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Special Information
BEDSORE TREATMENT

Stage I and II bedsores usually heal within a few weeks and/or months with appropriate general care of the patient and conservative care of the wound. Stage III and IV bedsores are more difficult to treat.

TREATMENT TEAM

Wound care usually requires a multidisciplinary approach. Members of a care team must include:

  • A primary physician who oversees the treatment plan0
  • A nurse specializing in wound care
  • A professional caregiver who will provide the patient with care and the family with accurate information in the long run
  • A physiotherapist who helps with improving mobility
  • A dietitian who monitors the nutritional needs and plans the appropriate diet
  • A plastic surgeon in cases which require surgical operation

 REDUCING PRESSURE

The first step in bedsore treatment is reducing the pressure on the area that has constant contact with the bed. Strategies include the following;

  • Repositioning: OF there is a bedsore, the patient needs to be repositioned regularly and placed in correct positions. If the patients use a wheelchair, they must shift their weight every 15 minutes and change their position every hour. If the patients are bedridden, position must be changed every two hours.

Ask for the cooperation of patients, if they are able to, when repositioning the patients. Caregivers can use bed linens to help lift and reposition the patients. This can reduce friction and skin irritation.

  • Using Support Materials: Special cushions and tampons must be used in order to lie and reposition the patients and to protect the skin against sores and pressure. If the patient is in a wheelchair, you can use the cushions filled with foam, air or water as a tampon.

CLEANING AND COVERING WOUNDS

Care model that helps with healing of the wound must include the following;

  • Cleaning: It is essential to keep wounds clean in order to prevent infection. If the affected skin is not broken (Stage I), gently wash the skin with a little soap and water and pat dry. Clean the sore with a physiological saline solution each time you change the dressing.
  • Covering the wound: Covering the wound promotes healing by keeping the wound moist, creating a barrier against infection and keeping the surrounding tissue dry. Wound covering choices include gauze dressing, gels, wound films and barrier creams. A combination of those materials may be used for wound treatment as well.

Your physician selects a covering material by considering a number of factors such as the size and severity of the wound, the amount of discharge and the ease of placing and removing the dressing.

REMOVING DAMAGED TISSUE (WOUND DEBRIDEMENT)

The wounds must be free of damaged, dead or infected tissues in order to provide proper healing. Wound debridement is applied by means of a number of methods depending on the patient’s overall condition, the objectives of treatment and the severity of the wound.

  • Surgical Debridement: Cutting away dead tissues
  • Mechanical Debridement: Loosening and removing wound debris. This procedure may be carried out with a pressurized irrigation device, low frequency ultrasound or special dressing materials.
  • Autolytic Debridement: Autolytic debridement uses the body’s natural process of using enzymes to break down dead tissue. This method is used on uninfected and small wounds.
  • Enzymatic Debridement: This type of debridement involves applying chemical enzymes and appropriate dressings in order to break down dead tissue.

OTHER INTERVENTIONS

Other interventions that may be applied are;

Pain Management: Bedsores can be painful. Non-steroidal anti-inflammatory drugs such as Ibuprofen or Naproxen etc. may reduce the pain. Those medications may be very helpful during debridement procedure and dressing changes. Topical pain medications may also be used during those procedures.

Antibiotics: Topical or oral antibiotics promote the treatment in case of infected sores.

A healthy diet: In order to speed up wound healing, your physician may recommend a high protein diet rich in vitamins and minerals which increase the calorie and fluid support.

Incontinence: Urinary or bowel incontinence may increase the risk of infection by causing bacteria and excess moisture on the skin. Managing incontinence speeds up the wound healing. Helping the patients with urinating, frequent diaper changes, protective lotions on healthy skin and using urinary catheters are some of the strategies to be applied.

Muscle Spasm Relief: Spasm related friction or damaging worsens the bedsores. Muscle relaxants are useful in such cases.

Negative Pressure Therapy (Vacuum Assisted Closure – VAC): This treatment involves using a device that applies negative pressure (suction effect) to a clean wound. This procedure speeds up the healing in the treatment of some pressure wounds.

SURGERY

Surgery operations may be required in case of bedsores that cannot be healed. The objective of surgical operations include improving hygiene and appearance of the wound, preventing and treating the infection, reducing fluid loss through the wound and mitigating the risk of cancer.

In case a surgical intervention is required, the procedure to be carried out depends on the location of the wound and whether there is a scar tissue. In general, most bedsores are covered by using muscle, skin and other tissues as a pad and cushion the affected bone.

You may request for a visit from our wound care nurses who hold relevant certificates regarding bedsore treatments and visit our Medical Center site for professional assistance.

UZMANINA SOR
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