Bedsore - necrosis of soft tissue arising from the violation of their power and prolonged pressure on a certain area of the body. The development of pressure ulcers helps the patient limited mobility, lack of care, as well as violations of sensitivity and trophism. Pressure sores normally occur in the areas adjoining bone projections to skin (sacrum, heels, shoulder blades, etc.). Defeat can be both superficial and deep (with necrosis of muscles and tendons). The treatment of bedsores depends on the depth and necrosis stage. When superficial bedsores performed ligation, excision is necessary for deep necrotic tissue isotretinoin acne. Treatment is a long, difficult task, so in the process of patient care, special attention should be paid to preventive measures for the prevention of bedsores.
Bedsore - necrosis that occurs due to prolonged pressure in conjunction with the violation of the innervation and blood circulation in a particular area of the body. Developed in debilitated bedridden patients. Furthermore, decubitus may occur in patients with fractures due to the pressure is too tight or uneven plaster cast, as well as people with dentures (if poor fit).
The likelihood of developing bedsores depends primarily on two factors: the quality of care and disease severity. In some cases, pressure sores quite difficult to avoid and to prevent them have to use a whole arsenal of special devices: anti-bedsore mattresses, special absorbent diapers, circles, and place them under certain parts of the body, and so on..
The main cause of decubitus is compression between bone and tissue located outside the solid surface. The soft tissues are compressed between the bone and the bone bed or wheelchair, and that leads to disruption of blood flow in small vessels. To the cells constricted region ceases to flow oxygen and nutrients, resulting tissue site mertveet and dies.
Additional causes skin lesions in typical locations of Education bedsores are friction and glide. The friction of the sheets or clothing occurs when the patient changes position independently, or it is inverted or transplanted family members or honey. workers. Slip promotes too high lift head end of the bed in which the patient slides down and attempt to remain in a sitting or semi-sitting position without proper support.
Other factors that increase the risk of pressure sores include:
Sensitivity degradation due to neurological diseases, spinal cord injury, and so on. d. Under these conditions, patients do not feel pain and discomfort, evidence of compression of the soft tissues. Pressure ulcers in patients with paralysis tend to be prolonged, persistent course and can occur even in atypical locations (for example, due to the pressure shoe edge).
Elderly age. With age, the skin becomes thinner, it becomes thinner, drier and less elastic. Its regenerative ability are reduced, and the probability of the development of pressure sores increases.
Poor diet and lack of fluids. Due to lack of fluid and nutrients to the skin condition is disrupted, which creates conditions for the occurrence of bedsores. Weight loss and muscle atrophy. Muscle and fat tissue are natural layers between bony prominences and skin. If they decrease the skin is exposed to a pressure increase in the load. Therefore, pressure ulcers are often formed in malnourished patients.
Too wet or too dry. The skin becomes dry when the temperature rises, and wet - when sweating, which can be caused by both the disease and the patient's excessive overheating (too warm blanket, too high temperature in the room). Incontinence of urine or faeces. Patients unable to control their bladder is often damp skin, making it more vulnerable to the formation of bedsores. And the bacteria present in the stool, may contribute to infection of pressure ulcers and cause of severe local complications.
Diseases caused by circulatory disorders (diabetes, arterial occlusive disease, acute occlusion of blood vessels, atherosclerosis). Muscle spasms. When involuntary movements of the skin is constantly plagued by friction of the sheets, clothing and other surfaces.
Disorders of consciousness. Patients can not adequately assess its condition and to refrain from actions that provoke the formation of pressure sores or perform actions that prevent their appearance. Smoking. Nicotine constricts blood vessels, which leads to deterioration of the blood supply. Furthermore, smokers suffer from chronic lack of oxygen. All this becomes a cause of deterioration and slow process of healing any wounds, including - and bedsores.
The skin becomes thin bedridden patients and is very vulnerable to damage, so care it should be gentle, delicate. It is undesirable to use silnopahnuschih alcohol-based cosmetics that can cause allergies and skin irritation. Preferably use special sparing hygiene.
Care should be taken so that the patient's skin was always dry and clean: wipe it with a soft towel when sweating, as quickly as possible to remove from the skin the natural selection (feces, urine) to conduct hygiene of intimate areas after each defecation and urination. The change of bed linen must be performed with the use of special techniques, turning the patient and rolling it on clean sheets, but in any case not pulling out of his underwear.
It should also encourage the patient to move and ensure that its food was moderate, balanced, rich in minerals and vitamins, but relatively non-nutritive, because of the low mobility of the number of calories needed in such cases is reduced.
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