ArticleManagerDue to various diseases or aging and other reasons, some patients, especially elderly patients, will lose the ability to move limbs autonomously, and thus be in a long-term bedridden state. After long-term bed rest, there will be many complications, common is that the lungs and urinary system are easy to infect, and pressure ulcers are prone to occur. Therefore, nursing patients who are bedridden and preventing pressure ulcers is one of the important nursing tasks. How can this be done? Here’s a detailed explanation for you.
What is a pressure ulcer
Pressure ulcers are also called bedsores and pressure ulcers. Due to long-term compression of local tissues, local blood circulation is blocked, persistent tissue ischemia, hypoxia and malnutrition, resulting in tissue ulcer necrosis.
In mild cases, only local skin redness appears, and as the pressure time stops, local blisters will appear, and after the blisters are broken, a relatively shallow wound will appear. In severe cases, necrosis and loss of skin, subcutaneous tissue, and muscles may occur.
People who are prone to pressure ulcers
The most common people for pressure ulcers include: coma patients, patients who have been bedridden for a long time after surgery, patients with activity dysfunction such as hemiplegia and paraplegia, elderly people who have been bedridden for a long time, and patients with cachexia states such as tumors.
Prone to pressure ulcers
Pressure ulcers mostly occur in bone carina that has no muscle layer or a thin muscle layer, lacks the protection of adipose tissue and is easily injured, such as the sacral coccygeony, heel, ankle, shoulder blade and posterior occipital, as well as the hip joint and iliac crest. In particular, the sacral coccygeal and buttocks are most susceptible to pressure and are most prone to deep ulcers. Pressure ulcers can occur in the rest of the body life position, as long as they are pressurized for a long time and do not receive timely decompression care.
Clinical manifestations and staging of pressure ulcers
Pressure ulcers can be divided into six stages according to the clinical presentation:
The first stage is mainly a change in skin color, manifested by redness of the skin without skin breakage.
Secondary pressure ulcers may appear as reddened or purple skin with blisters and induration or superficial ulcers under the skin;
Third, the full-thickness skin is broken during pressure ulcers, the subcutaneous tissue can be exposed, necrotic tissue can be shed, and pus exudation during infection, but it does not hurt the muscle layer.
Stage IV is the most severe and deepest period of pressure ulcers, the wound can be seen that the muscles and bones are all exposed, if the infection spreads, it can reach the bone surface, the necrotic tissue is black and smelly, and severe can cause sepsis.
In addition, there is non-staging, the finger pressure ulcer is wrapped in a black scab, I don’t know how the actual damage is inside, and the black scab must be clamped to know whether there is a sinus formation inside.
Finally, there is suspicious deep tissue, which refers to seeing a change in the color of the affected skin, but not knowing the extent of damage to the internal tissue.
Treatment of pressure ulcers
Once pressure ulcers occur, they need to be treated as soon as possible and need to be treated in a professional facility.
For mild pressure ulcers, local cleaning and disinfection, drying and ventilation while enhancing nutrition can be used, and then external medication can be applied.
For pressure ulcers above grade 3, the wound is easily infected, and local dressing change can be selected when the disease is mild. When the disease is severe and co-infected, surgical debridement is required to remove the necrotic tissue.
If there is a relatively large defect in the wound, it can also be treated with flap transplantation.
Prevention of pressure ulcers
Prevention is mainly scientific care for bedridden patients to avoid the occurrence of pressure ulcers.
Stress reduction care, that is, turning the patient over regularly, about two hours later. At the same time, the decompression method can also use a variety of cushions to remove the parts that are prone to severe pressure off the bed. An air bed can also be used to prevent persistent pressure on the local skin. In conclusion, decompression is the most important way to prevent pressure ulcers.
Dry care, including proper care for sweat and fecal incontinence, aims to keep the skin dry, as the moist environment of the skin is also prone to pressure ulcers.
Nutritional support, bedridden patients need to strengthen nutrition, balanced diet, so as to ensure nutrition, is also an important aspect to prevent pressure ulcers from occurring or promoting healing after they occur.
In short, long-term bedridden patients, nursing is not in place, it is very easy to cause the occurrence of pressure ulcers, so it is necessary to do stress reduction care and dry care, and pay attention to diet and nutrition, in order to effectively prevent the occurrence of pressure ulcers.