What are bedsores, causes
Bedsores - are areas of ischemia (bleeding) and
necrosis (necrosis) tissue resulting from prolonged
of compression, shear or displacement between them and the human skeleton
It is well known that human tissue function,
obtaining the necessary nutrients from the blood. Delivers blood into
all organs and tissues of the human body blood vessels which
countless permeate all human tissue and are
a soft flexible tube. The smallest of them - the capillaries -
especially important for normal metabolism in tissues. Motion
liquid in such tubes is easy to slow down or stop completely
by compression of them. At any sitting or lying person happens
soft tissue compression and compression of blood vessels, resulting in
to a lack of blood flow to the tissues. If this condition
It lasts more than 2 hours, the power supply (ischemia) the violation occurs, and then
and necrosis (necrosis) of soft tissues. Develops decubitus. therefore
we must remember that prolonged immobility lying down or sitting -
A second reason for which may be formed bedsores - is
for example, when the patient is pulled on the bed, pulled out from under him
wet clothes, trying podpihnut under his boat. At that time
there is a significant displacement of surface layers of soft tissue by
deeply located with respect to the layers, resulting in a small
torn blood vessels, and blood supply of these departments is broken.
Similarly, pressure ulcers may form and weak bedridden
patients who, without stop in the legs, slowly begin to slip
on a chair or bed from a sitting or half-sitting, that is barely noticeable
eye, but very palpable soft tissue.
Risk factors for pressure ulcers:
Potential locations of Education bedsores can be all places
over bony protrusions on the body, which are compressed when lying or
seat. In these places it is weaker all the subcutaneous fat
fiber, most strongly expressed pressure of bony protrusions. If
the patient lies on his back - these places are the sacrum, heels,
ischial tuberosity, elbows, shoulder blades, back of the head. If on one side - on the hip
side (the region of the greater trochanter), on the sides of the ankles and knees. If
the patient lies on her stomach - the pubic area and cheekbones.
Preventing pressure ulcers
Prevention of bedsores are inseparably connected with the whole complex for a sick man care measures.
The material on the prevention of pressure ulcers cost is always less than their treatment.
Organization of care and monitoring of patients should be engaged in one
human. He may have assistants - specialists, which can be
to consult; but a final decision should be exactly that,
who organize care and has the most opportunities to watch
The preventive measures need patients who use
wheelchair, bedridden patients, patients suffering from partial
immobility (the hotel part of the body), incontinence of urine and / or feces,
depleted patients, obese patients suffering from diabetes,
consequences of a stroke.
The principles of prevention:
- reduction of compression, friction and shear;
- nutrition and personal hygiene;
- reduction of skin irritants;
- skin care - keep the skin clean;
- decrease in skin moisture;
- the regularity and correctness of items (urine and stool).
Decrease of compression. Requires soft but springy mattress. To do this, fit foam
mattress thickness shall not be less than 15 cm. The bed should be
smooth, without bumps and pits. You can purchase special
anti-bedsore mattresses, but remember that it is not a panacea for bedsores,
other measures with a deficiency in a patient lying on it can still
formed bedsores. Daily inspect the skin, especially in areas
bony protrusions, as it was there and formed bedsores. must
often change the position of the patient's body, the skin has experienced minimal
friction and soft tissue - the minimum displacement. This should be done not
at least every 2-3 hours, including at night. By place
bony protrusions further enclose the rollers, for example, soft
pillows feather or foam. Under the fixed limb can sew
bags filled with round grains, such as millet. Under the sacrum
enclose rubber circle. The meaning and use of a variety of rollers
anti-bedsore mattresses is that they increase the area
body contact and the surface on which the patient lies, and means
reduced pressure on every part of the body, reduces violation
blood flow and thus decreases the risk of bedsores.
Do not tighten the patient alone if the patient can not help you.
Do not pull or yank underwear from under the patient, especially wet. Not
podpihivayte under his boat. For all this, there are some simple techniques,
the basic meaning of which is that the patient must first
lift, and only then move or underlay under him anything.
Do not leave the patient in an uncomfortable position, and weak patients
try to sit down and give them a semi-sitting position, because their
muscle activity is not enough to hold in position, and they
begin to slide. Provide these patients stop (any
a device for the stop) in the legs.
Eating and drinking. Drink and food should be complete within the constraints if
any. The food must contain at least 20% protein. choose
products, which contain many trace elements - zinc and iron, and
and vitamin C. Use dairy products, greens, vegetables,
fruit. For severe cases the meat - tough food. Use chicken
soup, fish, beans, whole grains and dairy products to meet the needs of
protein. Drinking at least 1.5 liters, if there are no restrictions. Do not drink
sugary and carbonated drinks, as well as freeze-dried products,
those. Fast Food out by dissolving the solids in water.
Reduced skin irritation. Stela old, faded, and so soft linen; watch,
to the laundry was not rough seams, buttons, patches; regularly and
often recovers bed to a patient did not have wrinkles and fine
items. Use skin care low-allergenic tested
means, for example, children's soap. Avoid bright colors and strengths on
odor substances. Most spend perineal toilet because fecal particles and
urine are strong irritants. In no case do not
limit patient drink with urinary incontinence, because the shortage
fluid increases the concentration of urine, and thus the strength of
irritation. Short cut the nails themselves and the patient: Statement - to
do not accidentally scratch the patient, and the patient - that he did not combed
skin because with prolonged sitting or lying flattened areas itch.
Make sure that the patient was wearing a blanket and closed, respectively,
room temperature conditions. In case of overheating of the patient is enhanced
sweating and increases the risk of developing pressure ulcers.
Rules skincare. The rules are simple enough: Do not allow contamination of the skin,
excessive dryness or humidity, because such a skin is less likely
able to resist external influences, use plain water,
soap, washcloth from x / cotton fabric or natural sponge, nutrients and
moisturizers, dries ointment, powder. closely monitor
skin, and you will become clear in a moment that apply. overall
rule is: wet skin need to dry, and dry - moisturize. Not
Use an antibacterial soap, because along with the harmful bacteria
destroyed and beneficial micro-organisms; skin after termination
Use this soap becomes poor talent to resist even
minor infections (advertising tells the truth, but not all).
Alcohol-based agents such as lotions and camphor alcohol can
used only for patients with oily skin. Skin in places
compression of not rub when washing. Eat soft sponges and use
them very delicately, so as not to injure the upper layers of the skin. at
Drying of the skin do not wipe it, and blotted. reddened areas
skin in no case do not massage, but light regular massage
around these areas it is highly desirable. Be sure to arrange for a skin
On skin moisture significantly affects primarily urine and perspiration.
The main thing - the patient's personal hygiene and linen. Do it often. at
incontinence pads or better to use diapers, although
Some patients only often enough to give the ship. for lack of
means for backing up and try to use diapers diapers from
clothes (many times folded c / b lingerie, padded crotch or
planted under the buttocks, will limit the spreading of urine; old faded
Linen absorbs moisture). When incontinence in men can be
mochepriemnuyu use a special system (the bag).
Sweating occurs in temperaturyaschih patients. For
To reduce sweating, must first of all, to treat
underlying disease. For wiping the patient's better not to use soap
and water, and a weak solution of vinegar (1 tbsp. tablespoon of vinegar to 1
glass of water).