Bedsores in bedridden patients: how and what to treat

Bedsores are necrotic tissue sites - skin and subcutaneous tissue in bed patients, formed as a result of prolonged pressure on them in conditions of disorders of nervous innervation and upset blood circulation.

Here we will consider the general principles of treatment of decubitus in bedridden patients at home, questions about how to better and more effectively cure bedsores in a patient lying person on the sacrum, coccyx, buttocks, heels.

Causes and symptoms

Most often bedsores are formed in humans, long confined to bed due to illness or injury. Although sometimes bedsores also occur in relatively healthy people in areas of the skin under the cast plaster, as well as in some areas of the mouth( with poorly fitted crowns).

If the patient is very weak and has a severe circulatory disturbance, the bedsore can form quickly - within 24 hours.

The occurrence of bedsores is facilitated by poor care of the patient( untimely change of bed linen or bed linen, folds on the sheet, crumbs and leftovers in the bed, a long position in one pose).

The first signs of beginning bedsores are a sharp blanching of the skin, swelling, exfoliation of the epidermis and the formation of blisters. Then the necrosis of soft tissues and, sometimes, even the periosteum, join it.

Treatment and prevention of bedsores: general recommendations

To prevent the occurrence of bedsores, the following preventive measures are recommended:

1. . As often as possible, change the position of the patient in bed and rotate it( at least twice a day).
2. The sheets should be tightly stretched, without creases and rough seams.
3. Rubber or cotton-gauze circles are placed under the coccyx and sacrum( the places of greatest pressure).When the patient is on the abdomen, the circles are placed under the knee joints.
4. The patient's linen should always be clean.
5. Places of greatest pressure must be disinfected with camphor alcohol, 2% tannin solution or diluted table vinegar.
6. If you have the first signs of pressure sores, you should immediately consult your doctor for advice on treatment.

How to reduce skin irritation

1. Stil an old, washed, and therefore, soft underwear;make sure that there are no coarse seams, buttons, patches on the clothes;regularly and often adjust the bed so that under the patient there are no folds and small objects.
2. Use low-allergenic, proven products for skin care, for example, baby soap.
3. Avoid bright colors and strong odors.
4. Often spend perineal toilet, because feces and urine particles are strong irritants.
5. Do not limit the patient's drinking with urinary incontinence, because with a lack of fluid, the irritation force increases.
6. Briefly cut the nails to yourself and the patient: yourself - so as not to accidentally scratch the patient, but to the patient - so that he does not comb the skin, because with prolonged lying or sitting, the compressed areas itch.
7. Ensure that the patient is dressed and covered with a blanket according to the temperature conditions of the room. When the patient overheats, sweating increases and the risk of developing pressure ulcers increases.

Skin Care Rules

1. Do not allow skin to get dirty, dry and damp, because this skin is the least able to resist external influences.
2. Use plain water, soap, cotton woolcloth or natural sponge, nutritious and moisturizing creams, drying ointments, powder. Watch your skin carefully, and it will become clear to you at what point what to apply. The general rule is: wet the skin to dry, and dry - to moisturize.
3. Do not use antibacterial soap, because along with harmful bacteria, beneficial microorganisms are also destroyed;the skin after stopping the use of such soap becomes incapable of resisting even a minor infection( advertising says the truth, but not all).
4. Alcohol-based products, such as lotions and camphor alcohol, can only be used for patients with oily skin.
5. Do not rub the skin in the areas of compression when washing. Use soft sponges and use them very delicately, so as not to injure the upper layers of the skin. When drying the skin, do not wipe it, but soak it.
6. Do not massage the reddened areas of the skin in any case, but an easy regular massage around these places is highly desirable. Be sure to arrange for the skin of air baths.

The skin condition is significantly affected by moisture, mainly urine and sweat.

The main thing is personal hygiene of the patient and change of linen. Do this often. If urinary incontinence is better to use pads or diapers, although some patients only need to give the vessel more often. For lack of funds for pads and diapers, try using diapers from underwear( many times folded cotton linen, padded in the crotch or placed under the buttocks, will limit the flow of urine, the old washed laundry absorbs moisture well).

If urinary incontinence in men, you can use a special urinary system( urinal).Elevated sweating is observed in fever patients. In order to reduce sweating, you need, above all, to treat the underlying disease. To wipe the patient is better not to use soap and water, and a weak solution of vinegar( 1 tablespoon of table vinegar per 1 glass of water).

Tips for Drinking and Nutrition

Drinking and eating should be full, subject to restrictions, if any. Food should contain at least 20% protein. Choose foods that contain many micronutrients - iron and zinc, as well as vitamin C. Use sour-milk products, greens, vegetables, fruits.

For heavy bed patients, meat is heavy food. To cover the protein requirements, use chicken broth, fish, beans, cereals and dairy products. Drinking - not less than 1.5 liters, if there are no restrictions. Do not eat sweet and carbonated drinks, as well as freeze-dried products( quick cooking from solids by dissolving in water).

How to treat and how to cure bedsores in bedridden patients

Traditional medicine advises you to use the following effective means at home:

Ointment for bedsores

Take( by weight) 8 parts of oak bark and 80 parts of water( 1:10).Boil on low heat until half of the liquid is left. Strain and add 4 parts of lead vinegar and one part of alcohol. To obtain lead vinegar, take 8 parts of lead sugar, one part of lead in powder and 10 parts of distilled water. First, the lead oxide by heating is freed from carbon dioxide, then cooled and mixed with lead sugar. All pour water, insist a few days, filter.

Rose oil. Red rose oil has bacteriostatic, bactericidal, granulating and epithelial properties. Based on rose oil make 1% ointment, which is used in the treatment of pressure ulcers, trophic ulcers, various burns. Lotion of rosehip oil is recommended to do 2-3 times a day with bedsores.

Aloe juice. Aloe enhances regeneration and enhances the body's defenses. Widely used in the form of dressings for the treatment of long-term ulcers, bedsores, corneal ulcers, burns and frostbites.

Kirkason. Curative baths are prepared from the roots of the kirkazone.50 g of crushed roots pour cold water, leave for two or three hours and boil for 20 minutes. Broth for 1 hour, strain and pour into the bath. The bath temperature is 36 ° C, the duration is 15 minutes. The course of treatment is recommended 12-15 baths every other day.

Birch. External application of alcohol extracts of birch gives good effect in the treatment of pressure sores, abrasions and skin erosions. Birch buds are used for baths and for chronic eczema. The

bedsores are washed with weak potassium permanganate solution and lubricated with ointment ointment ( powder) and black poplar in a 2: 1 ratio on unsalted butter( 5 parts).The mixture is insisted in a warm place for 12 hours, brought to a boil, squeezed through gauze and poured into a jar.

With bedsores, erysipelas of the skin, brew milk with black elder and apply to affected areas.

External application of in mackerel, corn, sea buckthorn, hips and peach oil cures most skin diseases.

St. John's Wort. Infusions and herbal teas from St. John's wort for external and internal use.

The shredded sheet of blackberry is applied to lichens, eczema, ulcers and purulent ulcers for early cleansing.

Cucumber. Seeds of yellow( overripe cucumber) in an amount of 50 g( per 100 ml of alcohol or 200 ml of vodka) pour vodka or alcohol and put in a warm place for 15 days. Strain.

Applied for irrigation, tampons, bandages with bedsores.

It is recommended to use the following herbal and plant mixtures in bedsores:

Gather 1:

1. cocoa butter - 10,0;
2. catechu powder - 5.0;Olive oil - 10.0.

Before applying the formulation, wipe the reddened area with diluted table vinegar or vodka.

Gather 2:

1. fat - 17 g;
2. lead vinegar - 2.0;
3. tannin - 1.0.

Do daily dressings with the received ointment.

Treatment of pressure sores by means of medicine: procedures and preparations

Treatment rules

Treatment of decubitus is a painstaking process requiring diligence. The following rules must be observed:

1. it is necessary that the bed is soft enough( if there are no contraindications to it, as, for example, with a fracture of the spine);
2. the bed linen on which the patient is lying must be dry and clean( it is better to change it every day or every two days), soft and do not have wrinkles( the sheet needs to be pulled, fixing the edges with a mattress or some other way);
3. under the pelvic area, you can put special inflatable rubber circles;
4. the patient must be turned over from the back to the side during the day, leaving him in this position for an hour or two;
5. areas undergoing pressure must be gently massaged to improve blood circulation
6. by turning the patient from the back to the side, it is necessary to "ventilate the skin" in the places on which he lay, that is, for some time not covered with a blanket;
7. temperature and clothing( including blanket) should be such that the skin does not sweat;
8. methodically perform all procedures using drugs.

Principles of treatment

You should not rely on the help of ointments, powders and other drugs, until you release the affected area from the pressure so that the blood can flow freely to the place of the formed decubitus.

Speaking about the treatment of decubitus, you need, first of all, to say a few words about wounds in general.

How does the wound appear and develop? Initially, the damaging force acts on the tissue( in the case of decubitus this damaging force is represented by compression), which causes a disturbance in nutrition and then necrosis of the tissues. The damaging force acts impermanently. If its action is weakened or stopped, the blood circulation at the injury site will be restored. This will lead to the rejection of formed necrosis( decubitus) and the gradual healing of the wound through granulation and epithelization.

Treatment of pressure ulcers, therefore, boils down to three principles:

1. First of all, it is necessary to restore the blood circulation at the site of damage as much as possible.
2. To promote the rejection of necrotic masses( most decubitus).
3. Promote the fastest healing of the cleansed wound.

Restoration of blood circulation

To restore blood circulation, it is necessary to use all the principles of prevention in the complex( see above).In this case, the nutrition of the patient plays an important role.

Rejection of necrotic masses

For the rejection of necrosis use:

1. mechanical removal of necrotic masses surgically;
2. use of drugs that accelerate self-rejection: ointment "Iruksol".As a good home remedy, you can use wet dressings with a solution of salt on cognac( 30 g of table salt and 150 ml of cognac).For the rejection of necrosis, the dressing should be applied under the compress paper and changed as needed. Before applying a new dressing, it is essential to wash the wound to avoid increasing the salt concentration.

Treatment of the cleared wounds

Wet conditions for the wound should be created using, for example, alginates( in the form of napkins and powder for filling wounds), hydrocolloid dressings( Hydrocoll, Duoderm, Hydrosorb, etc.) that help clean and close the wound. These dressings are quite expensive.

To heal the wound, you can use a variety of healing remedies: ointments "Levosin", "Levomekol", "Actovegin", "Solkoseril", sea buckthorn oil and many others. Often bedsores are complicated by the addition of a secondary infection, and then use of antiseptic and antibacterial agents such as boric acid, white streptocide in powder, 3% hydrogen peroxide solution, furatsilin solution 1: 5000, "Levomecol" and "Levosin" ointments is necessary.

In severe cases, weakened and elderly patients are shown to use antibacterial drugs inside.

Large area and difficult to heal bedsores can sometimes be cured only by surgery - transplantation of tissues.

When treating pressure sores, dressings must be used. Where possible, use a bandage to fix the dressings, in other cases, use a band-aid, but not everyone is suitable. Bedsores need to be treated for a long time, which means that the patch will have to be used for a long time.

What can be the problem with this? The plaster prevents the normal functioning of the skin( breathing, secretion, etc.).When removing the patch, the surface layer of skin cells breaks off, which can cause additional wounds in the place of prolonged use of the patch.

To avoid such complications, use a plaster on a paper basis - the skin underneath breathes well, and the glue fixes the bandage well, but does not tear off cells from the skin surface when removing the patch. When applying the patch, do not tighten it strongly to avoid the formation of small skin folds, and also take into account the fact that when the patient's position changes, the soft tissues will shift and stretch, which can lead to the formation of unwanted skin folds.

The skin around the decubitus needs the most thorough care. It must be washed with soap. Do not be afraid that soap foam will get into the wound - this will not worsen the condition of decubitus. During washing, do not rub the skin - only to soak.

After washing, it is necessary to achieve either self-drying of the skin, or one of the following preparations can be used: 1% solution of potassium permanganate, diamond greens, zinc containing ointments. The last remedy is preferable to others, as when using it gauze dressings do not adhere to the edges of the wound and, therefore, do not injure the newly formed epithelium and granulation when removing the dressing.

Applying bandages to deep bedsores, the wounds must be tamped to the full depth( covered) with a bandage, but not tight, but loose.

When bubbles appear, they are smeared with an alcohol solution of brilliant green, put a dry bandage. When the necrosis is delimited, the dead tissue is removed, and the ripped edges in the circumference are split. The wound is covered with gauze, impregnated with a 1% solution of potassium permanganate. The dressings are changed twice a day. With the purification of the wounds, they pass to ointment dressings( Vishnevsky ointment, streptocid or sintomycin emulsion, soap baths, and also quartz irradiation).

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Source: YNGorgov. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.