Prevention and treatment of pressure sores

Prevention of bedsores - proper care: the change of the position of the patient, if this is not contraindicated (eg, myocardial infarction, vascular diseases of the brain and spinal cord with the paralysis), placing the patient on a special anti-decubitus or even a mattress covered stretched, without folds, sheets. The seams of underwear should not be located in places where is possible the formation of bedsores. Under the sacrum and coccyx enclose a circle or a rubber boat, covered with sheets or placed in a case. The circle must be fool enough to moderate the pressure on his hand felt the subject on which he lay. Under the heel pad of cotton-gauze circles, and when the patient on his stomach them placed under the knee cap, combs and hair Ilium. Wet, contaminated linen should immediately change. Places of maximum pressure not less than 3-4 times a day rubbed one of the solutions: with camphor spirit, 0.5% solution of ammonia, 1-2% solution of tannin in alcohol, 1 % salicylic spirit, free or diluted vinegar. Wiping combined with a light massage and exposure to quartz.
Treatment. When hyperemia in places pressure leather apply the same measures as for prevention, as well as local d'arsonvalization, paraffin and UHF. To prevent transition of dry necrosis in wet contribute systematically wiping the skin around the bed sore alcohol, lubrication site necrosis alcoholic iodine solution. When the demarcation line of the dead tissue is removed. Self exclusion necrosis lasts a long time. Early excision of necrotic areas when the weeping sore prevents the formation of satikov, reduces intoxication. Excising the necrotic tissues until the bleeding edge of the wound. New necrotic lesions are removed at each dressing change with subsequent application of bandages with 25% solution of magnesium sulfate, 10% solution of sodium chloride, enzyme - himotripsina. In patients with diabetes makes exclusion necrosis and granulating wound irrigation its pure insulin or with the addition of amiotrofia or acetylcholine 1 : 1000 (1 ml 10 ml of insulin). After purification of bed sore from dead tissue and pus impose ointment bandages, dressings from a solution of boric acid, potassium permanganate with antibiotics. At all stages of treatment, the daily quartz lamp radiation affected areas. Prevents the formation of bedsores and accelerates their treatment is the use of drugs arsenic (drazhirovannye arsenic tablets, tablets Blo with arsenic 2-3 times a day), strychnine (0.5 - 1 mg 2-3 times a day), aloe, vitamins [ascorbic acid, thiamine (B1), cyanocobalamin (B12)], prozerina, transfusion of donor blood, nutritious meals, shared bath. In some cases, accelerate healing of pressure ulcers perirenal procaine blockade. Treatment of pressure sores can be under the bandage and the open way. In an open way, especially when extensive bedsores, part of the patient's body with bedsores is under a wire skeleton, covered with a sterile sheets. The treatment is carried out by the same means, but wound bandage is not closed.
Conservative treatment of pressure sores is very long and not always with good results. Operative treatment is the excision of necrotic tissues at a distance of 1 to 1.5 cm from the edge to healthy skin and suturing or close the wound movement of skin flaps or free a skin graft.

Treatment. With the appearance of bubbles and excoriation to lubricate alcohol (officinalis) solution brilliant green, put the dry bandage. When necrosis is delineated, dead tissue is removed by type how agressively to debride (see), and saped edge in circumference split. Encountered the wound closed with gauze soaked in 1% solution Kalii hyperm., dressings are changed 2 times a day; as cleansing of wounds move on ointment dressing (Vishnevsky ointment, streptocida or zulfigarova emulsion), soapy bath, as well as exposure to quartz. At impossibility of early rising need to cause increased blood circulation throughout the body by means of baths and active, or at least passive movements. Apply on the testimony transfusion single-group of blood.
Prevention. Particularly susceptible to pressure sores body parts must be protected air rings (rubber pressurized air circles), water pillows and moving from place to place linings. Once or twice a day to the skin in this area is washed with cold water and soap and wipe alcohol (camphor, salicylic), Cologne or free and vinegar, and then pripudrivayut. Pressure bus, plaster cast, etc., if the patient complaints should be immediately eliminated. Lying on the back of a long suffering should be during the day at least 1 hour replaced by a provision on the side.
Cm. also care for the sick.