Pressure ulcers - Treatment at home - Prevention of pressure ulcers. How to treat bedsores (superficial and deep) in bedridden patients on the buttocks, coccyx, heel and back at home Bedsores begin what to do

Bedsores in bedridden patients, how to treat this problem, because it can cause very serious complications? Bedsores occur in bedridden people due to the fact that they do not move, their body is too weak, and the skin does not receive the necessary care.

Most often, bedsores form in those parts of the body where bones protrude or where a significant mass of the human body presses on a small area of ​​\u200b\u200bthe skin, which leads to impaired blood circulation. Bedsores in bedridden patients occur due to the fact that the nutrition of the tissues stops and they gradually begin to die. A similar condition can be prevented by a layer of subcutaneous fat that every person has, but in bedridden people it will become thinner over time and will no longer perform this function.

In addition, severe bedsores occur on those parts of the body that are at least slightly in contact with some surface. If a sick person constantly lies on his back, then bedsores eventually begin to form on the shoulder blades, heels, elbows, and sacrum. If a person lies on his stomach, then this problem occurs on the pubis, on the cheekbones and in the ilium. During lying on your side, tissues begin to die off at the hips, ankles, and side of the knee.

As numerous practice shows, bedsores in most cases occur in elderly people, whose body is more depleted. Also affects the development of the problem excess weight or that the person is too thin. Among the factors that provoke the appearance of bedsores include:

• diabetes;
• problems with heart;
• defecation and urination that the patient cannot independently control;
• poor nutrition of a sick person.

Sometimes bedsores can occur after a few days, and therefore you need to constantly examine the areas of the body where they most often occur. If there is a similar problem, then it is worth immediately starting treatment.

If a person is conscious and has not lost sensitivity, then even before a bedsore has begun to form, the patient may complain of numbness of one or another part of the body, as well as a slight tingling in this area. Pressure ulcers have four stages of development.

First stage. The skin becomes red and the redness does not disappear with time. There may be compaction. In some cases, there is swelling, but the integrity of the skin is completely intact. It is possible to treat bedsores at this stage of development with the help of antibacterial and special wound-healing drugs.

Second stage. On the skin, you can notice a strong seal, erosion and peeling, there is a violation of integrity. Then this process begins to spread to the subcutaneous tissue. At this stage, treating the problem is more difficult, but quite realistic.

Third stage. Deeper layers of soft tissue are affected, which leads to necrosis and complete death. In some cases, fluid may begin to leak from the wounds. The third stage is of course treated, but the result of this treatment is not always the same as expected.

Fourth stage. The damage is very strong, there is a necrotic change in the soft tissue: tendons and even bones can be seen in the cavities. Bedsores of the fourth stage are very dangerous, because they can cause severe intoxication or blood poisoning. Although bedsores are considered dangerous at any stage of development, it is better to prevent their occurrence.

The method of treatment and drugs are selected depending on what stage of the development of the problem and the severity is observed in a bedridden patient. If we talk about a severe degree, then it is not treated with a conservative method, only surgery will help. The treatment is based on actions that are aimed at restoring full blood circulation in the damaged area of ​​the body, while removing necrotic masses, and wounds heal. So, there are several principles for treating the problem:

• whatever the stage, everything possible must be done so that the problem does not continue to progress;
• in no case should you use deaf bandages or ointments of a softening type that will not allow oxygen to enter the tissues;
• if, during the development of dry necrosis, wet dressings are applied, then weeping bedsores begin to appear, and soft tissues are damaged several times faster and die;
• if there are weeping wounds with the release of pus, then it is imperative to apply an antibacterial ointment or other antibacterial remedy for bedsores;
• additional antibacterial therapy is necessarily carried out, during which the sensitivity of dangerous microflora and the individual characteristics of the problem are taken into account.

When the first stage of pressure sore development is observed, the patient must be turned over every two hours, or even more often. In addition, it is very important to eliminate constant pressure on the skin or to minimize it. For this purpose, you can use special rubber circles, mattresses or pillows. At the same time, you need to use anti-decubitus medications that will not allow the problem to develop further.

When the second stage is observed, then you need to use a remedy for bedsores, which would help the skin recover faster. If the inflammatory process is clearly expressed, and the bedsore continues to develop, then it would be reasonable to use an antibacterial agent. Quite often, you need to wash the wound with hydrogen peroxide, with the help of scissors, the damaged area is cleared of the epithelium, which has already died. After examining the patient by a specialist, special antiseptic dressings can be applied to bedsores.

The third stage of bedsores already needs to be treated with surgery. It is very important to thoroughly clean the wound from pus and necrotic masses. You should not count on the fact that the body will reject the tissues on its own, because in this case the lesion begins to move to neighboring tissues and parts of the body. After the surgeon removes necrotic areas and pus, remedies for the treatment of bedsores and complex therapy are prescribed. In this case, different types are used antiseptics, antibacterial drugs, sanitation of a decubitus ulcer is carried out.

The fourth stage is the most dangerous for human life, after all. In this case, the joints, bones, muscles, tendons are affected. In this case, the only way to treat is the excision of dead tissue, then the absorption of the discharge occurs. It is very important to do everything possible so that the ulcer does not dry out during the healing process.

Folk remedies for the treatment of bedsores show a good result, and therefore they can be used in practice. The following are considered the most effective ways to treat bedsores.

If the wound is weeping, then it can be dried a little using potato starch, this remedy is much better than powder, because it does not form crusts, and the skin can breathe normally.

Under those places where bedsores begin to form, you need to put a small pillowcase, which is pre-filled with flax seeds or millet.

Melt a small amount of beeswax in a water bath, add a little refined olive or ordinary vegetable oil to it. Mix thoroughly, you will get a fairly soft mass, which may resemble Vaseline in appearance. The places where bedsores begin to appear are lubricated with this remedy.

At night, a bandage soaked in Kalanchoe juice or even a whole sheet, which is cut lengthwise, should be applied to the damaged areas.

The problem at the first and second stages of development should be wiped a couple of times a day with fir, sea buckthorn or tea tree oil.

Prepare fresh elderberry leaves, then scald them with boiling water or hot milk. Such leaves are applied to bedsores twice a day.

In order to treat wounds, you can prepare calendula ointment at home. With this remedy, bedsores should be treated 2-3 times a day. To prepare this remedy for the treatment of bedsores, you need to take a tablespoon of pre-crushed calendula flowers and then mix them thoroughly with petroleum jelly (50 grams).

Before you start applying the ointment to the wound of a bedridden patient, it is imperative to wipe the damaged area of ​​the bedsores with saline. In addition, you can wipe and camphor alcohol. Some time ago, in order to kill microbes, various kinds of ion-exchange agents were used, but it is better to use a solution and camphor alcohol, because they do not kill leukocytes and do not reduce the ability of cells to resist pathogenic bacteria.

As a remedy that dries the wounds well, you can use a special powder - Xeroform. In addition, you can use Shestakovsky's Balm. These medicines are considered the best and dry well weeping bedsores. If we talk about Shestakovsky's Balm, then before use it warms up under hot water, then applied to the wound and a sterile gauze dressing must be applied on top.

In order to put in order the blood circulation in the affected area of ​​the body and nourish the soft tissues with oxygen, you can use a special Actovegin ointment. A very good analogue is considered another medicine - Solcoseryl. With the help of these tools, you can significantly speed up the process of recovery and regeneration of the affected areas of the skin and soft tissues. Quite often, experts prescribe medications based on panthenol, Bepanthen and D-panthenol, which help the patient's skin to recover.

An effective remedy for the problem is Olazol spray, which treats bedsores well. Its composition contains sea ​​buckthorn oil, boric acid, benzocaine, chloramphenicol. Doctors recommend using the spray even if the wounds contain pus.

Of course, such bedsores must be thoroughly rinsed with hydrogen peroxide and cleaned of pus before applying the spray.

The only drawback of the spray is that it stains clothes and bed linen, just like pure sea buckthorn oil.

How to properly care for a bedridden patient?

There are special care rules that are very important to follow so that there are no problems in the future, because everyone knows how dangerous bedsores are and that this can even lead to lethal outcome person.

The skin of a lying person must be kept as clean as possible. However, it should not be too dry or wet. To achieve this, it is necessary to carry out air baths from time to time.

When you wash a person, you can not rub the skin too much, refuse to use antibacterial soap. Use a soft sponge and the simplest soap.

If the skin is too dry, then it needs to be moisturized with a baby cream.

In the event that the skin is very wet, it is necessary to immediately dry it using a solution of potassium permanganate, zinc ointment or brilliant green. Zinc ointment can only be used in the first stage of the formation of bedsores.

If you find redness, then you should immediately massage using a dry towel or terry mitten. Massage should be done so that the damaged areas of the skin are not affected.

In the event that a sick lying person sweats very much or the body temperature is elevated, then instead of water, use a weak solution of vinegar and wipe the patient with it.

Bedsores are a serious problem, the formation of which in no case should be allowed, because in this way not only the human body weakens faster, but also poisoning occurs due to tissue necrosis. All this can cause numerous health problems and a person can even die.

Pressure sores are areas of necrosis of the skin and soft tissues that occur in patients with limited mobility with improper care.

With timely detection and proper treatment, they do not pose a serious threat to health and life. In advanced cases, the damage turns into deep festering wounds, which can cause severe complications and death of the patient.

From this article, you will learn about the rules for caring for patients with bedsores, how to treat them at home, as well as modern techniques that can effectively deal with these injuries.

Reasons for the development of bedsores

The key factor is the pressure of the hard surface on which the patient is located on the protruding areas of the body. Most often, injuries occur in such areas as the sacrum, thoracic spine, shoulder blades, back of the head, heels (in situations where a person lies on his back) - it is in these areas that there is a very small layer of muscles and adipose tissue between bone tissue and skin.

When the patient lies on his side, the greatest pressure falls on the region of the greater trochanter of the femur, the ilium. In the position on the stomach, tissues in the areas of the protruding iliac bones and chest suffer. In sedentary patients, the risk of injury is higher in the buttocks, sacrum, heels, fingers, feet, and shoulder blades.

Why does pressure cause tissue damage?

• The blood vessels are pinched, providing the delivery of oxygen and nutrients to the cells of the skin and muscles. Oxygen starvation (hypoxia) and nutritional deficiency leads to inhibition of cell vital activity and its death;
• Nerve fibers that regulate tissue metabolism are compressed: which, in turn, negatively affects cell viability
• The lymphatic vessels responsible for removing the products of cell vital activity from the intercellular space are squeezed, toxins and poisons begin to accumulate, reducing the viability of cells and leading them to death as a result of poisoning. Also, the lymphatic system is responsible for the removal (utilization) of dead cells: squeezing the lymphatic vessels leads to the accumulation of dead cells in the tissues - and this creates favorable conditions for the development of infection

Among the most important reasons for the development of bedsores in sedentary patients is the lack of microvibration in the patient's body. This is the energy that is produced by muscle cells, even when the body is at rest (the so-called background activity of the body). The famous physicist V.A. Fedorov in the book “Resources of the body. Immunity, health and longevity” speaks of microvibration as a resource that is as important for life support as air, water, food and heat. The energy of microvibration is necessary for the flow of all physiological and biochemical processes in the body, ensuring metabolic processes in each cell.

Maintaining the level of microvibration at the level necessary to ensure the full functioning of the body is possible only thanks to constant physical activity. Therefore, sports, walking, swimming, exercise are so important for maintaining health. Hypodynamia, a sedentary lifestyle lead to the impoverishment of the body with this valuable resource. If, however, due to some reasons - illness, injury - a person is chained to a bed or a wheelchair, the deepest deficiency of microvibration energy in the body is almost inevitable. How does this situation contribute to the development of bedsores?

1. The blood supply to tissues (including skin and muscles) suffers, which leads to an even greater depletion of cells in oxygen and nutrients;
2. Due to the inhibition of the lymphatic system, liver and kidneys, the removal of processed substances from the intercellular space is disrupted, which leads to their poisoning and accelerates the process of death. Damaged and dead cells are also not utilized, but accumulate in tissues, creating favorable conditions for the development of infectious processes.
3. Due to disruption of the lymphatic system, immunity suffers, the number of immune cells that detect and destroy foreign microbes decreases. It also increases the body's susceptibility to infections and increases the risk of developing purulent complications and blood poisoning (sepsis).

In addition, the longer a person is forced to lead a sedentary lifestyle, the less muscle mass(This process is called atrophy - the loss of muscle tissue due to disease or severe limitation of movement). Therefore, even the background muscle activity gradually decreases, providing the body with a minimum level of microvibration at rest. Also V.A. Fedorov notes that a pronounced decrease in the microvibration background is observed in the body of patients who have plaster casts applied: rigid fixation leaves no chance for even minimal movements, therefore muscle atrophy (and, consequently, an increase in resource deficit) occurs faster.

In addition to the main causes - pressure on tissues and a decrease in the level of microvibration in the body, pressure ulcers are also caused by factors such as friction, which contributes to mechanical damage and desquamation of skin cells, and shift (displacement) of deeper tissues relative to the skin, which leads to vascular ruptures. .

Also, the risk of skin damage increases with high humidity, which contributes to the swelling of the skin, increased friction. Especially high is the likelihood of their occurrence with incontinence of feces and urine containing substances that irritate the skin.

Stages of development of bedsores

Bedsores can appear on the patient's body after two hours of lying in one position. Pressing the tissues of the body with the weight of the body to the surface of the bed causes their poor nutrition and is the cause of disruption of their normal vital processes up to necrosis.

Negative processes proceed sequentially from slight redness to serious festering wounds. Experts have divided the transformations that occur with tissues in pressure sores into four stages:

1. The first degree is characterized by redness and roughness of the skin in places of greatest pressure, which are often accompanied by slight swelling. At the same time, structural skin disorders are not observed. By starting the treatment of bedsores in the elderly at the first stage, it is easiest to achieve a positive effect of therapy. No complicated healing procedures are not required.
2. The second degree of development of bedsores is indicated by a lesion of the upper layer of the epidermis, which provokes a violation of its integrity. In addition, at this stage, the processes of exfoliation and erosion begin, which concern the subcutaneous tissue.
3. The main characteristic of the third degree is the onset of serious difficulties in the treatment of bedsores. At this stage of development, completely dead skin areas are observed, under which fatty and muscle tissue. Quite often, this stage of bedsores is accompanied by purulent filling of the wound.
4. The extreme degree of development of bedsores is manifested by the involvement in the process of destruction of tendons and bone tissue. The resulting wounds are very deep, the skin and adipose tissue is actually completely destroyed by necrotic processes. All wounds of pressure ulcers of the fourth degree are filled with pus. Treatment mainly requires surgery.

Complications

Insufficient care for bedridden patients, as well as not proper treatment developing bedsores, can lead to very serious consequences. These include:

• circulatory problems throughout the body,
• gangrene
• sepsis,
• skin cancer,
• osteomyelitis.

All these consequences are extreme cases. But the likelihood of their development must be remembered and every effort must be made to prevent the development of bedsores or overcome them in the early stages.

Where to start treatment?

Preventive measures include:

1. Changing the position of the patient's body every 1.5-2 hours - this measure avoids prolonged squeezing of the same part of the body, which is the main cause of bedsores. If in any area there are already signs of the initial stage of ulceration (red, persistent spot, maceration), the patient should not be placed on this area.
2. Protein-rich nutrition - protein is the main building material of animal tissues. Its deficiency leads to disruption of many processes, including regenerative and immune ones. Affected tissues are not restored, resulting in bedsores.
3. Compliance with hygiene measures - the skin, constantly in a humid environment, gets wet. Macerations occur. To avoid this, it is necessary to wash the patient immediately after defecation or urination. It is also necessary to wipe the patient's body several times a day with his excessive sweating.

Above were three fundamental principles, without which it is impossible to treat pressure ulcers at home or prevent them. However, this is not enough for recovery in severe trophic disorders. In such situations, to stimulate regenerative processes and fight the infection that has joined, apply medications.

Treatment of bedsores 1 and 2 stages

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

1. Assessment of the state of health in order to eliminate as much as possible the internal and external risk factors for the development and progression of bedsores.
2. Treatment of all concomitant syndromes and pathologies that aggravate bedsores.
3. Detoxification of the body - blood transfusion, reopoliglyukin, gemodez.
4. Immunostimulating therapy - vitamins, immunomodulators and immunostimulants.
5. Elimination of continuous pressure. It is recommended to turn bedridden patients from one position to another every 2 hours.
6. Reducing the force of pressure on the tissues and ensuring discontinuity in pressure.

This event involves the use of special tools:

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

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

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

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

Local treatment of places of emerging bedsores requires a competent approach, since incorrect actions can provoke further development of necrosis.

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

The modern scheme of local treatment of bedsores includes:

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

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

1. Toilet of the formed wound with removal of the dead epidermis from the blisters. Ideally, it is carried out in a dressing room: cutting the dead epithelium with surgical scissors, washing the wound with saline, hydrogen peroxide.
2. Observation of pressure sores in dynamics with an assessment of the development of the process.
3. Antibacterial therapy in case of progression of bedsores and the onset of an inflammatory reaction.
4. Applying antiseptic dressings to bedsores devoid of epidermis, after consulting with a doctor, which dressing is best used to treat this wound surface, taking into account the stage (presence, absence of necrosis), the area of ​​the lesion: transparent film dressings with an adhesive surface (Tegaderm, Gyrofilm, Kosmopor, Blisterfilm), wafer hydrocolloid (Hydrocoll, Duoderm) or hydrogel (Hydrosorb) dressings, semi-permeable dressings based on hydropolymer (Tielle), spongy dressings with a top layer of breathable polyurethane, which prevents the penetration of bacteria and fluid (Pemaf).

Treatment of bedsores 3 and 4 stages

Treatment of bedsores of the third and especially the fourth stage should correspond to the treatment of purulent wounds. Purulent wounds are difficult to treat, but for many years field surgery developed a standard treatment algorithm. Of course, additions and improvements to treatment are regularly made, but the goal and objectives of treatment have remained unchanged.

In the first phase when the bedsore wound is filled with pus and necrotic tissues, one should:

• ensure the outflow of pus from the wound;
• remove swelling;
• suppress microbial contamination of the wound.

Revision of the wound, cleaning the edges of necrotic tissues is performed in the conditions of the surgical department. For the outflow of pus, drainage tubes are made and they are regularly inspected.
Passive drainage can be done at home:

1. To do this, the wound is filled with special napkins, impregnated with compounds that promote the outflow of pus. Change napkins periodically. As napkins, you can use ordinary bandages, the edges of which do not fall apart into threads. Solutions and ointments are used to impregnate napkins.

Outdated medicines: hypertonic solutions 10% sodium chloride, 3-5% boric acid solution and others. At present, the use of such solutions is limited due to the low suction power of 4 to 8 hours.

Hydrophobic ointments (liniments, emulsions) on a vaseline basis (liniment according to Vishnevsky, synthomycin emulsion, tetracycline, neomycin and others). Their disadvantage is that they do not absorb pus, the antibiotics in their composition do not work in full force.

Modern medicines: hydrophilic (water-soluble ointments) - Levomekol, Levosin and other water-soluble formulations. They well remove pus from the wound, for about 20-24 hours. Attention! Use hydrophilic ointments only if there is pus in the wound; in another situation (no pus), these ointments are not effective.

1. Enzyme therapy is the next method of surgical treatment of purulent wounds (therapy with pus-removing enzymes).

Proteolytic enzymes (trypsin, chymotrypsin, others). To enhance their action, a combination of these or other enzymes with ointments is used, for example, a combination of enzymes and Iruksol ointment.

1. Antiseptic solutions for external use. furatsilin, hydrogen peroxide, boric acid (currently used to a limited extent). Modern formulations are shown for use - 0.5% iodopyrone solution, 1% dioxidine solution.
2. Physical methods of treatment. Traditional methods are used (UHF, ultrasonic cavitation, oxygenation, vibrophoning, laser therapy and other similar methods)

In the second phase, after cleaning the bedsore from pus, they achieve the appearance of healthy tissues. A healthy scab is a thin layer of dried granulations. A purulent scab is a thick crust of dried pus. Recovery under a purulent scab is impossible!
When healthy granulations appear, treatment is prescribed:

• relieving inflammation;
• protecting healthy granulations (healthy tissues) from accidental damage;
• stimulating tissue repair processes.

To relieve inflammation use:

• ointments (hydrophobic ointments - methyluracil, troxevasin, hydrophilic ointments - bepanten and others);
• herbal preparations - aloe juice, Kalanchoe, oil (sea buckthorn, rosehip);
• laser therapy with a therapeutic effect of stimulating tissue epithelialization.

Into the third phase, achieve regeneration and scarring of the wound process. They use modern drugs that stimulate epithelialization and scarring of tissues, for example: EDAS-201M, vitamins, immunostimulants. At all phases of pathogenesis, the use of antibacterial agents is allowed, intravenous drip administration of metrogil solution, antibiotics is recommended.

The resulting defects and the consequences of bedsores are treated in a hospital.

How to 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 change the position of a bedridden patient - be sure to turn it from side to side, if it is possible to raise the upper body, then this will be excellent;
• 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 the primary signs of the 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.

Features of treatment from the location of bedsores

The therapeutic result is increased if the following treatment rules are observed, taking into account the localization of the necrotic process.

1. Bedsores on the heels - wedge-shaped pillows, skin protection with a colloidal dressing with Comifil for 2-5 days.
2. Bedsores on the buttocks - treatment and prevention includes the use and regular change of diapers, special buttock circles. Preventive massage of the gluteal zone in the absence of signs of necrotization can be deeper, since this area has a fairly pronounced muscle layer.
3. Bedsores on the coccyx - the minimum muscle layer causes the rapid spread of necrosis to the bone tissue, so this area is treated with antiseptics in the first place.

Mattresses and pillows against bedsores

Anti-decubitus mattress serves to activate blood circulation in the area prone to the formation of pressure sores. Due to the constant change of pressure points, the body of a bedridden patient is massaged. They produce balloon and cellular mattresses.

When buying mesh models, keep in mind that they are not designed for people weighing more than 120 kg. Large patients need a balloon-type mattress. Microperforation of these mattresses promotes additional air flow.

On sale you can find different types of pillows for the treatment of bedridden patients:

1. Foam pillows are inexpensive. However, they gradually lose their original elasticity. This somewhat reduces their therapeutic effect.
2. To prevent the formation of bedsores, you can use a gel pillow. Please note that the gel hardens at low temperatures.

Folk remedies

Folk remedies cleanse wounds and promote the formation of new tissues. However, in this case, you need to consider the likelihood of an allergic reaction. Before contacting folk medicine, contact your doctor.

There are several simple and effective ways to treat ulcers at home:

1. Infusion of oak bark- applied at the stain stage. To prepare the product, you need to take a tablespoon of raw materials, pour it with a glass (200-250 ml) of boiling water and leave for 2-3 hours. After that, the medicine is filtered, poured onto a sponge and wiped with the location of the bedsore during the general hygienic treatment of the body. The drug has a tanning effect, forms a tannin film on the surface of the wound, and reduces the intensity of inflammation.
2. Sea buckthorn oil- an excellent regenerating agent, which, however, does not have the properties of an antiseptic. In the initial stages of a bedsore, it can be used as the only treatment. To do this, the surface of the focus is treated with the drug twice a day. With deep bedsores, their tamponade with napkins soaked in sea buckthorn oil is possible. Dressing and replacement of napkins is made 1 time in 1-2 days. Oil is not suitable for the treatment of purulent processes.
3. Onion. You need to take two medium-sized onions, finely chop and fry in vegetable oil until golden brown. Then the oil is filtered, beeswax or a church candle (1 piece) is added to it, 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.
4. 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.
5. Field chamomile infusion- prepared and applied in the same way as a decoction of oak bark. Possesses strong anti-inflammatory and antibacterial action. It is used to treat the skin and wash wound surfaces. It can be used indefinitely, however, the average frequency of treatment of bedsores is 2 times per day.
6. 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.

Prevention

In order to prevent the occurrence of pathology in patients who stay in a sitting or lying position for a long time, it is necessary to carry out the prevention of bedsores in a timely manner. Experts recommend using special cellular (dynamic) mattresses.

They are effective because:

• They guarantee a uniform distribution of the patient's mass over the surface, adapt to the contours of the body.
• Provide free blood circulation throughout the skin. "Honeycombs" are constantly moving, contributing to normal blood flow.
• They help to neutralize the resulting foci of rejection (in 9 out of 10 cases).

A massage (occipital) pillow will help prevent pathology - it “remembers” the contours of the neck and shoulders. The rectal pillow will provide a comfortable stay of the individual in a sitting or lying position.

Tip: When purchasing a mattress, take into account the weight of the patient so that there is no “sagging effect”. This can lead to the disappearance of the therapeutic and prophylactic effect of the accessory.

You have learned how to treat bedsores depending on the stage of the disease, the location, which pharmaceutical preparations and folk remedies help to cope with the problem that has arisen, how to smear weeping, dry and purulent wounds in the elderly, as well as who is at risk of the disease and what to do for prevention. The information received was supported by photos and videos.

Prolonged forced stay in bed, weakening of the body and insufficient skin care lead to the fact that bedsores occur in bedridden patients.

How to treat the resulting tissue damage, and what methods are there to prevent bedsores?

Where and why do bedsores occur?

Most often, bedsores form in the area of ​​​​the protrusion of the bones, where a significant body weight of a person puts pressure on a small area of ​​\u200b\u200bthe skin, thereby disrupting its blood supply. The nutrition of tissues is disturbed and their death occurs - a bedsore. Congestive changes can be prevented by the subcutaneous fat layer, but in bedridden patients it gradually becomes thinner.

The formation of pressure sores are subject to those parts of the body that are in contact with the surface. If the patient lies on his back - these are the shoulder blades, elbows, sacrum, heels. Prolonged position on the stomach leads to the formation of bedsores in the pubis, ilium, cheekbones. With prolonged lying on your side - on the hips, sides of the knees and ankles.

Most often, bedsores occur in elderly malnourished people, their appearance is also facilitated by excess weight or, conversely, excessive thinness. Uncontrolled defecation and urination, diabetes mellitus, heart disease, unbalanced nutrition of the patient are additional risk factors.

In some cases, the formation of a bedsore occurs in just a couple of days. Therefore, potentially dangerous areas must be inspected daily and, if changes are detected, urgent action should be taken.

A patient who is conscious and whose sensitivity of certain parts of the body is not impaired, even before the formation of a bedsore, may complain of tingling and numbness in places where the development of the disease is most likely.

Bedsores in bedridden patients have 4 stages of development:

• I stage. Persistent reddening of the skin, thickening is possible, sometimes swelling is present, while the skin is not broken. This stage is successfully treated with antibacterial and wound healing drugs.
• II stage. The upper layer of the epidermis is affected, its integrity is violated, delamination and erosion occur. The process extends to the subcutaneous tissue.
• III stage. Deep damage to the subcutaneous layer, which is accompanied by irreversible necrosis (death) of the tissue, sometimes with liquid discharge from the wound. Poorly treatable.
• IV stage. Excessive damage and necrotic changes in soft tissues (tendons and bone tissues are visible in the resulting cavities), which can lead to severe intoxication of the body and blood poisoning.

Methods of treatment, as well as the choice of drugs, will vary depending on the severity and severity of the pathological process. Severe bedsores are practically intractable conservative treatment and require surgical intervention.

The main therapy is aimed at restoring normal blood circulation at the site of injury, removing necrotic masses and wound healing.

Principles of treatment:

• At any stage, they try as much as possible to prevent the progression of the bedsore.
• Do not use deaf bandages and softening ointments that prevent the access of oxygen.
• In dry necrosis, the application of wet dressings can provoke wet necrosis and tissue death.
• With purulent weeping wounds, apply antibacterial ointments.
• Additional antibacterial therapy is carried out taking into account individual characteristics and sensitivity of pathogenic microflora.

In the first stage of bedsores, when there is only redness and thickening of the patient's skin, it is recommended to turn it over at least once every 2 hours. It is necessary to eliminate the continuous pressure on the skin or reduce its strength. To do this, use rubber circles, special (or self-made) pillows and mattresses. Along the way, they treat diseases that contribute to the formation of bedsores.

When damage is already visible on the skin and the second stage begins, measures are needed to promote the regeneration of the epidermis. If the bedsore progresses and there are signs of inflammation, it is advisable to use antibacterial agents. The wound must be regularly washed with hydrogen peroxide or saline and cleaned of dead epithelium with scissors. After consulting a doctor, special antiseptic dressings can be applied to the bedsore.

Pressure sores of the 3rd degree require surgical cleansing of the wound from purulent contents and necrosis. It cannot be hoped that the rejection of dead tissues will occur on its own. In this case, in a very short time, the process spreads to neighboring tissues. After the surgeon cuts off the areas of necrosis and opens the purulent cavities, complex therapy is prescribed using local antiseptics, antibacterial drugs, rehabilitation of decubitus ulcers.

The fourth stage is characterized by the presence of deep necrosis, muscles, tendons, joints and bones are already involved in the process. Treatment involves excising the necrosis, absorbing the discharge, and preventing the healing ulcer from drying out.

Ointment from bedsores for bedridden patients

1. Levomekol. The active basis of the ointment is the antibiotic chloramphenicol and the wound healing component - methyluracil. The ointment has antibacterial properties and promotes wound healing. Levomekol is used for bedsores in the purulent-necrotic phase.
2. Levosin. In addition to chloramphenicol and methyluracil, the composition includes sulfadimethoxine and a local anesthetic trimekain. Due to which the ointment has a high hydration activity, cleanses the formed ulcers from pus, necrotic masses and heals. The drug is used daily, loosely filling the affected surface with it, followed by dressing.
3. The cream from bedsores Argosulfan, thanks to the antibiotic sulfathiazole and silver ions, inhibits the growth and reproduction of the bacterial flora. The cream rarely causes allergic reactions, has an analgesic effect, moisturizes the wound and accelerates its healing. Argosulfan is applied to the entire surface of the cleaned wound three times a day, the course of treatment can last up to two months. Cream Dermazin and Sulfargin have a similar effect.
4. Ointment from bedsores Iruksol helps to cleanse the wound and prevents infection from entering it. Before application, exfoliated necrotic masses must be removed from the wound with tweezers or by washing with saline, while drying the surface is not necessary. Applications with ointment are done 1 time (less often 2 times) a day for 6-10 days until the wound becomes clean.

Another remedy for bedsores

Before using the ointment, pre-treatment of bedsores with saline or camphor alcohol is mandatory. Previously, ion-exchange drugs were often used for these purposes: chlorhexidine, iodinol, and others. Recently, there is an opinion that they kill leukocytes and reduce the resistance of cells to bacteria.

As a drying remedy for bedsores for bedridden patients, Xeroform powder is used. A lot of good reviews about Vinylin (otherwise Shestakovsky's Balm). Before use, the bottle with Vinylin is heated under running hot water, and then applied to the wound surface. A sterile gauze pad must be applied over the wound.

Actovegin ointment and its analogue Solcoseryl help to improve local blood circulation and oxygen supply to tissues. These ointments significantly increase the energy resources of cells and accelerate the healing of ulcers. The regenerative effect is also exerted by ointments, which include panthenol (Bepanten, D-panthenol).

Spray from bedsores Olazol, the active basis of which is sea buckthorn oil, levomycetin, boric acid and benzocaine, can even be applied to purulent wounds washed with hydrogen peroxide. A significant drawback - it stains things too much, like sea buckthorn oil.

Rules for caring for bedridden patients

• The patient's skin must always be kept clean. It should not be wet or dry; air baths are organized for this.
• When using the toilet, do not rub your skin or use antibacterial soap. It is best to use plain soap and a natural sponge.
• If the skin is overdried, it is moisturized with a baby cream.
• Too wet skin is dried with a weak solution of potassium permanganate, a solution of brilliant green or zinc ointment. Zinc ointment is relevant only in the first stage of the disease.
• If redness appears, massage with a dry towel or terry mittens. Just do it without affecting the damaged skin.
• With increased sweating, as well as at a temperature, instead of water for wiping the patient, it is better to use weak solution vinegar.

Prevention of bedsores in bedridden patients.

The formation of bedsores occurs quite quickly, the death of cells can begin in just a few days. Despite the continuous search for new means to combat this disease, treatment causes many problems and is not always effective. Therefore, the prevention of the occurrence of bedsores is of great importance and should be carried out constantly.

Preventive actions:

• If the patient's condition allows, it is necessary to turn it several times a day.
• It is necessary to ensure that there are no folds, buttons and crumbs on the patient's personal and bed linen, as they represent a potential hazard.
• Bed linen should be clean; if dirty, it cannot let air through and allow the skin to breathe.
• For bedridden patients, it is recommended to place a rubber circle against bedsores under the sacrum, so that the sacrum is above the opening of the circle.
• The skin in places of constant contact with the bed should be wiped daily with camphor alcohol, vodka or other disinfectant solution.
• Wash the places of softening and maceration with cold water, wipe with alcohol, and then powder.

Bedsore mattresses and pillows

It is very difficult to care for bedridden and disabled people, and if the patient cannot roll over on his own, it is also physically difficult. It greatly facilitates the care of a patient with a bed sore mattress, which you can buy in an online store or, after ordering, in a pharmacy. It not only prevents the appearance of bedsores, but also provides the patient with the most comfortable conditions.

The anti-decubitus mattress helps to activate blood circulation in areas of possible necrosis, exerting a massage effect on the tissues due to the alternating change of pressure points. It can be balloon and cellular. The principle of operation for both types is the same - air is alternately injected into the cells or tubes (cylinders), with an interval of approximately 6 minutes, into even and odd elements.

Cellular mattresses are designed for patients with low weight, no more than 120 kg. They are more suitable for the prevention of pressure sores and the treatment of the first and second stages of the process. If the body weight of a bedridden patient exceeds 100 kg, and pressure sores have already reached 3-4 degrees, it is better to choose a balloon anti-decubitus system. The unique laser microperforation of the surface of the balloon mattress provides additional air flow and prevents body sweating.

A balloon mattress from bedsores will cost more. However, comparing the cost of the mattress with the possible material costs for medical and surgery, you will come to the conclusion that the amount is quite acceptable.

A bed sore pillow also helps to reduce pressure on the body of a bedridden patient. She may be:

• foam rubber is the most economical option, but over time it loses its elasticity and the level of protection against bedsores is significantly reduced;
• gel - used for prevention, at low temperatures it can harden;
• air - suitable for both prevention and treatment of bedsores.

To combat bedsores in the pharmacy assortment, there are special patches with a specific hydrocolloid structure. The pressure sore patch accelerates healing several times and promotes cell regeneration. The gel mass absorbs exudate, provides moist healing and, depending on the composition, relieves pain, and the semi-impermeable protective film regulates evaporation.

The patch is applied to a wound previously treated with saline or chlorhexidine for a period of two to four days. For complete treatment a medium-sized pressure sore will take about three to four patches. If there is pus, necrosis and other signs in the wound that indicate the attachment of an infection, the patch is not used.

Folk remedies for bedsores

• Weeping wounds can be dried with potato starch, which has an advantage over regular powder, as it does not form dense crusts, and the skin breathes better.
• A small pillowcase is filled with millet or flax seeds and placed under areas where pressure sores may form.
• In the beeswax melted in a water bath, refined vegetable or olive oil and the resulting soft mass, outwardly similar to petroleum jelly, lubricate problem areas.

• A bandage with Kalanchoe juice or a leaf cut lengthwise is applied to the affected area overnight.
• Bedsores of the 1st and 2nd stages are lubricated several times a day with tea tree oil, fir or sea buckthorn oil.
• Freshly picked elderberry leaves are scalded with boiling water or milk and applied twice a day to the surface of the bedsore.
• Calendula ointment for treating wounds twice a day can be prepared independently. For this, crushed flowers in the amount of 1 tbsp. l. mixed with 50 grams of vaseline.

If bed sores appear in bedridden patients, you don’t know how to treat the photo, or you doubt how to treat bedsores, call a specialist at home. He will be able to determine the degree of damage and give appropriate recommendations for treatment. So you prevent the development of complications in the patient, which in some cases can cost him his life.

- a serious and common complication of diseases associated with the restriction of the patient's mobility. Due to prolonged pressure on soft tissues with forced inactivity, blood supply and nutrition are disturbed in them, which leads to necrosis (death). Manifestations and symptoms depend on the disease. At the initial stage, there is local hyperemia of the skin, minor damage. Then, if no measures are taken, non-healing ulcers appear on the skin, deeper layers are gradually involved in the process - subcutaneous fat, muscles and even bone tissue.

The general condition of the patient also suffers - there is a general weakening of the body's defenses, signs of intoxication appear. A serious complication of the necrotic process is sepsis, which can lead to. It is important to diagnose the process at the initial stage, in this case it is enough to remove the cause and use antibacterial agents to treat pressure sores. In this case, folk remedies give a good effect. If necrotic ulcers appear, it is necessary to undergo a course of antibiotics, and sometimes surgery is required, which is performed in a hospital.

Home treatment for bedsores

It should be noted that at any stage of treatment it is important to eliminate. Therefore, it is recommended to use a functional bed and during the period of pressure ulcer therapy. It is selected individually, depending on the weight of the patient. This stimulates blood circulation in the tissues, due to the constantly changing pressure in it. This redistribution of pressure plays a role and significantly reduces the development of necrosis. For maximum convenience, they are used, thanks to which the patient can take the most comfortable position of the body.

Taking care of the cleanliness and skin of the patient is important. should be performed with sterile dressings, and with gloves, in order to prevent re-infection of the wound.

In the treatment of bedsores at home, folk remedies are widely used. These methods have the greatest effect on initial stages necrosis, but also in the treatment in complex therapy, traditional medicine recipes are used. Most herbs and natural elements have a pronounced wound healing, drying or antibacterial effect, which has a good effect and significantly accelerates tissue regeneration.

The following folk remedies are most often used to treat bedsores:

• honey and bee products,
• essential oils,
• camphor alcohol,
• soda,
• laundry soap,
• onion,
• starch,
• medicinal herbs.

Honey and bee products

Product	Properties	Application
Honey	bactericidal Nutritious Enhances regeneration Anti-inflammatory	Treatment of eczema, bedsores, burns, wounds, psoriasis, furunculosis. Treatment and prevention of infectious diseases. As a general tonic.
Propolis	Antimicrobial Antifungal Stimulant	Treatment of skin tuberculosis, diseases of the gastrointestinal tract, teeth. Treatment of eczema, hyperkeratosis, fungal diseases.
Wax	Emollient Anti-inflammatory Stimulates regeneration	Treatment of burns, wounds, bedsores, strengthening of teeth and gums.
royal jelly	Stimulates the immune system Enhances hematopoiesis Increases the body's resistance	General tonic. Skin treatment, eczema, neurodermatitis, patchy alopecia.

Ointment from bedsores with wax

Ignite vegetable oil in the amount of 1 tablespoon, then cool to 70 degrees. Add 2 tablespoons of animal fat (you can use ghee or butter), 100 grams of beeswax and 10 grams of pine resin. Stir until the consistency of the ointment, store the resulting product in a cool place, and heat it in a water bath before use until the wax melts.

Before applying the ointment, the wound is cleaned of necrotic plaque with swabs dipped in and dried. applied, covered with cling film and wrapped with a warm cloth on top. A day later, the compress is removed, the wound is cleaned (if necessary) and the ointment is reapplied. At the first signs of ulcer healing, young skin is lubricated with emollients, and treatment with ointment is stopped.

Remedy for honey

Shredded fresh potatoes and honey should be mixed in a ratio of 1:1. Soak a gauze bandage with the resulting composition and make a lotion for the night. This mixture relieves pain and hyperemia, softens the skin, promotes tissue regeneration.

Melt propolis 10-15 grams and add 30 grams of vegetable oil. Mix the mixture, cool and store in a cool place. Ulcers should be wiped with a cooled mixture at least three times a day. This helps to remove pus and plaque, well stimulates tissue repair.

Onion remedy

Thanks to volatile substances - phytoncides, which are part of it, onions have antimicrobial and anti-inflammatory effects. This property is successfully used in the treatment of bedsores in folk medicine.

For the manufacture of the composition will require:

• 2 medium sized onions;
• 40 grams of vegetable oil;
• ¼ part of a church candle.

Finely chop the onion, simmer in vegetable oil for 20 minutes, until golden yellow. Dishes must be enamelled. Then strain the resulting mixture and mix with melted candle wax. Store the resulting mixture in a cool place.

Means to lubricate necrosis 2 times a day. The ointment should be used to treat shallow wounds that have not been aggravated by fungal, viral or bacterial infections.

Starch in the treatment of skin lesions

Bedsore starch is used with preventive purpose, as well as to eliminate the first signs of the disease. After hygiene procedures, the skin is dried, hyperemic areas are sprinkled with starch and wrapped with a tissue bandage.

This allows and does not allow the process to progress.

Use of laundry soap

Simple laundry soap has a strong antibacterial, decongestant and drying effect. It has long been noticed that its use can reduce pain, accelerate the healing of wounds and cracks in the skin.

For cooking medical paste soap needs to be crushed (rubbed on a grater). Then mix 150 grams of dry matter with triple cologne so that a homogeneous mixture is obtained, resembling an ointment in consistency.

soda for ulcers

It is necessary to dissolve a teaspoon of soda in a glass of boiling water and soak cloth (preferably linen) in the resulting solution. Allow the product to cool slightly, squeeze the fabric a little and apply to the wound. Such a compress draws pus from the wound and removes necrotic plaque. It is better to soak several napkins at once and change them as they cool. This method allows you to quickly clean the wound, which contributes to its healing.

Calendula flower remedies

The plant has an antimicrobial effect, neutralizes inflammation, accelerates the healing of ulcers. Fresh calendula leaves for severe skin lesions are applied directly to the areas of necrosis, the leaves should be crushed first.

In the treatment of necrotic skin lesions, various dosage forms based on calendula flowers are used:

• Ointments and lotions;
• Decoctions and infusions;
• Alcohol tincture;
• Applications and compresses.

Ointment from calendula flowers

Dry flowers (heaped tablespoon) chop and mix with vaseline, 50 grams. Store the resulting ointment in a cool place. Apply to a previously cleaned ulcer, 2 times a day. Treatment can be continued after the start of epithelization of the wound.

Calendula tincture

Dried flowers insist 14 days on vodka, in a ratio of 1:2. Strain the resulting product and store in a cold place. Before use, dilute the tincture with water - 1 tablespoon of tincture in ½ cup of boiled water. Wipe areas of hyperemia with the resulting agent. Can be used as a lotion up to three times a day for 20 minutes.

Herbal infusions and decoctions

Treatment of bedsores with folk remedies is not complete without the use of the power of medicinal herbs. Using proven recipes, you can not only prevent the development of necrotic changes, but also cure superficial ulcers.

Composition	How to cook	How to apply
Chamomile 50 grams Medicinal sweet clover 50 grams Boiling water ½ cup	Mix chamomile and sweet clover, pour boiling water over and leave for 30 minutes.	Wrap the resulting slurry in gauze, apply to the changed areas of the skin 2-3 times a day. Used in the early stages.
Field horsetail 30 grams Chamomile 30 grams St. John's wort 40 grams Water 0.25 liters	Pour a mixture of herbs with boiling water, heat in a water bath for 15 minutes and strain.	Infusion to wipe the wounds, use in the form of lotions, as well as take orally 1/3 cup 3 times a day. Has a general strengthening effect.
Oak bark crushed dry 40 grams Water 0.2 liters	Pour hot water over oak bark. Bring to a boil and keep for 20-30 minutes on low heat, then cool and strain.	moistened with a decoction of the bark, apply to the wound 3 times a day for 10 minutes.
Lungwort officinalis (all except the root) 2 tablespoons Water 0.5 liters	Pour the crushed dry matter with boiling water, heat in a water bath for 15 minutes. Cool and strain.	Rinse and ulcers 2-3 times a day.

Camphor

In folk medicine, camphor alcohol and camphor oil from bedsores are often used. Its source is the wood of the Japanese laurel. Pharmacies offer dosage forms:

• Camphor ointment;
• Oil solution;
• Alcohol solution.

When applied topically, camphor oil gives the following effect:

• Bactericidal and bacteriostatic;
• Relieves itching and irritation;
• Reduces tissue inflammation;
• Enhances regeneration.

The most effective use of the chamber as a prophylaxis of skin necrosis, when camphor oil the areas subject to the greatest pressure are rubbed -, back, shoulder blades,. However, if the process is already beginning, the remedy can also be used as a treatment for stage 1 and 2 bedsores. It must be remembered that camphor is not used when the process has affected the subcutaneous fat, muscles, and bone. In this case, the use of the drug can only worsen the situation by provoking tissue burns.

There are several effective recipes treatment of bedsores using camphor alcohol.

Chatterbox

Camphor alcohol, medical alcohol or vodka and shampoo (preferably for children) mix 100 ml each, lubricate areas of hyperemia with a prepared product. Such a talker is applied at night, in the morning the skin must be wiped with a clean, damp sponge. Effective at the initial stage of the disease.

Oil lotions

If bubbles have not yet appeared on the skin, the following procedure will give a good result: treat the skin with a sterile swab dipped in an oily camphor solution, do not wipe the skin. Apply sea buckthorn oil or rosehip oil on top.

Camphor with yarrow

With minor damage to the skin, with the formation of blisters on the skin, the following remedy helps: pour 20 grams of dry matter of yarrow herb with 1 liter of boiling water, leave for an hour, then strain. In the resulting broth, add alcohol tincture of calendula, 20 drops. Lubricate the bubbles formed on the skin with camphor oil, put gauze moistened with medicinal infusion on top. leave until completely absorbed. The procedure should be carried out 5 times a day for 10 days.

Plant sap products

In folk medicine, not only decoctions and infusions of dried herbs are used to combat pressure sores. The juice of some plants has good wound healing properties.

Aloe

Freshly chopped leaves of aloe, which is rightfully considered a medicinal plant and is used in the treatment of many diseases, help cleanse ulcers from pus and necrotic decay products. It is the leaves that should be applied to the wound, since tissue soaked in juice does not have such a pronounced effect.

Kalanchoe

Kalanchoe has a pronounced wound healing effect. The leaves of the plant should be cut with a knife and applied to the ulcers, having previously cleaned them with sterile swabs with hydrogen peroxide. The milk of Kalanchoe, getting into the wound, contributes to its epithelization.

Millet therapy

Steamed millet helps relieve pain and reduce signs of inflammation. To do this, take 50 grams of millet, steam it in a water bath to a mushy state. Put the resulting mass in a tissue bag, which should be applied to the bedsore for 2-4 hours. Continue the procedure for a week.

Features of home treatment

In folk medicine, it is important not only to treat, but also to prevent pressure sores. It should be remembered that this disease on its own is possible only at stages 1 and 2, until necrotic ulcers have formed. When the process goes into stages 3 and 4, it is necessary to urgently consult a doctor.

In the treatment of necrotic wounds, folk remedies are used as an addition to complex therapy and help strengthen the patient's immunity and accelerate the healing process on the skin. But it is the doctor who must prescribe the correct treatment and decide on the hospitalization of the patient.

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Bed sores are one of the most common complications that occur in bedridden patients. What is it?

Bedsores are called changes in body tissues in a certain area (or several), caused by prolonged contact with a hard surface. Such changes are provoked by impaired blood circulation, lymph circulation and innervation.

It is very important to understand what bedsores are, their prevention and treatment.

Development features

It is natural that pressure sores appear on the side of the body on which the person lies, in areas that touch the surface. So, when the patient is on the back, bedsores in bedridden patients most often develop on the buttocks, in the area of ​​the sacrum, coccyx, heels, on the shoulder blades, at the level of the spinous processes of the spine. If a person lies on his stomach, bedsores can appear at such points of contact with the surface: the knee area, the anterior surface of the chest wall, the iliac crests. In the half-sitting position, the typical site of the lesion is the region of the ischial tuberosities.

But lesions of areas not listed above are not excluded. For example, bedsores (a photo depicting this pathology can be found in a medical reference book) sometimes develop on the occipital region and in the folds under the mammary glands. Perhaps a specific location in the presence of plaster bandages in places of their tight fit of the material to the skin, when using oilcloth fabrics, rubber tubes, catheters, prostheses. That is, localization is determined by where exactly there are damaging factors.

The condition of the patient's body is also important. There is a high risk of occurrence and more rapid development of bedsores with general exhaustion, the presence of congestion, which is often observed in heart failure, in patients of advanced age. Young, conscious people, on the other hand, are less likely to develop pressure sores. And if they do appear, they very rarely develop to advanced stages. But at the same time, it should be remembered that due to the gradual development of lesions in these patients, it is sometimes possible to miss the first signs of pathology.

In almost all cases, the development of bedsores occurs according to the same pattern, only the time of each stage is different. The beginning is always stagnation of blood as a result of compression; if left untreated, the affected tissues become necrotic.

What is the danger of bedsores?

The main danger is associated with their complications. Since in most cases bedsores in bedridden patients develop quickly, and in a very short time a large area can suppurate and necrotic, it is often necessary to excise the affected tissues. This sometimes leads to disruption of the blood supply and innervation of nearby areas, which, in turn, leads to disruption of their functioning.

In some cases, the development of bedsores results in a need. In addition, the development of necrotic processes in the periosteum or bone tissue, gas gangrene or sepsis is possible.

It is also important that the processes occurring in the body during the development of bedsores, their treatment require considerable energy costs, therefore, they deplete the patient, thereby aggravating the course of the underlying disease. Festering bedsores are especially dangerous.

Thus, it is very important to understand how to recognize bedsores. The etiology, pathogenesis, prevention, treatment of bedsores of different localization are very similar.

Why do bedsores occur?

The reason for their development is a violation of blood circulation in a certain area of ​​\u200b\u200bthe skin. This can happen in several cases.

Most often, this phenomenon is observed when squeezing blood vessels, especially if the squeezing time exceeds two hours, which happens with a long stay in one position. Tissues that do not receive blood become necrotic, and this is already the development of a bedsore.

A possible cause is microdamage to small vessels in the skin. This can be observed when a wet tissue is pulled out from under the patient, for example, a soiled sheet. Sometimes injuries occur as a result of a person's attempts to independently change position or move around. Therefore, any friction, minor damage to the skin and mucous membranes should be avoided, and if a person wants to turn around or do something, you need to try to help him.

If you know the causes of bedsores, prevention, treatment of such a pathology are carried out more correctly and efficiently.

What increases the risk of pressure ulcers?

In order to understand what pressure ulcers are, what their causes are, what are the prevention and treatment, it is very important to know what affects the risk of their occurrence. There are many such factors. Some of them are related to the characteristics of the patient's condition, others - to the organization of the correct

Of the first group of factors, the most significant are the following features:

• Age- increased risk of development in elderly patients.
• Weight- here the danger is both overweight and underweight. The more weight, the more pressure on the fulcrum of the body. But insufficient weight often indicates depletion of the body, and this is also a predisposing factor not only for the appearance, but also for the more rapid development of necrotic processes.
• heart disease and vascular system - with pathologies of this type, congestion in the circulatory system develops faster, blood vessels are more easily damaged, any influence that provokes a violation of their integrity is more significant.
• Accompanying illnesses- a special place here is occupied by diseases that lead to a violation of innervation (for example, previous strokes), as well as those in which metabolic processes(for example, diabetes).
• Food and drink- insufficient intake of fluids and food is dangerous, it is especially important to monitor the amount of protein in the diet.
• Inability to independently control urination and defecation- this is observed if the patient is unconscious, paralyzed or unable to control his behavior and condition due to dementia.
• Strong sweating- can be both a consequence of metabolic or endocrine disorders, and the result of the presence of fever.
• Features of perception medicines - an unfavorable factor may be the appearance of allergic reactions to drugs used for skin care in places where bedsores develop. Prevention, treatment of bedsores implies the need to take into account all the characteristics of the patient's body.

The second group of factors includes care features. Rare changes of bed and underwear, lack of or improper hygiene procedures, unevenness and excessive hardness of the surface on which the patient lies, the presence of crumbs and small objects in bed increase the likelihood of developing bedsores.

Bedsores: how to recognize them?

If the patient is conscious and sensitive, he can talk about subjective feelings to those who care for him. Signs of the beginning of the development of bedsores include complaints of a tingling sensation. It occurs as a result of stagnation of blood and lymph in a place where there is a high probability of the appearance of pathological processes leading to the formation of a bedsore, if the necessary measures are not taken. As a result of such stagnation, the nerve endings do not receive the necessary nutrition, but are felt as a tingling sensation. After a few hours, loss of sensitivity is possible, the appearance of a feeling of numbness in areas of the skin to which blood does not flow.

After a while, visible signs appear. In places of contact of the protruding parts of the body with hard surfaces, bluish-red spots appear - venous erythema. They do not have well-defined edges. Their color can be both saturated and barely noticeable.

If such signs were noticed, it is necessary to take immediate measures to prevent the further development of pathological processes in the affected areas. Care must be taken to recognize bedsores. Prevention, treatment of bedsores is the more effective, the earlier the first signs were noticed and actions were taken to eliminate them.

Help with the first signs of pressure sores

For prevention and treatment at the initial stage of their development, measures should be taken to even more carefully care for the patient, to ensure that he is able to be in a comfortable and correct position.

Use special mattresses that help those who have bedsores. Prevention and treatment of these formations is the direct goal for which they are made. Such anti-decubitus mattresses are of two types: cellular and balloon. They are equipped with compressors that operate silently and maintain the required hardness of the surface on which the patient lies. For patients who are in bed for a long time, special pillows filled with air, foam or gel can be used.
If a person is in a supine position, it is desirable that the head of the bed be slightly lowered or at the same level with the body.

Another important factor is the regular change of body position. If there are no contraindications, this should be done at least once every 2 hours. In this case, it is desirable to use specially made pillows. They help to change the position of individual parts of the body relative to the surface on which the person lies. Due to this, for some time there is space between individual areas of the skin and the bed, there is no squeezing of blood vessels, and the likelihood of development and progression of bedsores is reduced. Patients in a wheelchair need a change in body position every hour. The bed on which the patient lies should be remade at least once a day. At the same time, it is important to monitor the condition of bed and underwear - it is dangerous to form wrinkles, get crumbs or other small objects on the linen that can cause irritation and microdamage to the skin.

Skin hygiene is of great importance. Particular attention should be paid to their humidity. To control this characteristic and prevent excessive hydration, special powders, creams, solutions, sprays, warm (but not hot) baths are used. These hygiene procedures should be carried out at least twice a day. In addition, during urination and defecation, dirt from the skin and linen should be removed as quickly as possible. For this purpose, as well as in order to remove sweat, food debris, wound discharge, use diapers, towels, napkins, diapers, absorbent pads.

It is permissible to stroke areas of the skin where there are signs of congestion, but you can not rub these places, do an intense massage. Such actions can provoke an acceleration of the process.

Pathogenesis

In the pathogenesis of bedsores, four stages of development are distinguished. During stage I, venous erythema develops at the site of skin contact with a foreign surface. The reason for the development of erythema is a violation of the outflow of blood. Outwardly, erythema looks like a bluish-red spot; when pressed, the skin on the affected area turns pale. The temperature in the area of ​​erythema is the same as the rest of the skin or slightly lower. The most common place of development is bony protrusions. The skin remains intact, there are no violations of its integrity.

At the II stage of the development of bedsores, the epithelium becomes thinner, the skin flakes off, bubbles form on it. This is all a consequence of malnutrition of tissues, which occurs due to stagnation of blood. It leads to a violation of innervation. In addition, fluid accumulates in the skin, the cells of the epidermis swell, and eventually rupture and die. Thus, at this stage there are already visible damage to the skin, maceration can be observed on the affected areas.

Stage III decubituses are characterized by the type of wound. If pathogenic microflora enters it, suppuration may develop. It is at this stage that the deep layers of the skin, subcutaneous tissue, muscles are involved in the pathological process, and necrotic processes begin. Necrosis and the likelihood of purulent inflammation are a huge threat to the health of the patient.

At stage IV, there is already a significant tissue defect in the form of a cavity, on the walls of which purulent inflammation is visible. The reason for the appearance and increase of the cavity is tissue necrosis.

One person in different parts of the body may have bedsores that are at different stages of development.

Possible Complications

Most of the complications that occur during the development of bedsores are associated with contact with the damaged area. pathogenic bacteria. Most often it is staphylococcus or streptococcus, but cases of seeding with other pyogenic microorganisms are quite possible.

Most often, suppurative processes in the bedsore develop as erysipelas or phlegmon. In cases of general exhaustion of the body, weak immunity or improper organization of hygiene measures, inadequate treatment of bedsores, life-threatening complications, such as sepsis or gas gangrene, may develop.

Bedsores in patients may begin to suppurate in the second or third stages, when an area of ​​damaged epithelium or an open wound appears, subsequently, further development of purulent processes occurs.

Therefore, if bedsores are present, prevention and treatment are needed not only for them, strict control over the general condition of the body is also important. Alertness should be caused by an increase in body temperature, an increase in weakness, headache, swelling around the bedsore, a change in the color of the skin around it to a grayish, putrid smell from the wound, and other changes.

Typical localization of bedsores

Depending on the position in which the patient lies, where bedsores occur, their prevention and treatment may differ somewhat.
Particular attention should be paid to the options for their possible localization in the position of a person on his back. In this case, bedsores most often occur on the heels, buttocks, coccyx, in the area of ​​​​the shoulder blades.

The occurrence of bedsores on the heels is not uncommon. Since congestion in the legs is often present in older people, as a result of pressure on the heels, such processes are only exacerbated. In addition, usually in these areas of the body, the skin is denser, so it is more difficult to notice the first signs of pathology. For the same reason, with this localization, bedsores (their treatment) require long-term and especially careful attention.

Bedsores on the buttocks are dangerous because this area of ​​the body is close to important organs. The defeat of these organs not only requires careful treatment, but can further greatly affect the general condition and functioning of the body, even shorten life. Therefore, special efforts should be made to prevent such bedsores. Prevention and treatment (photos depicting appearance such type of bedsores are available in specialized journals) such injuries should be carried out in accordance with all the rules. Otherwise, there is a high probability that the process will lead to undesirable consequences.

Bed sores: treatment and prevention

In addition to knowing what pressure ulcers are, where they can be, and what they look like, you need to know how to treat them and how to prevent them. Treatment of bedsores in a patient includes treatment of the skin in hygienic, preventive and proper medicinal purposes. This treatment should be carried out regularly.

It is important to understand the reasons why bedsores appear. Prevention, treatment of bedsores must also be mastered. Hygienic treatment of the skin is carried out to maintain at a safe level its basic properties and characteristics: acidity, moisture, elasticity. To do this, you need to eliminate pollution in time.

Preventive treatment involves actions that improve blood circulation and restore the sensitivity of the skin and underlying tissues. Do not forget that damaged skin is more prone to the occurrence of bedsores and suppuration processes, so it is necessary to prevent its overdrying and the appearance of cracks on it.

Treatment is very important. This already requires special drugs. Now there are a huge number of them, they are produced in the most different options and forms. A variety of ointments, gels, powders, solutions, sprays are used against bedsores. Each of dosage forms has its own characteristics: contraindications, methods of application. Therefore, it is important to consult an experienced specialist when choosing a treatment.

What is the best cure for bedsores? Feedback from people who have encountered this problem allows us to highlight some of the most common options for solutions that are successfully used in such cases. For external treatment, it is recommended to use a solution of magnesium sulfate (25%), or a hypertonic (10%) solution of sodium chloride with chymotrypsin, and intravenously inject a 0.5% solution of metronidazole. It is undesirable to use potassium permanganate, iodine, brilliant green.

It is very important to ensure that new bedsores do not appear. Prevention, treatment of bedsores usually require a lot of effort, time, and money.

The nutrition of the patient is of great importance. Vitamins, minerals, especially zinc and iron, proteins should be present in the diet in the required amount, vegetables and fruits should be consumed. It is recommended to include dairy products, fish, chicken eggs, meat (preferably poultry) in the diet. If it is difficult for a person to eat meat, it can be replaced with broth.