Pathological changes in the dermis, which are formed in patients confined to a wheelchair or bed, are called bedsores or ulcers. They can also appear with good care. The reason is a violation of blood flow in areas of the body, the access of oxygen to which is difficult. The main reason for their formation is the lack or absence of movement, as a result, the tissues do not receive enough nutrients and oxygen, which leads to their destruction. First of all, the skin is damaged in those places where the hard surface of the bed or chair comes into contact with the bone. Therefore, it is important to see the pathology in time and start timely treatment, as well as carry out preventive measures. In this article, we will try to figure out how to treat bedsores in bedridden patients.
Types and causes of bedsores
Distinguish between external bedsores, which are formed in places where the bones protrude and internal - in areasplacement of catheters or drains in an organ or wound. By location - on the hips, spine, feet, buttocks, sacrum, shoulder blades, back of the head, ankles, elbows, heels.
By origin, there are endogenous and exogenous. The first are formed as a result of a violation of innervation in the tissues. The second ones are formed from mechanical impact.
The main causes of pressure sores are slip, pressure, friction and moisture. Factors that provoke their development:
- edema;
- oncology;
- vascular disease;
- age-related changes in the dermis;
- stationary state;
- fecal incontinence;
- fractured limbs;
- dry dermis;
- stroke;
- diabetes;
- hypotension;
- anemia;
- malnutrition;
- low weight.
Decubitus ulcers form quickly if the dermis is very dry or waterlogged. In the first case, the protective layer of the skin is exfoliated, and in the second, there is a high probability of infection. Poor circulation exacerbates this process.
General recommendations
The treatment of bedsores depends on the stage of development. It can be conservative and surgical, the latter is used in case of ineffectiveness of all other methods. When treating bedsores at home, you must adhere to the following rules:
- be sure to take preventive measures to prevent the transition to another stage;
- do not apply bandages that prevent the evaporation of moistureand oxygen supply;
- do not use topical creams or ointments that have emollient properties;
- at the initial stage of a decubitus ulcer or with dry tissue necrosis, do not apply wet dressings;
- The use of antibacterial agents is indicated for a weeping wound.
Decubitus symptoms. Complications
The clinic depends on the stage, of which there are only four:
- Skin has redness or irritation, no other damage. Feeling sore and sensitive.
- There is an open wound surface, the skin is affected. The wound is red, the edges are swollen. In some cases, there is a bubble, bursting or whole, inside of which there is liquid.
- Tissue necrosis. The wounds are deep, down to the bones. The bedsore spreads between layers of he althy dermis.
- The heaviest. Muscles and tendons are visible through the wound. extensive necrosis. He althy tissues are actively affected.
Treatment of neglected bedsores at home is difficult, as in this case surgery is required. The consequences of poor-quality therapy are quite severe: sepsis, meningitis, dermal cancer, damage to bones and joints. In some cases, if the pathology has touched the walls of the vessels, bleeding may develop.
Preventive measures
If bedsores have begun to form, it is difficult, almost impossible to stop this process, and each new stage only aggravates the patient's condition. Pretty hard to give intreatment of pressure ulcers at home, and prevention in this case plays an important role.
It must be started at the first signs of the pathological process. As preventive measures, the following conditions should be provided to the patient:
- Complete nutrition and drinking regimen.
- Keeping the skin clean. Regular cleaning, decontamination and maintenance of a certain dryness.
- Regular change of underwear and bed linen.
- Purchase anti-decubitus mattress.
- Remove pressure on the patient's body in certain places prone to the formation of bedsores with the help of special pillows, linings.
- Change the patient's position every 120 minutes.
- Properly apply bandages and splints.
- Timely change catheters, tubes, drains.
- Perform muscle simulation using massage or electric underwear.
Basic therapy rules to follow
Treatment of bedsores at home implies the fulfillment of certain conditions:
- Maintain the cleanliness of the dermis, do not overmoisturize or overdry. Regularly arrange air baths. To wash the patient's body, use ordinary soap, a cotton sponge, and water. Wipe the patient's skin lightly. Pat damaged areas gently.
- Monitor the state of the dermis. Wet dry using powder, talcum powder, potassium permanganate solution or zinc ointment. Dry - moisturize with baby cream. oily skincan be treated with alcohol-containing solutions. However, these actions are only allowed at the first stage.
- Incontinence patients are advised to change pads or diapers more frequently.
Treatment of pathology at home
Elimination of bedsores is possible provided that blood circulation resumes in the affected area, and if it continues to be in contact with the surface, then any actions are not effective. Treatment for pressure ulcers at home consists of the following:
- Change the position of the patient to restore blood flow in the damaged area of the dermis. At the first detection of redness or wounds, contact of this place with the bed should be completely excluded. To do this, you can put soft rollers under the body. Preventive massage and wiping with camphor alcohol is allowed in the absence of a wound surface.
- Remove dead skin. Lifeless areas of the epidermis are removed using antiseptic agents: hydrogen peroxide or chlorhexidine solution. If the wound is festering, use "Iruksol" or "Proteox-TM"
- Wound healing. Medicines used to treat ulcers are prescribed by the doctor depending on the stage of the bedsores.
Decubitus ulcers on the coccyx and buttocks
If there are injuries on the buttocks, the patient should lie on his stomach or on his side. It is necessary to eliminate the negative impact and restore the blood supply to the tissues, otherwise the effectiveness of therapy will be reduced to zero. To treat pressure sores on the buttocks at home, you will need:
- Restore blood flow in the damaged area.
- Remove dead skin areas.
- Clean the wound.
- Treat with a drug containing silver ions. Due to its antiseptic and analgesic properties, it will help to heal the wound surface faster.
The bedsores are the largest on the coccyx and quite often necrosis occurs in this place. To prevent them, the patient should be periodically laid on a special circle so that the coccyx area does not come into contact with the surface of the bed. A good effect in the treatment of bedsores on the coccyx at home is obtained using dressings moistened with saline-cognac solution in a ratio of 30 to 150 grams, which are applied under compress paper. Change it as needed. Before applying a new bandage, thoroughly rinse the damaged area from s alt.
For healing, use antibacterial ointments, sea buckthorn oil. For purulent wounds, use streptocide, which must first be crushed in a mortar to a powder state or boric acid. These products have bacterial and antiseptic properties.
Heel bedsores
They appear in every second patient. The reason for their formation is a violation of blood flow, lack of physical activity, poor-quality care. Treatment at home for pressure ulcers on the heels of the first and second stages is as follows:
- daily foot hygiene;
- air baths;
- contrasting douches;
- deletekeratinized skin;
- treatment of damaged areas with sodium chloride solution;
- application of medicines that improve blood circulation, as well as special dressings soaked in antiseptic preparations.
The use of drugs is possible only after consulting a doctor.
Any therapeutic measures should be aimed at improving blood circulation in the tissues, removing dead areas of the dermis and healing wound surfaces.
Treatment of deep bedsores at home involves the following steps:
- Disinfect the heel with a solution of chlorhexidine or hydrogen peroxide. If the bone is visible, then it is treated with special products containing biologically active substances.
- Remove the keratinized parts of the dermis, clean the wound from pus, using sterile material and medical products. In some cases, surgery will be required to remove damaged tissue.
- A drug is applied to the wound surface and a bandage is applied to it for a period determined by the doctor.
Home Therapy
Treatment of bedsores in the initial stage at home does not require specific therapy. All therapeutic measures should be aimed at eliminating congestion:
- light massage;
- hygiene;
- maintaining the integrity of the dermis;
- use of various anti-decubitus devices;
- turning the patient every twohours.
In some cases, the doctor may recommend treatment of the damaged area of the dermis with an alcohol solution of camphor, Japanese Sophora or sea buckthorn oil.
At the second stage, the following activities are carried out at home:
- treat bedsores with chlorhexidine or hydrogen peroxide;
- apply a sterile bandage with drugs: Solcoseryl, Levomekol, Actovegin, Levosin or use special patches, for example, Cosmopor, and hydrogel dressings that support the wound have also proven themselves well necessary moisture and have a healing effect;
- preventive measures.
Treatment of purulent bedsores at home
In these cases, it is necessary to carefully select therapy, as there is necrosis, inflammation and infection. The pathological process quickly spreads to areas of the body with impaired blood circulation. Dead tissues are not torn off on their own, surgery is required to remove them and open purulent cavities.
For the healing of deep ulcers, antibacterial and antiseptic drugs are used internally and externally. Treatment of grade 3 bedsores at home involves regularly cleaning the wound from pus and protecting the dermis from overdrying. The list of ointments used for these purposes is given below. In addition, you can use medicines in the form of gels:
- Metronidazole. The drug helps to slow down the growth of pathogens, eliminatesbad smell from the wound.
- "Intrasite". This hydrogel removes necrotic tissue. The drug is used together with a bandage. The medicine absorbs the discharged contents from the wound and gently cleanses the damaged area.
In the fourth degree of bedsores, ulcerative lesions extend not only to the dermis, but also capture bones, joint capsules and tendons. Treatment of bedsores consists in excising the site of necrosis, removing pus from the wound, and moisturizing the healing ulcer. Provided that in two weeks of conservative treatment the bedsore will decrease by thirty percent, the doctor changes the therapy. After the acute stage of necrosis, an operative intervention is performed, in which the wounds are cleaned, while preserving living articular bags, tissues and vascular bundles. Further, physiotherapy is recommended for tissue restoration, which includes mud applications, laser, UHF, ultrasound, electrophoresis, electroacupuncture. Treatment for stage 4 bedsores at home is similar to the treatment used for stage 3.
Bandages, pressure ulcer patches
Ulcers in bedridden patients, especially in the elderly, are difficult to treat at home. In addition to solutions, ointments, gels, tablets, doctors increasingly began to recommend the use of patches and dressings. Special medical products protect the wound from infection and microbes, create a favorable environment that prevents the open wound from drying out. Treating pressure ulcers at home with bandages works well:
- Comfil Plus promotes rapid wound healing.
- "Multiferm" is used at the initial stage without infection.
- "Hydrosorb Comfort" is used for shallow wounds.
- "Biaten" for deep damage to the dermis.
- "Proteox-TM" relieves inflammation, removes pus, restores tissues. Used for terminally infected ulcers.
The doctor determines the frequency of dressings in the treatment of bedsores at home individually. When treating at home, you should follow all the instructions and instructions of the doctor. Anti-decubitus healing patches create a humid environment, which contributes to faster wound healing. The patch is quite convenient, since it can be glued for several days, provided there are no allergic reactions. Using a patch, in five courses it is quite possible to cure a bedsore in the second stage.
External medicines
Using ointments to treat bedsores at home will help to avoid many negative consequences. Their benefits are as follows:
- availability;
- help improve blood circulation;
- eliminate discomfort;
- have analgesic and wound healing effects;
- destroy bacterial and viral infections.
The disadvantages include individual intolerance and inability to use in advanced cases. The selection of a drug for external use should be entrusted to the doctor. To widely prescribed ointments forPressure ulcer treatments include the following:
- Zinc. This remedy, having anti-inflammatory and antiseptic properties, dries and protects the wound surface from the irritating effect of environmental factors. Apply it at least six times a day. A small amount of the drug is applied to the damaged area. The course of therapy is about two months.
- "Argosulfan". The composition of this medication includes silver, which has a healing and antibacterial effect. The ointment helps to eliminate pain and burning sensation. It is applied to the wound in a thick layer at least twice a day. The pre-damaged surface is treated with an antiseptic solution and dried.
- "Levosin". Due to the antimicrobial, antiseptic and wound-healing effect, the use of ointment in the treatment of bedsores at home helps to cleanse the wound of purulent contents and dead cells.
- "Solcoseryl". The drug, when applied externally, has a regenerating effect on tissues. The wound is disinfected, then an ointment is applied, resulting in a thin film that protects the damaged surface from external factors. Apply the ointment until complete healing.
- Levomekol. Antibacterial and restorative action is used to treat infected bedsores.
The use of drugs for the treatment of bedsores must be combined with preventive measures.
Healing pressure ulcers with herbs
There are quite a few recipes thatrecommended to treat bedsores. However, it should be remembered that the use of alternative medicine methods is possible as a prophylaxis, in the first, rarely in the second stage, and only after consulting a doctor.
In the treatment of bedsores at home, folk methods use infusions and decoctions prepared from various herbs. They wash the wounds and make lotions using sterile dressings. Medicinal plant materials are selected depending on their medicinal properties:
- Calendula is an excellent anti-inflammatory, antibacterial and regenerating agent that successfully treats weeping bedsores. For washing wounds and lotions, the infusion is used at least three times a day.
- Chamomile has anti-inflammatory, disinfectant and analgesic properties. A healing decoction is prepared from the flowers.
- Donnik. The wound healing, analgesic, anti-inflammatory property of this plant is used to prepare a decoction. Strengthen its action with chamomile flowers in a ratio of 1: 1. The resulting solution is moistened with a sterile material and applied to the damaged areas of the dermis several times a day.
- Infusion of periwinkle herb, which has a disinfecting effect, is used to wash wound surfaces. The procedure is carried out twice a day.
- The leaves of Kalanchoe or Aloe are cut lengthwise and the pulp is applied to the wound, fixing with a bandage. This procedure is performed before going to bed.
- Sea buckthorn and rosehip oils, which have antibacterial andregenerating action, mix and lubricate the damaged area with them.
If the treatment of bedsores at home with folk remedies does not work, then more effective measures are needed, that is, the use of medicines. Treatment by non-traditional methods refers to additional measures to combat this disease. Medicinal herbs can cause allergic reactions, and then the treatment should be stopped. It is forbidden to use medicinal raw materials with a tannic effect for bedsores.
Treatment of bedsores in dogs at home
Such trouble can happen to a pet. The cause of bedsores is paralysis of the hind limbs, which develops due to a spinal injury; prolonged illness, squeezing the skin with a collar. Bedsores in a paralyzed animal are formed on those parts of the body that experience the greatest pressure. At the same time, the skin becomes covered with sores, swells, unpigmented areas turn red, and an unpleasant odor appears. If they are found, you should contact your veterinarian, who will advise special protective pads or bandages.
Damaged skin is treated with a solution of brilliant green, potassium permanganate, hydrogen peroxide, camphor alcohol. A sick dog should be turned over more often and pick up a soft bed for her. For the prevention and treatment of bedsores, there are special designs in the form of an orthopedic bed for animals. In addition, massage serves as a preventive measure.
