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Bedsores are a problem not only for bedridden people who stay in bed for months. They can be formed within days or even hours. It is worth knowing how to prevent them and how to treat them if they occur.
A he althy person, even during deep sleep, unconsciously changes their body position every 15-20 minutes. In this way, the body makes sure that due to the pressure on no organs, includingskin , is not exposed toischemia . It is different in people immobilized by disease, unconscious or under the influence of strong sedatives. Pressing (with the weight of the body) the soft tissues of the skin against a hard surface (e.g. a bed or a wheelchair) causes ischemia and the subsequent death of these tissues. Strong pressure, e.g. in obese people, can lead tobedsoresafter an hour.
Control the appearance of your skin to prevent pressure ulcers
Bedsores most often occur where the bones are shallow under the skin. In the case of lying patients, the most vulnerable areas, because they are constantly pressed by the weight of the body, are the occiput, ears, the area of the back, sacrum and coccyx, and the protruding part of the femur at the point where it meets the pelvis. In sedentary patients - buttocks, heels, toes, shoulder blades, elbows. The greater the likelihood of pressure ulcers, the worse the condition of the skin. Therefore, this especially applies to diabetics, people with circulatory disorders, as well as malnourished and elderly people, because in their case the subcutaneous fat is thin, and the skin has less collagen fibers and is less resistant to injuries. Moistening of the skin (e.g. due to urinary incontinence), insufficient hygiene, uneven bedding or friction of oppressed parts of the body may also contribute to the development of pressure ulcers. Therefore, the condition of the skin must be monitored frequently and carefully. The first symptom of blood supply disorders is redness which does not disappear under pressure. Then the skin is damaged, at first only superficial, which manifests as an abrasion, blister or shallow ulceration. The lesions worsen, the ischemic tissue dies and becomes yellowish, then brown. There is extensive damage to the muscle, bone or other tissue (tendon, joint capsule).
Prevent pressure ulcers
How to take care of a sick person to prevent the development of bedsores?
- Changepositioning the patient's body - at least every 2 hours. Avoid placing it completely on its side, because high pressure is conducive to the development of pressure ulcers in the area of the hip bone. It is best to tilt the body about 30 degrees forward or back and support it with pillows. Tuck the pillow between your legs, especially at the knees and ankles. Also, limit sitting in bed, as this position causes the patient to slide down and put pressure on the lower back and heels.
- To relieve pressure, place pillows between the bony prominence and the bed or chair where the patient is. In rehabilitation equipment stores, you can also buy special anti-bedsore discs (e.g. for buttocks), wedges, foot protectors, elbow and heel supports, neck and knee rollers.
- Use special anti-bedsore mattresses. You can buy or rent them. They are variable-pressure (pump-operated) mattresses with chambers in which air is forced. Due to stronger or weaker inflation, the pressure on the various parts of the body in contact with the mattress changes. There are also gel mattresses, latex mattresses or, for example, made of a corrugated sponge - they resemble a hedgehog, whose spikes exert pressure on other areas of the body with every movement.
- Try to provide the patient with some exercise if possible, even by passive exercise, such as lifting and bending the legs and arms.
- Take care of the patient's body hygiene. Use delicate soaps or special liquids (pH 5.5) for washing. After washing, dry the skin thoroughly with a towel (without rubbing), and then lubricate it with, for example, baby oil. Places particularly exposed to bedsores can be additionally covered with a preparation that not only protects the skin from contact with sweat or urine, but also contains disinfecting and healing substances.
- In order to improve the blood supply to areas at risk of developing pressure ulcers, it is good to pat them. This is a type of massage that is best done several times a day - place the hand with the fingers joined in the "peak" and pat so that there is a so-called airbag.
- Take care of appropriate bedding and underwear for the patient - they should be made of airy, natural and delicate materials so as not to irritate the skin. You have to make sure that the sheet is always clean and neatly stretched, because the creases irritate and press the skin.
- Make sure that the sick person eats properly. For the good condition of the skin it is important, among others vitamin C and zinc. Their sources are vegetables, fruits, wholemeal grain products, offal, lean meat and fish. He must also drink enough (about 2 liters a day) to prevent dehydrationthe body (as well as the skin).
What to do when pressure ulcers appear
Treatment of pressure ulcers, even superficial ones, should be carried out by a doctor. Modern therapy involves the use of special semi-permeable dressings that absorb excess wound exudate, protect it from contamination and prevent it from drying out (this reduces the treatment time by half). These can be hydrogel, hydrogel with alginates or gel hydrocolloid dressings. In advanced necrotic lesions, the wound must first be surgically debrided.
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