with adjustable pressure and vibration; anti-decubitus beds; plastic tires; pads, mattresses, pillows, circles with fillers);
elimination of prolonged pressure (the position of the patient's body should be changed every 2 hours).

Rules for caring for bedridden patients:

keep the skin clean so that it is not dry or wet - do air baths;
for hygiene, use a simple, non-antibacterial soap, clean water, a cotton washcloth or a natural sponge; gently wipe the skin, after washing - blot;
wipe oily skin with alcohol-containing products;
moisturize dry skin with a hypoallergenic baby cream, wet skin - cover with talc or powder, use a brilliant green solution, 1% potassium permanganate solution, zinc ointment(after the first stage, do not use potassium permanganate and products containing zinc);
if redness is present, massage the skin with which they are surrounded, using a mitten made from a terry towel;
if the patient suffers from urinary incontinence, use diapers or homemade cotton pads for women and a urinary system for men; regularly toilet the perineum.
in case of excessive sweating, wipe the skin with a weak solution of table vinegar (take 1 tbsp of vinegar for 250 ml of water).

Local treatment

Skin lesions require treatment. To know what to handle

bedsores in bedridden patients, you need to familiarize yourself with the modern scheme of local treatment, it includes:

skin toilet using camphor alcohol or saline, and drying it;
improvement of local blood circulation through the use of special preparations (solcoseryl, actovegin);
treatment of bedsores with xeroform powder;
applying patches-bandages made of polyurethane; they are glued without tension, protect the skin from bacteria, provide oxygen access and moisture evaporation, and allow you to visually monitor the condition of damaged areas.
skin washing cold water; as a result of the application of this technique, the vessels expand, the nutrition of the tissues increases.

Bedsores of the second degree

In the second stage, small lesions appear that require minimal surgical intervention and carrying out activities aimed at stopping tissue necrosis, regeneration of damaged areas:

care for bedsores - removal of dead epithelium, washing the wound with hydrogen peroxide and saline (preferably in a dressing room);
monitoring the condition of the affected areas of the skin;
the use of antibiotic therapy in the event of inflammatory response and progression of bedsores;
applying antiseptic dressings recommended by the doctor to the places from which the epidermis was removed.

For lesions of the second degree, the following dressings are used:

transparent film with an adhesive surface (blisterfilm, cosmopore, gyrofilm, tegaderm);
wafer hydrogel (hydrosorb) and hydrocolloid (duoderm, hydrocoll);
spongy with a breathable layer of polyurethane (pemaf);
semi-permeable on a hydropolymer basis (thielle).

Treatment in the third stage

At this stage, necrosis of the dermis and subcutaneous fat to the fascia occurs. The wound is cleaned surgically, providing further absorption and protection from drying out. The pathological process quickly moves to areas of connective tissue that are poorly supplied with blood, so you should not wait for the rejection of dead tissues and self-cleansing of the wound. Necrectomy should be performed before the appearance of capillary bleeding, followed by treatment of the ulcer. How to treat bedsores in bedridden patients in the third stage, you need to find out from your doctor, they are usually used:

anti-inflammatory drugs (vulnuzan, dexamethasone, algofin, hydrocortisone) and necrolytic action (chymotrypsin, terrilitin, deoxyribo-nuclease, trypsin, collagenazine);
means that improve blood microcirculation (tribunoside, pyricarbate);
tissue repair stimulants (bepanten, curiosin, vulstimulin, vinylin, Kalanchoe ointment, methyluracil).

Thanks to integrated approach it is possible to stop the septic condition and clear the ulcer.

For local treatment, the following agents are used:

argosulfan cream;
ointment iruksol;
ointments Levosin and Levomekol;
metronidazole gel;
intrasite hydrogel.

Fourth stage bedsores

On last stage deep necrosis occurs. The tendons of the joint capsules, muscles and bones are involved in this process. Treatment is performed by excising the necrosis, absorbing the decubitus discharge, and then moistening the healing wound. Since the exact boundaries of dead tissue are difficult to determine, it is necessary to produce them complete removal impossible. Tissue repair is stimulated with the help of physiotherapy treatment:

reduction of microbial contamination (phonophoresis of antiseptics, electrophoresis of antibiotics, UHF in a thermal dose, ultrasound);
activation of reparative processes (electroacupuncture, direct current, mud applications, low-intensity laser, darsonval of healthy tissues that surround the bedsore);
improvement of microcirculation and blood supply (massage of healthy tissues located near ulcers).

Surgery

Inappropriate and incorrect intervention can lead to an increase in pressure sores, so surgical treatment is performed according to strict indications after evaluating its effectiveness. Methods such as plasty with local tissues and autodermoplasty are used, as well as excision of the ulcer with a comparison of its edges. Surgical treatment does not always positive result, because the wound is not sterile, and the transplanted tissue does not take root well in areas with poor blood circulation. Early surgical complications are possible - suture divergence, bleeding, exudate formation under the skin flap, wound necrosis, marginal necrosis of the skin flap. A later complication is the formation of a fistula filled with pus. Such a complication can lead to recurrence of the bedsore.

Alternative treatment

Treatment of bedsores at home with folk remedies is an auxiliary measure aimed at cleansing ulcers and forming new tissues. Medicinal plants necessary for the implementation of folk methods, with hypersensitivity, can lead to the development of allergic reactions, and they can not be used at all stages. Before using them, you should consult your doctor. It is forbidden to use medicines prepared from plants with a tannic effect (oil of acorns, willow and oak bark, infusion of green walnut, and etc.). Treatment of bedsores at home with folk remedies is carried out using:

Most problematic areas

The coccyx, heels and buttocks are most susceptible to bedsores. Treatment of bedsores on the coccyx should be done first. With such lesions, a children's inflatable or special rubber circle is placed under the patient. Thus, it will be possible to create additional air circulation and reduce the load on the lumbar region. The measures that accompany the treatment of bedsores on the coccyx should be carried out with great care.

With constant lying on your back, treatment of pressure sores on the heels may be required. It is necessary to eliminate long-term pressure on this area and provide proper care for the resulting ulcers. Treatment of bedsores on the heels, as well as on other parts of the body, is mandatory. Problems with the buttocks also appear with constant lying on your back, they are more difficult to get rid of. Most often, the bedsores on the buttocks are the first to form and the last to disappear, the treatment of which must be done using special compresses.

To make a talker, you need to take butter, levomycetin (10 tablets), insulin (10 ml), high-quality honey (a few spoons), a small amount of novocaine, alcohol (4 spoons). Using a gauze base, the resulting mass is lubricated with bedsores on the buttocks. Treatment with this remedy is performed when the patient lies on his back. The ointment is stored in the refrigerator, on the bottom shelf. The affected area is lubricated in a position on its side, leaving oxygen access.

Possible Complications

Bedsores can provoke the development of contact osteomyelitis, wound myiasis, phlegmon, purulent arthritis. With damage to the walls of blood vessels, there is a possibility of arrosive bleeding. If bedsores for a long time do not heal, the risk of developing skin cancer increases. The most severe complication is sepsis. The infection spreads through the body through the blood, resulting in multiple organ failure, which leads to death.

Preventive measures

It is necessary to take into account risk factors and provoking factors:

swelling, dry skin;
dirty skin, the presence of coarse seams, buttons, folds, crumbs and other particles on the bed linen;
friction, humidity, constant pressure;
Parkinson's disease, diabetes, obesity, causes of excessive sweating;
bone fractures, immobility;
stroke, tumors (malignant), anemia, low blood pressure;
the age of men exceeding 70 years (men are more prone to bedsores than women);
allergic reactions to hygiene products, urinary and fecal incontinence;
diseases of the heart, spinal cord and brain, smoking;
lack of fluid, poor nutrition, exhaustion of the body.

Prevention should begin immediately after the detection of the disease. It should be carried out with great care and perseverance. It is difficult to prevent the progression of a lesion if it has already developed. With each subsequent stage, the chance of spontaneous disappearance of such pathologies as bedsores decreases, the prevention and treatment of which should be carried out in a timely manner.

Preventive measures include:

proper skin care (cleansing, drying with a non-contact method and disinfection);
the use of special pads, circles and mattresses (vibrating, pneumatic, water);
stretching the sheets without wrinkling, regular change of bed linen;
change in the position of the body of a sick person with a frequency of 2 hours;
imitation of muscle work (electric underwear, massage);
rational nutrition, compliance with the drinking regimen.

At home, bedsores can be cured, the main thing is the presence of desire and time. But still, it is better to prevent the occurrence of bedsores than to treat them. Provide proper care for bedridden patients, and then you will be able to avoid many complications.

How to treat bedsores in a bedridden patient

Unfortunately, a bedridden patient is not only round-the-clock care, regular procedures, but also the need to monitor his health. And even if the underlying disease was stopped in its development, it is by no means possible to relax - for bedridden patients, the formation of bedsores is typical.

What causes the formation of bedsores in bedridden patients? Firstly, the patient is constantly in one position - gradually there is a violation of blood circulation in places of constant contact of the body with the bed, the skin begins to atrophy. Secondly, in bedridden patients, both the level of immunity and the regenerative abilities of the body are significantly reduced - this significantly aggravates the condition of newly formed bedsores.

The main methods of treatment of bedsores

Bedsores in a bedridden patient can form anywhere, it depends on the position in which the person is most often located. For example, if he is forced to lie on his back for a long time, then the lower back, buttocks, the area between the shoulder blades will be affected, and if the bedridden patient is on his side, then the bedsores will be located only on one side of the body.

As soon as the first signs of bedsores appear, treatment should be started immediately - if this process is started, the process of skin decomposition will actively progress, which will lead to necrotic processes, the formation of deep ulcers.

The first thing to do is to ensure that the position of the patient is such that places with already formed bedsores do not come into contact with the bed and clothes. To do this, you can use special anti-decubitus rubber circles - they look like swimming, allow you to support body parts with pathological changes on the skin in a "suspended" state. Thus, absolute dryness of sore spots is ensured - this is an indispensable condition for successful treatment bedsores.

But all other treatment, both with the use of drugs and with the use of funds from the category of "traditional medicine" must be agreed with the attending physician.

The specialist will determine the stage of development of bedsores:

1 stage. The skin in certain places becomes red, if you press this hyperemic area with your finger, it does not turn white, in some cases, edema appears in places of redness. Stage 1 bedsores are called superficial and are considered the most accessible for treatment. If certain measures are taken at this very moment, then further development of necrotic processes can be avoided.
2 stage. Bedsores are not only red in color, but also small blisters or sores. At this stage, the main task is to prevent the development of an inflammatory / purulent process. As a rule, the regular use of dressings with specific drugs gives excellent results - the treatment will not be long and difficult.
3 stage. Bedsores are a deep wound, the skin is completely "eaten" by the necrotic process, adipose and muscle tissues are clearly visible, and the wound can be filled with purulent content.
4 stage. The pathological process actively spreads to the tendons and even bone tissue, inflammation develops, the wound in each case is filled with pus.

Bedsores at stages 3 and 4 of development are classified as deep, and doctors believe that only a surgeon can help the patient. Of course, there are a lot of remedies from the “traditional medicine” category, which often turn out to be quite effective in the fight against bedsores, but home treatment can only be carried out after consulting a doctor.

Treatment of bedsores with drugs

There are a number of medicines that can be used to treat pressure sores. But it will first be necessary to establish precisely the stage of development of the pathological condition- this will help to make the right choice in favor of a particular drug.

1 stage bedsores

At this stage of the necrotic process, the following should be done:

wipe the affected area of skin every 2-3 hours camphor alcohol;
several times a day, treat reddened areas of the skin with Japanese Sophora extract or sea buckthorn oil;
make sure that bedsores are always dry.

Note: in no case should you massage the reddened places on the body, even treat them with oil or alcohol very carefully, with minimal effort. This is due to the fact that there is a very high risk of injuring thinned, inflamed skin - this immediately leads to infection and the development of an inflammatory-purulent process.

2nd stage bedsores

At this stage of development of the pathological process under consideration, it is imperative to use specific drugs - unfortunately, oil and alcohol alone cannot be dispensed with. What doctors recommend:

several times a day the resulting wound should be treated antiseptic solution- chlorhexidine is optimal for this;
immediately after the initial treatment, Solcoseryl, Actovegin or Levomekol should be applied to the wound - they are available in the form of ointments, only one drug needs to be selected for treatment;
periodically apply hydrogel dressings - for example, Hydrosorb Comfort;
use applications with substances that have wound healing properties - for example, Multiferm.

Note: hydrogel dressings and applications with specific substances have enough high cost V pharmacy chains, but when they are used, the treatment time for bedsores is significantly reduced.

3rd and 4th stage bedsores

As mentioned above, at these stages you will need the help of a surgeon - the doctor will definitely carry out the following procedures:

wound sanitation;
cleansing the affected area of the body from necrotic masses;
the use of special wound healing dressings - for example, Proteox-TM;
the use of special absorbent sponge dressings (Biaten) - they are used if too much necrotic mass and pus has accumulated in the wound.

Only after the decubitus wound has completely dried out, it will be possible to apply specific drugs to the affected areas of the skin.

Treatment of bedsores at home folk remedies

Since a bedridden patient is most often at home, those who care for him need to know various methods bedsore treatment. Of course, before using each of them, you need to get permission from your doctor, but all of the following remedies have practically no contraindications.

Essential oils

They have not only a pleasant aroma, but also have an antiseptic and healing effect. Not surprisingly, some essential oils can be actively used to treat pressure sores. Here are the two most effective recipes:

Mix palmarosa oil with St. John's wort oil in a ratio of 1:2 and make a warm compress on the affected area of the skin. Usually such a bandage is applied at night, and in the morning it is removed, the skin / wound is washed with warm water and dried thoroughly. As an additional ingredient, you can use not only St. John's wort oil, but also wheat germ oil.
Mix equal amounts of essential oils of geranium, myrrh, tea tree, lavender, petitgrain and add St. John's wort macerate to them. The effect of using this "cocktail" of essential oils it is simply amazing - if the bedsores are at stages 1 and 2 of development, then the first results of such treatment will be noticeable in a day, and if deep bedsores have already formed, then a positive result will appear after 3-5 procedures. Warm compresses should be made from this collection of essential oils once a day and it is better to leave a bandage on the wound overnight.

Sea buckthorn and rosehip oil

The fruits of these plants contain a large amount of vitamins A, E and C - these substances help restore and improve blood circulation, strengthen the walls of blood vessels and increase the level of regeneration in the body. That is why and traditional healers, and representatives of official medicine recommend treating bedsores with sea buckthorn oil and / or rosehip oil (you can simply alternate these two remedies).

Before applying these types of oil to the affected skin, it is necessary to treat the area with camphor alcohol. Then ulcers and clean wounds are treated with oil, wait until it is completely absorbed, and only after that they put clothes on the patient. Be sure to use sterile cotton swabs for the procedure - this will prevent infection.

Note: sea buckthorn or rosehip oil is excellent for bedsores of stages 1 and 2 of development - these two remedies will act as the main method of treatment. But if the bedsores are already deep, then sea buckthorn and rosehip oil can only be considered as an auxiliary component of complex therapy.

Camphor oil

This is a very specific remedy for bedsores - it will be effective at stages 1 and 2 of the development of the pathological process in question, but dangerous with deep pressure sores. The fact is that camphor oil has an antiseptic, wound healing and analgesic effect. This tool is able to restore tissue, improve metabolic processes in the body, but only if applied to the skin. Therefore, with superficial bedsores, camphor oil can be applied once a day to altered areas of the skin, but on existing ulcers, the same remedy will cause burns.

In pharmacy chains, an ointment based on camphor oil is sold - it is more expedient to use just such pharmacological form the drug in question.

Common products for bedsores

Often, when pressure sores appear, people immediately begin to use expensive medicines for treatment, some specially prepared preparations. But traditional medicine claims that even the most familiar products can help get rid of necrotic changes on the body of a bedridden patient. The most effective means:

Baking soda. It is used to treat stage 2 bedsores, when blistering with purulent contents is already observed. What should be done? Dilute a full tablespoon of soda in boiling water (2 cups) and moisten a linen towel in the resulting solution. Immediately apply a towel to the problem area and leave to cool completely. When the tissue is removed from the bedsore, pus is found right on it - it comes out of the blisters. The next clean towel is taken and also wetted in a soda solution, applied again. This procedure should be carried out until, after removing the tissue from the wound, a clean surface of the towel is noted.
Onion. You need to take two heads of medium-sized onions, finely chop and fry in vegetable oil until golden. Then the oil is filtered, it is added beeswax or church candle(1 piece), which must first be melted in a water bath. Such an ointment can be used to treat bedsores at any stage of their development, but before each use of the remedy, it must be warmed up / melted.
goat fat. Connecting table salt, finely chopped onion and goat fat in equal proportions - the product is ready. It should be applied to the affected areas of the skin for a minute.

Note: remedy from goat fat at the beginning of treatment, pressure ulcers can cause severe pain- it must be endured. But as the ulcers heal pain syndrome becomes less pronounced - this can serve as a kind of indicator of the results of treatment.

Cream. Everything is simple here - it is enough to lubricate bedsores with cream once a day. But you need to purchase them without any flavors and flavors, the best option is to cook the cream yourself.

How can you help a bedridden patient with bedsores

Of course, the treatment of bedsores is an important and necessary measure. But you also need to know some features of caring for bedridden patients - in this case, it will be possible to prevent the appearance of the pathological process in question. What do we have to do:

every 2 hours to change the position of a bedridden patient - be sure to turn him from side to side, if it is possible to lift upper part torso, then it will be fine;
be sure to purchase special mattresses filled with air or foam balls - they provide an even distribution of the load on the skin of the body, constantly changing the load from one place to another;
if a bedridden patient has fecal or urinary incontinence, then it is necessary to change diapers / diapers as often as possible - these biomaterials will certainly provoke the formation of bedsores;
daily you need to check the condition of the skin on the patient's body - so it will be possible to detect primary signs development of bedsores and provide the necessary medical care;
at least 2 times a week, a bedridden patient should be washed / wiped with a soft sponge and soapy water.

Treatment of bedsores in a bedridden patient is a lengthy process, often it is not possible to achieve success. But using all the means and methods indicated in the article, you can significantly alleviate the patient's condition.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

What to do if blood flows from a bedsore

In the initial stages, the bedsore is localized in the thickness of the skin (first and second stages), then deeper layers undergo necrosis - subcutaneous fat(third stage), muscles and bones (fourth stage).

Deep bedsores are formed, in the process of their formation connective tissue, walls of blood vessels and lymphatic vessels, muscle fascia, tendons, periosteum.

Causes of bleeding from bedsores

Necrosis in the first and second stages rarely gives such a complication. The blood vessels in the places of compression are obliterated, the blood flow in them is disturbed, with mechanical damage, the blood from the bedsore appears in the form of separate drops, and stops on its own.

Types of bleeding

Bleeding differs in the mechanism of occurrence and in intensity.

According to the mechanism of occurrence

Bleeding occurs when damaged vascular wall, which can be caused by various factors. Allocate:

Acute - due to a violation of the permeability of the walls of blood vessels;
mechanical origin;
Arrosive;
Bleeding due to bleeding disorders;
Artificial (bleeding).

With the formation of a bedsore ulcer, arrosive hemorrhages are more often observed. The appearance of blood from a bedsore means that the wall of the blood vessel has undergone erosion - destructive changes with the formation of a hole. This is due to purulent fusion of tissues.

By intensity

The intensity of bleeding directly depends on the size of the damaged vessel and the rate of blood flow in it.

Intense and deadly is arterial bleeding, in which a fatal outcome is possible.

Risk group

There are certain factors that contribute to the occurrence of hemorrhage.

Diseases of the blood system (hemophilia);
Endocrine diseases (diabetes mellitus);
Insufficient hygiene, crumbs and folds on linen;
Poor patient care;
Traumatic actions during dressings (strong friction, mechanical damage to the surface of the bedsore).

How to deal with bleeding from a bed sore

When blood appears, it is necessary to assess the intensity of hemorrhage. Stopping methods depend on the nature of the damaged vessel.

Help with arterial bleeding

This complication rarely occurs. If scarlet blood flows from the bedsore, a pulsation is visible - this is a sign that the artery is damaged. Assistance to the patient should be provided immediately, as the loss of even 10-15% of the volume of circulating blood is dangerous for weakened and malnourished bedridden patients. In bedridden patients, chronic hypovolemia is observed, which greatly complicates recovery after blood loss. First aid consists in temporarily blocking the lumen of the artery with a tourniquet or finger pressure. Small arteries overlap with tight tamponade of the wound. An ice pack is used locally. Such bleeding requires urgent surgical intervention, in which the damaged vessel is sutured. At the same time, general treatment, blood and plasma transfusions are prescribed.

Help with venous bleeding

The blood from the bedsore is dark in color, the pulsation is not pronounced, the blood loss is severe - these are signs venous bleeding. With the defeat of large vessels, there is a strong hypovolemia, so you need to respond immediately.

The lumen of the vessel is blocked, if the bedsore is located on the limb - a tourniquet is applied, no more than 2 hours. The application of a tourniquet is used as a necessary measure if it is impossible to stop the blood from the bedsore in other ways. The wound is tightly packed with a dressing material, a hemostatic sponge. Local cold.

The final stop of blood loss is possible in a hospital, when debridement wounds with suturing of damaged vessels.

Important! A prerequisite for bandaging when stopping blood from a bedsore is careful antiseptic treatment ulcers to prevent re-infection and purulent fusion of blood clots and the vascular wall.

Epsilon-aminocaproic acid, Vikasol, Vitamin R are prescribed as a general treatment.

Help with capillary bleeding

If observed bloody issues for a long time, of medium intensity, the wound is filled with clots - this is a sign of capillary arrosive hemorrhage. Most often, it is the capillaries that suffer from purulent fusion, so this type of blood loss is most common.

When a bedsore bleeds, the wound is treated with a solution of hydrogen peroxide, necrotic plaque and infected clots are removed. After that, the wound is packed with dressing material using hemostatic agents:

For shallow bleeding bedsores, cauterizing agents are used in the treatment, such as a solution of brilliant green, calendula tincture.

As a dressing, if the blood loss is insignificant, hydrogel wipes (Hydrosorb) can be used, which should be changed as they get dirty.

If the bedsore bleeds for a long time, tamponade is done with a hemostatic sponge, which gives a good hemostatic effect.

Concomitant general treatment, such as vasoconstrictor drugs, drugs that affect blood clotting, are used only on the recommendation of a doctor. From folk remedies for all types of hemorrhages, nettle decoction helps, taken orally ½ cup three times a day.

With deep necrotic ulcers, a doctor's consultation is necessary, it is he who decides how to treat a bleeding bedsore. Self-medication in this case is dangerous with chronic blood loss and a significant deterioration in the patient's condition.

Pressure sores are called ulcers, which are signs of serious complications many diseases that develop due to impaired blood supply to tissues or due to their compression with subsequent displacement. Pathologies are characteristic not only for bedridden patients, bedsores can occur with any external pressure on the skin. Especially often they are formed in the areas of bone protrusions. Bedsores are prone to patients suffering from a violation of the innervation (supply of nerves) of the skin due to diseases of the spinal cord. In patients, such ulcers often occur on the head, buttocks, and heels.

Stages of bedsores and features of their treatment

In search of effective methods of treating pressure sores, doctors have tried many means, but so far the best way to deal with them has not been found. Each medical institution uses its own methods, which it considers to be the most effective. The complexity of the treatment of bedsores lies in the passive blood supply in places of tissue compression during prolonged immobility of a bedridden patient.

Stages of pathology:

Light skin lesions.
Damage to the skin, fatty tissue.
Muscle damage.
Deep wounds to the bone.

Treatment of bedsores 1 and 2 degrees

At the initial stage of the development of diaper rash, preventive measures for the progression of the death of tissue cells should be actively carried out, since at this stage only skin hyperemia occurs, and seals appear. The doctor evaluates the patient's condition to identify or eliminate external and internal risk factors for the progression of ulcers. Further, the treatment of all existing pathologies and concomitant syndromes, which aggravate the situation, is prescribed. The specialist may prescribe:

Detoxification of the body (hemodez, blood transfusion).
Immunostimulating therapy (, vitamins).
Elimination of constant pressure (turning the patient every 2 hours).
Reducing pressure on tissues with the help of special means - plastic splints, anti-decubitus mattresses, pillows, pads, etc.

How to treat deep bedsores 3 and 4 stages

In 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 (clearing the ulcer from pus and necrosis, absorption of the detachable wound with protection from drying out). At stage 3, the pathological process quickly spreads to neighboring areas of the skin, where blood supply is also impaired. At this time, you can not be inactive, the skin can no longer regenerate itself. Removal of dead tissue (necrectomy) must be performed before capillary bleeding occurs.

Then the doctor cleans the bedsores with the help of local antiseptics. In the treatment of such ulcers, necrolytic drugs (Collagenzine, Chymotrypsin, Trypsin), anti-inflammatory drugs (Alfogin, Vulnuzan, Hydrocortisone), tissue repair stimulants (Vinilin, Bepanten, Methyluracil), drugs for normalizing lymph microcirculation (Tribenozid, Pyricarbate) are used.

The fourth stage is characterized by deep necrosis with damage to muscle tissues, tendons and bones. Treatment consists of excising the dead tissue, absorbing the pressure sore, and moisturizing the healing wound. After the cessation of the acute phase of the necrosis process, the doctor raises the question of surgical treatment. Such cleaning of the ulcer is carried out in order 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 the location

Bedsores are formed in bedridden patients due to squeezing of blood vessels and skin, as a result of which blood supply is disturbed and tissue cells die in areas of maximum pressure on the body. So, when lying on your side, ulcers form on the thigh, ankle, knee. If the patient lies on his stomach for a long time, wounds appear on the cheekbones, pubis. When lying on your back, wounds can open on the heels, sacrum, elbows, nape, coccyx, shoulder blades. Pressure sores are cared for and treated depending on the site of formation.

How to treat bedsores on the heels

For the treatment of ulcers on the heels, it is desirable to use special dressings "Komfil" (Denmark), they are glued to the damaged areas of the skin. The bandage has an antiseptic effect and prevents further infection. In case of contamination of the wound or the formation of pus in it, the ulcer is first cleaned and then disinfected with Proteox or similar means - hydrogen peroxide, tea tree oil, chlorhexidine in a spray, a solution of brilliant green.

Bedsores on the buttocks

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

Restoration of blood circulation in places of skin damage.
Assistance to tissues in the rejection of necrosis.
Wound cleansing and application of healing agents.

Pressure ulcers on the buttocks are often treated with medications containing silver. Such funds have antiseptic properties and reduce pain. Creams and ointments containing silver contribute to the rapid healing of wounds. Alcohol-based medicines are often not recommended because they can dry out the skin.

Tailbone

For the treatment of wounds formed on the coccyx, use dressings soaked in a solution of cognac and salt (in the ratio of 30 g of salt to 150 g of cognac). It is better to apply bandages under compress paper, changing it if necessary. Before changing the bandage to a new one, be sure to rinse the bedsores from salt. For wound healing, you can use remedies such as Levosin, sea buckthorn oil, Solkoserin. If the ulcers fester, it is necessary to use antiseptic or antibacterial agents (streptocid powder, boric acid).

Ways to treat 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, which is necessary for tissue restoration. Along with folk remedies and medicines, be sure to use modern remedies to treat ulcers, for example, a convenient antiseptic patch made from the latest materials, or anti-decubitus mattresses.

Medications

External treatment: ointments and creams

For the treatment of wounds, softening ointments should not be used or deaf bandages should be applied that block the access of oxygen. In the initial stages and with 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 with wet necrosis of skin tissues. To alleviate the patient's condition, the use of:

Vishnevsky's ointments;
"Boro-Plus";
Bepanten;
ointment "Autenrita".

Anti-decubitus mattresses

One of the most effective means of preventing the formation of pressure sores is considered to be an anti-decubitus mattress. Such products constantly change the pressure exerted on different parts of the body, by means of frequent inflating and deflating air in special mattress chambers. Alternate change of 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 pressure sores. Almost all folk methods of treatment are based on the use of medicinal plants, due to which the patient may experience an allergic reaction. The relevance of the use of folk remedies depends on the degree of the disease, therefore, before using them, you should consult your doctor about the advisability of such treatment. Here are some alternative medicine methods that help in the fight against pressure ulcers:

Several times a day, lubricate the wounds with fresh lungwort juice.
Scald 1 tablespoon of crushed young elderberry leaves with boiling milk and apply them 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 marigold 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 combine) and mix the gruel with honey (1: 1). Place the mixture on a thin washcloth and apply it to the ulcer.
At night, make a compress with fish or bear oil using a sterile bandage.
To make a wet bed sore dry out faster, sprinkle it with starch once a day.
Systematically tie fresh cabbage leaves to 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 evaluate the likely effectiveness of surgical methods of treatment, and only if the prognosis is positive, one of the methods of treatment is used: free skin grafting, plasty with local tissues, excision of the ulcer with comparison of the edges of the bedsore.

Not always surgical treatment gives the expected results. It happens that the transplanted skin tissue does not take root well on the affected area of the body due to its insufficient blood supply. Early complications after surgery have the form of accumulation of fluid under the skin tissue, divergence of sutures, necrosis of the wound or skin, bleeding. In the future, an ulcer may form, which often leads to a recurrence of the bedsore.

Prevention of bedsores

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

Preventive measures to prevent the occurrence of bedsores should be carried out from the first day of illness or placing the patient in a supine position. As practice shows, if 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 in the development of bedsores, the likelihood of a quick treatment of the pathology decreases. Prevention includes the following measures:

Systematic cleansing of the skin, non-contact drying (without the use of towels or napkins) and disinfection with antiseptics.
Frequent change of bed linen of the patient, straightening of folds on clothes and bed.
Acquisition of a special mattress (anti-decubitus, pneumatic, water, vibration).
Frequent change of position of the patient.
Proper diet and drinking regimen.
Stimulation of the patient's muscle activity (electric underwear, massage).

When the patient's mobility is limited, there are areas of the body on which pathological pressure is exerted. This usually occurs in the area of bony protrusions. In the case of continuous tissue compression for more than two hours, stagnation occurs in the blood vessels, ischemia occurs, and then necrosis. The process of formation of a bedsore begins with the epidermis of the skin, gradually moving to deeper layers. In the initial stages, the bedsore is localized in the thickness of the skin (first and second stages), then deeper layers undergo necrosis - subcutaneous fat (third stage), muscles and bones (fourth stage). Deep bedsores are formed, in the process of their formation connective tissue, walls of blood and lymphatic vessels, muscle fascia, tendons, periosteum are necrotized.

Causes of bleeding from bedsores

Types of bleeding

Bleeding differs in the mechanism of occurrence and in intensity.

According to the mechanism of occurrence

Bleeding occurs when the vascular wall is damaged, the causes of which can be various factors. Allocate:

Acute - due to a violation of the permeability of the walls of blood vessels;
mechanical origin;
Arrosive;
Bleeding due to bleeding disorders;
Artificial (bleeding).

By intensity

The intensity of bleeding directly depends on the size of the damaged vessel and the rate of blood flow in it.

View	Cause
capillary	Damage to the walls of large and small capillaries
Venous	Occurs when the venous wall is damaged
Arterial	When the wall of the artery is ruptured
mixed	In case of damage to capillaries, veins and arteries.

Intense and deadly is arterial bleeding, in which a fatal outcome is possible.

Risk group

There are certain factors that contribute to the occurrence of hemorrhage.

Diseases of the blood system (hemophilia);
Endocrine diseases ();
Insufficient hygiene, crumbs and creases on;
Poor patient care;
Traumatic actions during dressings (strong friction, mechanical damage to the surface of the bedsore).

How to deal with bleeding from a bed sore

When blood appears, it is necessary to assess the intensity of hemorrhage. Stopping methods depend on the nature of the damaged vessel.

Help with arterial bleeding

Help with venous bleeding

The blood from the bedsore is dark in color, the pulsation is not pronounced, the blood loss is severe - these are signs of venous bleeding. With the defeat of large vessels, there is a strong hypovolemia, so you need to respond immediately.

The final stop of blood loss is possible in a hospital, when surgical treatment of the wound is performed with suturing of damaged vessels.

Important! A prerequisite for dressing when stopping blood from a bedsore is a thorough antiseptic treatment of the ulcer in order to prevent re-infection and purulent fusion of blood clots and the vascular wall.

Help with capillary bleeding

If bleeding is observed for a long time, of medium intensity, the wound is filled with clots - this is a sign of capillary arrosive hemorrhage. Most often, it is the capillaries that suffer from purulent fusion, so this type of blood loss is most common.

When a bedsore bleeds, the wound is treated with a solution, necrotic plaque and infected clots are removed. After that, the wound is plugged with a dressing material using hemostatic agents:

Panthenol;
Tannin;
Alum-based medicines;

For shallow bleeding bedsores, cauterizing agents are used in the treatment, such as a solution of brilliant green, calendula tincture.

As a dressing, if the blood loss is insignificant, you can use hydrogel (Hydrosorb), which should be changed as it gets dirty.

If the bedsore bleeds for a long time, tamponade is done with a hemostatic sponge, which gives a good hemostatic effect.

Concomitant general treatment, such as vasoconstrictor drugs, drugs that affect blood clotting, are used only on the recommendation of a doctor. Of all types of hemorrhages, nettle decoction helps, taken orally ½ cup three times a day.

Video

Pressure ulcers, also known as traumatic diphtheria, are painful areas on the body caused by prolonged pressure on these areas. They can be very dangerous and sometimes lead to open wounds that need to be treated. In more serious cases, bedsores require surgery. There are several ways to treat and prevent pressure ulcers.

Steps

Diagnosis of bedsores

Watch for changes in skin color. Carefully inspect the entire body, paying special attention to areas of skin that come into contact with the bed or wheelchair. Grab a mirror or have someone help you examine hard-to-reach areas of your back.

Also check to see if the skin has hardened.

Blood circulation and nutrition of body tissues

Every human body needs to supply oxygen, water and nutrients and to remove waste products from it. These functions are performed by billions of tiny cells that form all tissues. The blood brings the necessary substances to the cells and carries away the waste. Thus, blood circulation is necessary to maintain the life of the cell.

Blood is pumped around the body as a result of the work of the heart. With each heartbeat, blood under pressure rapidly enters the large arteries, which branch many times into smaller arteries and then arterioles(Fig. 1).

Arterioles, dividing, form systems of the smallest and thinnest blood vessels - capillaries, which communicate directly with living cells.

Picture 1

Coming through capillaries, blood flows through thin venules, which, when combined, form veins. The small veins join to form large veins that carry blood back to the heart. For tissue nutrition not only blood circulation is necessary, but also the penetration of nutrients and oxygen contained in it into the cells. Capillaries are responsible for this task. The capillaries are so small that they can only be seen with a strong microscope, and their walls are so thin that oxygen and nutrients can easily pass through them and enter the cell (Fig. 2).

Blood flows through capillaries carrying oxygen and nutrients with it. Oxygen and nutrients (Fig. 1, green arrows) leave the capillary and enter the cells. Waste (Fig. 2, blue arrows) from the cells enters the capillaries and is carried away by the blood. The vital exchange of oxygen, nutrients and waste products takes place as long as the blood moves through the capillaries. We all know that if the heart stops pumping blood, then its movement in all arteries, capillaries and veins will stop and death will occur. But what happens if the heart continues to work, and the blood does not enter only some vessels?

Why do bedsores form? What happens when circulation is blocked?

There are often people with a disorder among patients. This often happens because some of the arteries, like old water pipes, become clogged from the inside. The tissues to which these arteries are connected suffer from lack of nutrition and retention of metabolic products. When blood flow is not restored, these tissues die. If this process occurs in the brain, then the result of this is a stroke, and if in the leg - gangrene.

Partial blockage of the inside of diseased vessels is not the only cause of circulatory disorders. Even healthy blood vessels can be easily blocked. Their soft walls are similar to those shown in Fig. 3 rubber tube. If you put pressure on them, they shrink and blood flow stops. When the pressure is relieved, the vessels dilate again and blood circulation is restored.

Figure 3

The tiny arterioles, capillaries, and venules of the skin cannot be viewed without a microscope, but it can be assumed that when pressure is applied to them, they overlap.

The skin has its usual pink color due to the blood flowing through the vessels.

Take an empty glass and squeeze it hard. Look through the glass at your fingers (fig. 4). Where the fingers press against the sides of the glass, the pink color disappears as the blood is expelled and circulation is stopped.

Figure 4

Now put the glass down. The fingertips will immediately turn pink as the blood flow resumes. What does the violation of blood flow have to do with bedsores? To answer this question, consider the place where bedsores very often appear - the heel.

When we lie on our back, most of the pressure of the foot is on the heel. The whole weight falls on a small surface of the skin, located directly under the bone (Fig. 5).

Place your fingers under the heel of the person lying down. You will feel the heaviness concentrated in this place. This pressure is enough to compress the blood vessels between the heel bone and the skin surface and stop the flow of blood (Fig. 6).

If the heel is in this position for a long time, insufficient blood supply leads to the death of some of the cells, and develops bedsore(Fig. 7).

Reasons for the formation of bedsores

The main reasons for the formation of bedsores are blocking and lack of movement of the patient. The blood flow is mainly blocked by the weight of the body in the area of the bony protrusions, which compress and press the soft tissues against the surface of the bed or chair, thereby blocking the blood vessels.

Sometimes soft tissues are compressed when the patient's body rests against sanitary or medical equipment. Badly placed dressings, splints, catheters, bedpans can contribute to the formation of bedsores. Almost any hard object that presses against the skin can be dangerous if the patient cannot move normally. Items such as buttons, knots in clothing, pins, and other small objects in bed can create areas under the patient's body. strong pressure where blood flow is blocked.

Pressure as well as shear forces are the most important reasons the fact that the blood circulation is blocked, and as a result, bedsores are formed. Damaged skin and soft tissues are more than healthy, at risk of pressure ulcers in violation of normal blood circulation. Many causes can lead to skin damage.

When the outer layers of the skin are scratched or frayed, an abrasion occurs. Usually this phenomenon is accompanied by itching and scratching. Patients whose skin itches for any reason can also comb it. Sometimes the abrasion is so small that it is barely visible, but it can be dangerous because the surface of the skin is already damaged. You have all seen what happens to children's knees when they fall. The same thing happens to the patient in bed when he rests his elbows and heels on the surface of the bed, trying to move. He slides, rubbing his elbows and heels against the sheet in such a way that it turns out, as it were, a “burn” from friction. This also happens when an immobile patient is pulled across the bed, with the skin rubbing against the sheet. If the sheet is made of coarse linen and starched, then the likelihood of getting a "burn" from friction is even greater.

The same movements that cause a friction “burn” can create shear forces that can damage the soft tissue under the skin if the tension is so strong that it tears the tissue.

Ordinary adhesive tape can be dangerous for patients' skin. When applied unevenly, the patch will stretch or compress the skin, forming folds. When the patch is removed from the surface of the skin, the top layer of the skin is torn off, making it thin and easily damaged. The skin of some patients is hypersensitive to the patch and thus may experience an allergic reaction.

Skin that is too dry can peel, peel, or crack, breaking the integrity of the inner layers. Bacteria can enter through the cracks and multiply on the surface of the skin and inside tissues.

Skin that is too wet also has less resistance to damage. Skin that is wet for too long becomes swollen, soft, and easily injured by scratching or rubbing. Patients who cannot control activities Bladder or bowel, need extra nursing care. It is important to prevent prolonged wetting of the skin, ensuring the change of clean bed linen. Profuse sweating in hot weather or when elevated temperature body is also a problem that needs to be resolved. Discharges from open wounds, sometimes from the bedsores themselves, can soften and inflame the surrounding skin.

Infection of the skin and soft tissues leads to their damage and affects deeper tissues. Dirty, too dry or too wet skin is especially prone to infection.

Medicines applied to the skin can often cause damage to the skin. Some of them, being strong chemicals, directly harm the skin; others cause an allergic reaction. Even soap used to wash the body can cause skin irritation and inflammation if it is too rough or not completely rinsed off.

Poor nutrition is detrimental to the health of any person. If the patient does not receive enough water, proteins and other necessary elements, including certain vitamins and minerals, then his tissues will not be able to resist the occurrence of damage and recover from them.

The disease itself, whether acute or chronic, weakens the patient. Some diseases impair tissue resistance, make it difficult to receive and assimilate water and food, and also disrupt blood circulation and the removal of metabolic products.