Pressure ulcers in patients who have to lie still for a long time

Posted by Specialist Doctor I Nguyen Cong Hoa - ICU Doctor - Intensive Care Department - Vinmec Times City International General Hospital

Pressure ulcers in patients who have to lie still for a long time are easy to appear if they do not know how to take care of the patient properly. In fact, the treatment of this condition is not an easy job because most of the causes of the disease are due to the influence of several organs in the body.

Pressure ulcers are localized lesions in the skin and underlying tissues, usually occurring on the part of the body where the bone is raised. In the process of the patient lying motionless for a long time due to constant pressure on this pressure position for a long time and combined with wet and scratched skin, ulcers form. The most common sites are the skin on the sacral side, heels, and hips, although other sites may be affected, such as elbows, knees, ankles, back of the shoulders, or occipital areas.

Complications of pressure ulcers are associated with significant morbidity and mortality. Most complications present with grade III and IV ulcers and these include cellulitis, osteoarthritis, joint infection, acute pyelonephritis, and tetanus. Tetanus complicates pressure ulcers, so it is advisable to prevent tetanus against tetanus with antiserum and vaccination with tetanus vaccine.

Because of the high morbidity and mortality, and the potential economic burden of having to treat this problem, the prevention of pressure ulcers is the primary goal. Identifying patients at risk is the first step in selecting preventive measures.
3.1. Prophylaxis Prophylactic treatment by skin care, using aids, surface care. Specifically:
Check and clean the skin systematically every day Controls excessive drying factors such as moisture, sweat, water drainage. Avoid massaging on the bony prominence Minimize friction and cutting Alternatively, use other methods such as:
Change the patient's position every 2 hours. Avoid headboards that are too low or too high. Use tools to reduce pressure. Use an air mattress, a machine to warm and dry the skin. 3.2. General treatment Good treatment of underlying disease Consider resolving urinary incontinence. Improve the nutritional status of the patient. Blood compensation, Albumin, electrolytes. Control blood sugar Control pain. Mental health care. Local and systemic infection control.

Methods to investigate the cause are as follows:
Biopsy for culture of muscle and bone tissue May require systemic antibiotics. Tissue ultrasound, X-ray, CT, MRI investigations Consider osteomyelitis. Inflammatory agent. 4.1. Methods of care

4.2. Ulcer care products Pressure ulcer care products are as follows:
Wound cover film: grade I, protection from friction Waterproof foam: phase II, III 3M Tegaderm Hydrocolloid Dressing : stage II, III Mesh gauze for degrees II, III. Calcium Alginate Contraindicated Hydrogel, amorphous: stages II, III, IV; must combine with gauze dressing Contraindicated Hydrogel, sheet Contraindicated Gauze packing Pressure ulcer surgery method can be used for grade III and IV ulcers to clean the skin sutures, skin grafts, skin flap transfer ...
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