Bedsore (Pressure Sore) Treatment Services
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During the pressure wound treatment and care process; Stage I and II bedsores usually heal within a few weeks and/or months with good care of the patient, comprehensive and meticulous care of the wound. Stage III and IV bedsores are more difficult to heal.
Bedsores are also called pressure sores or decubitus ulcer.
Bedsore Treatment Team
Pressure sore/bedsore treatment usually requires a multidisciplinary approach. And the members of a wound care team must be the following:
- Primary physician supervising the patient’s treatment plan
- A nurse specializing in pressure wound care
- A professional caregiver who will provide long-term care to the patient and share accurate information with the family.
- A physical therapist who helps to increase range of motion
- Dietitian who observes nutritional needs and plans the appropriate diet
- Plastic surgeon in cases that require surgical procedures
The first step in the treatment of pressure sores is to reduce the pressure on the area that constantly touches the bed.
The strategies are as follows;
- Repositioning: If 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. Thus, friction and skin damage can be reduced.
- Use of Supporting Materials: Special cushions and tampons must be used to lay the patient in the appropriate position, to give position and to protect the wound and skin from pressure. If the patient is in a wheelchair, a cushion filled with foam, air or water may be used as tampon.
Cleaning and Covering the Wound During Pressure Sore Treatment Process
The care model that facilitates recovery must comprise the following;
- Cleaning: Keeping the wound clean is essential to prevent infection. If skin is not broken (1st Degree) gently wash the skin with some soap and water and PAT dry. Clean the wound with saline solution every time you change the dressing.
- Covering the Wound: Covering the wound creates a barrier against infection by keeping the wound moist, and keeps the surrounding tissue dry, thus accelerates the wound healing Wound covering options may be gauze pads, gels, wound films, barrier creams. A combination of these materials can also be used for wound dressing.
Your physician, who is in charge of the bedsore treatment, chooses a wound covering material, by taking into account many variables such as the size and severity of the wound, its discharge, and the ease of application and removal of the material used.
Removal of Damaged Tissue During Bedsore Treatment Process (Wound Debridement)
For a true pressure sore treatment, the damaged, dead and infected tissues around the pressure sore must be removed. Wound debridement is performed by applying many different methods according to the general condition of the patient, the aims of the treatment and the severity of the wound.
- Surgical Debridement: Removal of dead tissue by incision
- Mechanical Debridement: It loosens and removes the scar remains. This process can be done with pressurized irrigation devices, low frequency ultrasound or special dressing materials.
- Autolytic Debridement: It is performed by using the ability of enzymes to destroy the dead tissue in the natural functioning of the body. This method is used for non-infected and minor wounds.
- Enzymatic Debridement: It is performed by using chemical enzymes and a selection of suitable wound covering materials that destroy dead tissue.
Other interventions that can be applied for the treatment of bedsores;
Pain Management: Bedsores can be painful. The lonsiteroid anti-inflammatory medications such as ibuprofen or naproxen may reduce pain. These drugs can be very helpful in debridement and dressing changes. Pain relief creams may also be used during these procedures.
Antibiotics: Cream or oral antibiotics support the treatment of infected wounds.
A Healthy Diet: In order to speed up pressure wound healing, your physician may recommend a vitamin and mineral rich, high protein diet that increases calorie and fluid support. It is recommended for the patient to take supplements containing vitamin C and zinc.
Urinary and Fecal Incontinence: Incontinence problems arising from bladder and intestines increase the risk of infection by causing bacteria and excess moisture in the skin. Fighting incontinence speeds up wound healing. Helping the patient with urination, changing diapers frequently, using protective lotions on healthy skin and using a urinary catheter are some of the strategies that can be employed.
Relieving Muscle Spasm: Friction and injury associated with spasm cause bedsores to worsen. In such situations, muscle relaxants are useful.
Negative Pressure Therapy (Vacuum Assisted Closure – VAK Application): In this treatment, a device is used to apply negative pressure (suction function) on the clean wound. This procedure accelerates healing in the treatment of bedsores.
Pressure Sore Surgery
Surgery may be required for the bedsores that cannot be healed. The aim of surgical procedures is to improve the hygiene and appearance of the wound, to protect and treat it against infection, to reduce fluid loss from the wound and to reduce the risk of cancer.
If surgical intervention is required, the method to be applied is decided according to the location of the wound and to whether there is scar tissue. Generally, most bedsores are closed using muscle, skin, and other tissues to cushion the underlying bone.
Pressure sore treatment is a difficult process and requires continuity. You must make sure that the person or institutions you will receive support from are licensed and get support from certified wound care nurses.
To learn more about bedsores you may want to read our blog articles titled “What is a bedsore?”, “Do bedsores kill?”
Evde Yatak Yarası Tedavisi Alan Hasta ve Hasta Yakınlarından Gelen Yorumlar
- Sinem Ergun
- İhsan Alaeddinoğlu
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