Caring for the seriously ill. Prevention of bedsores

Where do bedsores occur?

Most quickly, bedsores in bedridden patients form on the back, back of the head, areas behind the ears, elbows, shoulder blades, buttocks, hips, ankles and heels. In people who are forced to lie motionless on their stomach for a long time - in the areas of the knees, the anterior surface of the chest, and the iliac crests. When lying on your side for a long time, the area of the lateral surface of the leg, shoulder and ilium is primarily affected.

How to prevent it?

Make sure that you have easy access to the bed of a seriously ill patient (preferably from both sides), and that it is in a well-lit place (to monitor skin condition). Ideally, the bed should have an adjustable height and an anti-bedsore mattress.
When changing underwear, diapers, or washing a bedridden person, inspect his skin in risk areas.
Keep your skin clean .
If a person complains of pain, a burning sensation or pressure in any area, this may be the first symptom of a bedsore.
Do not massage the reddened area! This can lower the temperature of the skin and lead to tissue degeneration and pressure sores.
Change the patient's body position every 2-4 hours. If the person is able to move on his own, remind him to do so more often.
If possible, the person in bed should do exercises for the legs and arms (to speed up blood circulation).
Body position needs to be changed at night as well . Suitable poses: on the side, on the back, on the stomach and half-side. To fix the body in the desired position, make supports from pillows and blankets .
Raise the head of the head by 30 degrees only during meals or grooming procedures. When it is raised, a lot of pressure is placed on the buttocks, which increases the risk of pressure sores.
When laying the patient on his side, place a pillow from the groin area to the foot under the slightly bent upper leg of the person lying down.

How and what is the best way to treat bedsores?

Treating bedsores is a very painstaking process for which you need to prepare. First, caring for pressure ulcers on the buttocks or sacrum is often uncomfortable due to the patient's supine position. Therefore, products for treating bedsores must meet several requirements: ease of use and changing dressings as rarely as possible.

But you need to start with the choice of antiseptics that are used to wash bedsores before applying a bandage. It is strongly not recommended to use hydrogen peroxide, potassium permanganate, brilliant green or iodine. All these agents dry out the surface of the wound and damage the granulation tissue. The simplest and correct choice is chlorhexidine solution. You can treat bedsores directly from the bottle without touching the surface of the bedsore with your hands or a swab.

The next stage is choosing the right remedy for healing bedsores. It is necessary to evaluate the condition of the wound for the presence of necrosis (dead pieces of skin, muscle tissue) and pus. If the wound contains necrotic tissue (gray, white-looking tissue, especially at the edges of the wound), be sure to use Proteox-TM biological purification products for bedsores. If the bedsore is clean but inflamed, start with VitaVallis wound healing coverings. It is recommended to continue treatment with economical Comfil Plus coatings, which can be left on the wound for up to 5 days. Before each new dressing, be sure to re-treat the wound with chlorhexidine solution.

Aids

Mattress with compressor (anti-decubitus system) . They come in two types: cellular - intended for the prevention of bedsores (cost about 100 rubles) and tubular - used for the treatment of deep bedsores (280-300 rubles).

Rubber backing circles - an inflatable rubber ring with a valve for filling with air (from 8.70 rubles). They are placed under the sacrum, elbows, heels - depending on the size.

Cushions, soft foam pillows. They can additionally be placed under the elbows, knees, shoulder blades, and heels.

Bags filled with round grains (eg millet, rice). Can be sewn and placed under motionless limbs.

The point of using various bolsters and anti-decubitus mattresses is that they increase the area of contact between the body and the surface on which a person lies, which means that the pressure on each part of the body is reduced, which improves blood circulation.

A belt can be attached to the bottom of the bed so that a person can pull himself up to sit down on his own. Or build a trapezoid over (the so-called “goose”) at the head of the bed, which you can grab onto and stand up.

If a person does not have enough muscle activity to stay in a sitting position, provide support for his legs using bolsters or blankets .

Basic principles of prevention

The occurrence of bedsores depends on how well the patient is cared for. It is best dealt with by medical professionals who know how to act correctly in such circumstances. It is from them that you can find out how to prevent bedsores at home.

You need to understand the principle of the necessary actions and carry them out, which minimizes the risk of deterioration. But even in this case, a certain threat remains, since without the appropriate education, it is difficult to take everything into account. This is explained by the fact that measures to prevent bedsores are very diverse, and consist not only of hygienic procedures, but also of constant monitoring of the patient’s condition and the implementation of therapeutic procedures.

But understanding how to prevent the occurrence of bedsores is necessary for everyone who strives to preserve the health of their loved ones who find themselves in a difficult situation.

Prevention of bedsores in bedridden patients is based on the following principles:

Reducing irritating factors. This can be achieved by frequently changing the patient's position. This should be done at least once every 3 hours, both day and night. You should also be sure to examine those areas of the body where bedsores form most often.
Prevent the development of tightness or severe friction. To do this, you need to choose a comfortable mattress that is not too hard. Now there are special preventive mattresses, pillows and circles that can effectively influence the patient’s skin, preventing the development of bedsores.

But we must understand that the use of such devices alone will not allow 100% to avoid the development of bedsores.
Avoiding excessive moisture of the skin.
Compliance with personal hygiene rules.
Proper and rational nutrition. The patient's diet must contain sufficient protein, useful microelements and vitamins. Therefore, it is necessary to include fruits, herbs, fish, vegetables, and dairy products.
Normal discharge of natural needs. It is best to use diapers for this, although in some cases it is necessary to pad the bedpan quite often.

Bed sheets

It is advisable to use bedding and underwear made from natural materials that absorb moisture and allow air to pass through. It needs to be changed every day.

Avoid folds, bumps and crumbs in the bed as these can damage the skin.

Avoid rubber and oilcloth linings - they roll up and pinch the skin and do not allow air to pass through.

Absolutely forbidden:

pull up a person who is lying down alone if he cannot help;
dragging and pulling out underwear from under the patient, especially wet ones;
push a vessel under a person.

Skin care

Cleanse the patient's skin delicately using special care products.

Avoid strong cosmetics.

Do not forget about the hygiene of the patient’s intimate areas - clean them with delicate products and protect them every time you change the diaper.

Do not use bar soap, but use washing lotion or foam (these can be purchased at pharmacies). These products just need to be applied to the contaminated area of the body for a few minutes, then wipe clean with a damp cloth or towel. No need to rinse!

Do not rub or massage the area where bedsores occur; only lightly blot it.

In case of too wet skin (urinary or fecal incontinence, excessive sweating), you need to use diaper rash creams and powders without talc.

If you are doing a massage, do not rub the area within a radius of at least 5 cm from the bony protrusion. Massage is carried out only after generous application of nourishing moisturizer to the skin.

Features of care

It is very important that bedsore prevention is carried out correctly. Therefore, you should find out from your doctor what is needed to prevent such phenomena. It is also advisable to familiarize yourself with the features of activities aimed at preventing them.

A memo for relatives describing the actions that must be performed will help not to get confused in the event of a serious illness of one of the family members. To prevent bedsores, the assistance algorithm should be as follows:

Examine the patient’s skin daily to detect developing bedsores in time.
Even if there are no bedsores, it is very important to wash with warm water those areas of the bony protrusions that come into contact with the linen on the bed.
To prevent inflammation, treatment with camphor alcohol or ammonia is recommended in those places where the body comes into contact with other objects.
For problem areas, it is worth performing a light massage, which will improve blood flow.
It is necessary to check the patient's bed to make sure that the sheet is smoothed and there are no foreign bodies (debris, crumbs, etc.) on it.
To prevent bedsores from forming, it is necessary to periodically change the patient’s position.
Choose bed linen made from natural fabric. The clothes of a bedridden patient should be the same. Buttons, hooks and zippers on it will create an additional condition for the formation of bedsores, so they should not exist.
Maintain a comfortable room temperature for the patient.
Keep the patient's skin clean and dry. Cosmetics that can cause irritation or allergies should not be used.
If possible, help the patient make simple movements.
It is better to choose special mattresses and pillows, which in themselves are means of preventing bedsores.
If, when examining the patient’s body, reddened areas are found, it is worth performing a light massage around them and treating them with an antiseptic.
If the skin is excessively dry, it is necessary to moisturize it with baby cream, but if the skin is too wet, you can use powders or drying ointments.
Hygiene procedures for the perineal area should be carried out more often than for the whole body.

Using these steps, you can reduce the risk of this problem to a minimum. However, we must not forget that actions must be performed correctly, otherwise the result will not be achieved.

At first, you may need the help of a specialist who will show you exactly how to act and monitor compliance with all the rules. In the future, when the implementation algorithm is mastered, the nurse or doctor can only visit the patient from time to time.