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Treatment of decubituses

The word "decubituses" in medicine it is accepted to call necrosis of sites of skin which appears owing to their long squeezing. Bed patients, as the fates decree, for a long time the confined to the bed are most of all subject to this disease. In this article we will consider that represent decubituses and as to struggle with them.

Etiologies

Mirsovetov found out three main reasons of emergence of the similar phenomenon:

  1. Squeezing of a site of skin for a long time. Soft tissues of the person, it is long lying in a bed or sitting in a chair in one pose, are exposed to continuous pressing. As a result of a cage which are not supplied with blood and necessary oxygen, die off – so there are decubituses.
  2. The friction of epidermis about various surfaces which can occur when the patient changes situation in a bed and contacts to bed fabric. Excessively dry and sensitive skin is rather easily injured.
  3. The shift of integuments arising in that case when two adjoining surfaces move diversely. For example, at a bed back raising the patient slips a little down. In certain cases his skin thus remains on a place therefore blood circulation on this site worsens, and epidermis is injured.

It is necessary to add that some patients more than others are subject to risk of formation of decubituses. It is possible to carry to the factors promoting development of an illness:

  • bad and irrational food;
  • insufficient amount of the used liquid;
  • commitment to addictions: to smoking, alcohol intake;
  • humidity of skin because of plentiful sweating;
  • existence of diseases of cardiovascular system;
  • excess weight or, on the contrary, excessive leanness;
  • non-compliance with rules of hygiene;
  • allergy on various cream and ointment;
  • diabetes;
  • existence in a bed or on underwear of any subjects irritating integuments: crumbs, folds, seams, buttons and so forth;
  • impact on epidermis of urine or kalovy masses which is a consequence of their incontience.

Disease stages

The medicine allocates 4 stages of development of decubituses. Let's consider in more detail each of them:

  1. At the initial stage of an illness epidermis of the person has no visible damages. If a natural shade of skin of the patient light, on it it is possible to see reddenings. When pressing a similar site it does not become lighter as it occurs in a healthy state. At black representatives change of a shade terms on ashy or bluish is in rare instances observed. The damaged zone can hurt and differ from surrounding epidermis in the density and temperature.
  2. The second stage is characterized by existence of open ulcer educations. The top layer, and also part internal, are damaged or are absent. By the form decubitus most often represents a wound of pink color, but in certain cases it is similar to a blister with liquid inside.
  3. The third stage of development of an illness differs in emergence of deep ulcers through which fatty tissue looks through. Decubitus at this stage has the crateriform appearance, at the bottom of a wound there can be died-off fabrics of yellow color. Ulcers at the third stage of an illness are not always formed on a place of primary wound.
  4. The fourth stage – the heaviest. Depth of decubitus reaches muscles and even bones, and the bottom of a wound is covered by a dark firm crust.

Treatment of decubituses

Let's consider ways of treatment of a disease at various stages of its development.

I stage.

If you noticed the first symptoms of an illness at the person, start undertaking therapeutic measures immediately. Having seen reddenings on skin which when pressing do not change colors, be engaged in their daily processing. It includes wipings by camphor alcohol or oil of a sea-buckthorn. Remember that contraindicated to mass an affected area.

II stage.

In that case when the patient had first yazvochka, it is important to secure them against penetration of an infection and development of a further inflammation. Several times a day wounds need to be disinfected Hlorgeksidin and to grease with the healing means. It is possible to carry to that Levomekol, Aktovegin, Solkoseril. Now in treatment of decubituses the special hydrogel and hydrocolloidal bandages promoting healing of wounds in the shortest possible time are actively applied.

III and IV stages.

The third and fourth stage of an illness demand the immediate address to the doctor. He has to examine attentively an affected site regarding an infection and damage of a bone. Treatment should be begun with clarification of a wound, it becomes by means of Hlorgeksidin's solution. During processing it is desirable not to concern an ulcer therefore it is possible to pour out simply on it liquid of a bottle. Carefully examine an affected area, whether there is no the died-off skin or pus there. If reveal something similar, the wound surely should be processed a preparation Proteoks-TM.

After the wound is cleared, it is possible to impose on it the tampon impregnated with St. John's Wort oil. Instead of it it is also possible to use means on the basis of Sintomitsin or Streptocide. In case of existence of an inflammation as wound healing medicine it is possible to choose Multiferm. After the main puffiness descends, this expensive preparation can be replaced cheaper, such as Komfil Plus. The bandage with this means can be not removed from a wound to 5 days. Do not forget that before each change of such bandage it is necessary to wash out anew decubitus Hlorgeksidin.

Quite good option for healing of ulcers Dekspantenol is considered, it is necessary to process them an affected area at least 3 times per day. Doctors do not recommend to close for a long time a wound surface a gauze bandage as through such fabric enough air does not arrive, and too hardly tied bandage, besides, worsens blood circulation. But in certain cases, for example, in the course of rejection of the died-off cages from a decubitus surface, it is possible to use the gauze bandage impregnated with special enzymes.

Not so long ago in pharmacology there was a new effective remedy from decubituses – Alginates. They represent the sterile bandages made of seaweed which perfectly disinfect a wound.

There is a wish to remind once again that independently to treat the similar disease which especially reached a heavy stage extremely it is not recommended. It is best of all to visit the doctor who on the basis of the conducted examinations will make all necessary recommendations and will appoint the necessary preparations.

Prevention of decubituses

It is known that it is much simpler not to allow development of an illness, than to fight against its consequences. Let's consider the basic rules of prevention of decubituses:

  1. Periodically help the patient to change position of a body, thus observing accuracy and trying not to injure epidermis.
  2. Watch hygiene of the lying person, do not allow that his skin was dirty or sweaty.
  3. After clarification apply on special cream or powder subject to place decubituses.
  4. Perform inspection of skin of the patient as often as possible.
  5. Provide to the patient the balanced food and sufficient drink.
  6. Do not smoke in the presence of the patient and do not allow to do it to him.
  7. Whenever possible carry out special remedial gymnastics.
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