What is a pressure ulcer?
Pressure ulcer, bed sores, also called decubitus ulcer, are long-term wounds on the skin. These are injuries to the skin and subcutaneous tissues caused by pressure. It is a type of wound that can spread to muscles and bones. Pressure sores mostly develop in the skin covering bony areas of the body such as heels, ankles, hips and coccyx, shoulder blades, shoulders, skull bones.
Pressure sores People at highest risk of developing are the elderly, paralyzed, or those receiving treatment in intensive care who have health problems that limit their ability to change positions or cause them to spend most of their time in a bed or chair.
Pressure soresIt may develop within hours or days. It is possible for most wounds to heal with treatment. However, if the necessary and correct treatment approaches are not taken, fatal consequences may occur.
Pressure sores are caused by pressure applied to the skin, which prevents blood flow to the skin. Constant pressure on any part of your body can reduce blood flow to tissues and disrupt tissue nutrition. Blood flow is necessary to deliver oxygen and other nutrients to tissues. Without these essential nutrients, the skin and nearby tissues become damaged and may eventually die.
Risk factors for pressure sores
Immobility. The medical condition that causes admission to intensive care may be due to paralysis due to spinal cord injury or other causes.
Incontinence (lack of urinary or stool control). The skin becomes more vulnerable when exposed to urine and feces for a long time.
Sensory perception disorder (numbness). Spinal cord injuries, neurological disorders, and other conditions can cause loss of sensation. Lack of pain or discomfort may cause pressure sores.
Malnutrition and lack of fluid. People need adequate fluids, calories, protein, vitamins and minerals in their daily diets to have healthy skin and prevent damage to subcutaneous tissues.
Medical conditions that affect blood flow r. Health problems that can affect blood flow, such as diabetes and cardiovascular disease, can increase the risk of tissue damage such as pressure sores.
Stages of a pressure ulcer
Stage I :At this stagethe skin is intact, there is a red, painful, hard area that does not turn white when pressed on the skin. The skin may be hot or cold, firm or soft. Once the pressure is removed, redness or discoloration does not disappear within 30 minutes. This is a sign that a pressure sore may occur. A pressure sore at this stage can be reversed in about three days if all pressure in the area is removed.
Stage II: The top layer of the skin (epidermis) breaks down and a shallow and open wound forms. The area around the wound may be red and irritated. The arrangement of the second layer of the skin (dermis) may also be disrupted. There may or may not be a discharge of pus or fluid. The pressure is removed and recovery may occur within three days to three weeks after pressure sore treatment.
Stage III: An open wound, called a crater, forms on the skin and goes under the skin. Pressure sore extends from the dermis (second layer of the skin) to the subcutaneous fatty tissue. Bone, tendon and muscle are not affected. It should be checked for signs of infection (pain, redness at the wound edge, pus, bad odor, increased temperature) and possible necrosis (black, dead tissue). Relieve the pressure immediately and contact your healthcare provider for pressure sore treatment. Wounds at this stage often require special pressure sore treatment. Pressure sore treatmentmay take one to four months.
Stage IV: Pressure sore, It also passes through the subcutaneous fat tissue and proceeds to the muscle and bone tissues below. There is usually a lot of dead tissue and discharge. The possibility of infection is high. Osteomyelitis, also called bone inflammation, may develop. If pressure sore treatment is not done at this stage, the infection will progress further. It can reach a stage called sepsis, which affects the whole body and can cause death after organ failure.
What are the complications of pressure sores?
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It is life-threatening. It can cause death.
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Infection can spread to the blood, heart and bone.
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It can cause amputations (limb loss).
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It may make it necessary to lie down for long periods of time, which may keep you away from work, school and social activities for months.
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Involuntary disruption of your nervous system, called autonomic dysreflexia. It can lead to a state in which the patient overreacts to external or bodily stimuli.
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Because you are less active during pressure sore treatment, this may lead to breathing problems or urinary tract infections.
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Pressure sore treatment can be very costly in terms of medical expenses if it is not done on time and by authorized people.
How to Prevent Pressure Sores?
Measures to be taken to prevent pressure sores, after pressure sores occur, It is easier and more economical than treatment.
The first step in preventing pressure sores is education. The patient, his family, and hospital staff should be informed about the causes of wound formation and its consequences. The most effective method to prevent pressure sores is to change positions frequently and, if the patient has the ability to move, to help the patient move as quickly as possible. The position of these patients should be changed at least every 1-2 hours.
Those sitting in a wheelchair should raise themselves with their hands every 1-2 hours to ensure blood circulation to these areas.
Skin and bedding care is very important. The skin should be wiped with soapy water every day and dried so that no moisture remains. Massage should be applied to increase the blood circulation and durability of the skin. Bed linen should be clean and dry. There should be no folds in the bed and sheets under the patient.
Cleaning after urination and defecation is very important for bedridden patients.
Pressure Anemia, protein deficiency, vitamin deficiencies, incorrectly made dressings and splints, body resistance, which may cause wounds to open. Factors that will reduce pain should be eliminated.
Muscle and joint stiffness seen in paralyzed patients should be combated. Although many beds, wheelchairs and cushions have been developed to prevent wound formation, a device that will prevent all pressure sores has not yet been produced.
Pressure ulcer. Treatment
Pressure sore treatment includes changing your position regularly, reducing pressure or using special dressings for relief, and treatment approaches that help heal the pressure sore. Sometimes surgical procedures and surgery may be required. Pressure ulcer treatment should be done with teamwork and a multidisciplinary approach.
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