Prophylaxis of pressure sores

Clean skin and lack of damage on it - the main conditions for its normal operation. The function of the sebaceous and sweat glands contributes to the preservation of the elasticity, softness and flexibility of the skin.

Excessive perspiration results in skin contamination. Together with sweat, microorganisms accumulate on the skin, which cause skin itching. Itching causes scratching, contributes to the appearance of abrasions, which are the entrance gates for the penetration of microorganisms into the thickness of the skin.

If you do not follow the skin, it can form intertrigo. With poor skin care and a sharp weakening of the body in places with a small amount of subcutaneous fat tissue on the skin there are integrity disorders - the so-called bedsores. Such places are usually the area of ​​the sacrum, shoulder blades, large trochanter, elbows, heels.

Bedsores - necrosis( necrosis) of the skin, due to compression of tissues with trophic disorders. At a young age, bedsores occur as a result of diseases or injuries of the spinal cord, in the elderly - in weakened patients with prolonged lying, unable to independently change the position of the body or its individual parts.

Bedsores occur:

• in the position of the patient on the back - in the region of the hills of the heel bones, sacrum and coccyx, scapulas, on the back surface of the elbow joints, rarely over the spinous processes of the thoracic vertebrae and in the region of the external occipital protrusion;

• in abdominal position - on the anterior surface of the shins, especially above the anterior edges of the tibia, in the patellar region, as well as at the edge of the rib arch and the superior anterior iliac spine;On places where soft tissues are squeezed by the surface of the bed.

The formation of decubitus is facilitated by poor skin care, an uncomfortable bed, its rare re-laying. With insufficient care of the patient in the place of compression, at first the skin becomes pale, then cyanosis appears. The tissues become edematous, to the touch cold. In the future, the epidermis exfoliates, there are blisters and necrosis of the skin. Patients complain of numbness, then to mild pain. In severe cases, not only the soft tissues, but also the periosteum, as well as the superficial layers of bone substance are necrotic. Accession of the infection can lead to sepsis and cause death.

A nurse must wipe the skin of a seriously ill person daily with a disinfectant solution: camphor alcohol diluted with 40% ethyl alcohol. One end of the towel is wetted by the solution and all skin is wiped. Then the other end of the towel( preferably terry), the skin is wiped dry.

It is useful to carry out vigorous rubbing of the skin. Instead of a towel, a gauze swab can be used.

To prevent the formation of pressure sores, it is necessary: ​​

• if the condition allows, turn the patient several times a day on the side;

• spread the sheets, make sure that there are no crumbs in the bed;

• make sure that there are no patches, folds, etc.;

• put an inflatable rubber circle under the sacrum of the patient - so that the sacrum is located above the hole of the circle( on the circle, first put on a pillowcase or wrap it in a diaper);Instead of a circle, you can use water cushions, foam pads, etc.;

• daily wipe the skin with a disinfectant solution or a towel moistened with warm water;then the skin must be wiped dry and rub this place with a dry towel.

With the appearance of areas of redness, similar to the beginning bedsore, the listed activities are carried out more intensively. Assign UV-irradiation, the electric field of UHF.When bubbles appear, they are lubricated with a 1% alcoholic solution of brilliant green, then a dry bandage is applied. You can use a 1% solution of potassium permanganate. The enzymatic cleansing of the wound is facilitated by the preparation of Iruksol, which is applied twice a day, applying a moist bandage. The rejected necrotic tissue should be removed when changing the dressing. You can use Vishnevsky ointment, sintomycin emulsion, aerosol "Levovinisol", panthenol ointment, solcoseryl - in injections and externally as an ointment.