Transcript Care of Bed sores (Pressure ulcers)

Bed sores are the visible evidence of
pathologic changes in the blood supply
to dermal tissues
 Main cause – pressure or force applied
to susceptible tissues
 Hence concentrated wherever weight
bearing points come in contact with
surfaces


About 95% - lower part of the body

Most frequent – Sacrum followed by heel

Elderly

Bed ridden patients with extensive skin
involvement
› SJS/TEN
› Pemphigus
Turn and position the patient frequently
(no time limit)
2. Pressure reducing/relieving devices – air
mattresses
3. Proper nutrition (high protein diet)
1.
- Bed sores relatively more common in
malnourished patients (twice as likely) when
compared to nonmalnourished patients
4. Provide good skin care
- moisture macerates and injures skin
- keep the area dry especially in patients
with incontinence (urinary or fecal)
- keep the bed clean (food crumbs, iv
tubing, other debris in the bed can
greatly increase local skin pressure)
Relieve pressure, friction, shear
1.
- Air-fluidized beds
Optimize wound therapy
2.
-
Occlusive dressing enhances wound
healing
Moist environment provided by occlusion
increases the epithelization rate
Occlusive dressings:
- Polymer films
- Hydrocolloid dressing
- Hydrogels
- Saline soaked gauze : a good/cost
effective alternative if not allowed to dry

3. Remove necrotic debris which increases
chances of bacterial infection and
delays wound healing
- Wound cleansing with antiseptic
solutions e.g povidone iodine(Betadine),
hydrogen peroxide, acetic acid etc.
should be avoided as they destroy
granulation tissue
4. Manage bacterial contamination
- look for signs of infection- erythema,
edema, odor, fever or purulent
exudatec
- Foul odor – anaerobic org
- topical antibiotics like silver
sulphadiazine if wound fails to progress
towards healing
- for anaerobic infection – topical
metronidazole
5. Correct nutritional deficits
- higher protein intake
- Role of Zinc, Vitamin supplementation is
controversial but may be helpful