German ointment for bedsores. Effective relief from bedsores using ointments

Bedsores are ulcers that are signs of serious complications of many diseases that develop due to impaired blood supply to tissues or due to their compression with subsequent displacement. Pathologies are typical not only for bedridden patients; bedsores can occur with any external pressure on the skin. They form especially often in areas of bony protrusions. Patients suffering from impaired innervation (supply of nerves) of the skin due to diseases of the spinal cord are susceptible to bedsores. In patients, such ulcers often appear on the head, buttocks, and heels.

There are four degrees of severity of debutitus. In the case of first degree pressure ulcers, there is only limited redness of the skin. In the second degree, a skin defect has already occurred. Debutitus of the third degree is a deep defect of the skin, muscles, tendons and ligaments are visible. In the worst case, a defect occurs when bones are involved.

Infection may be added to the wound as an aggravating factor. When the tissue dies, it must be removed surgically. If a bedsore needs to be treated, it is already too late. Prevention is very important, so it doesn't even get to the pressure ulcer. Especially in bedridden patients, the skin must be in good condition. Rubbing with masks that stimulate circulation and massaging endangered areas can prevent canker sores. In addition, soft storage, possibly on special mattresses, should be considered.

Stages of bedsores and features of their treatment

• Detoxification of the body (hemodesis, blood transfusion).
• Immunostimulating therapy (vitamins).
• Elimination of constant pressure (turning the patient over every 2 hours).
• Reducing pressure on tissues using special means - plastic splints, anti-decubitus mattresses, pillows, pads, etc.

How to treat deep bedsores stages 3 and 4

At the third stage, active death of the skin and subcutaneous fat layer occurs. Treatment of bedsores in bedridden patients, as a rule, involves surgical intervention (cleaning the ulcer from pus and necrosis, absorption of the discharged wound with protection from drying out). At stage 3, the pathological process quickly spreads to adjacent areas of the skin, where the blood supply is also impaired. At this time, you cannot remain idle; the skin can no longer regenerate on its own. Removal of dead tissue (necrectomy) must be carried out before capillary bleeding occurs.

For example, a patient in a convalescent bed is at risk of developing bedsores. Shoulders or upper back elbows neck edges ears knees ankles heels or toes lower back and hips genitals and chest. Wheelchair users are at risk of developing bedsores. The buttocks of the tailbone are the blade of the spine of the shoulder and the back of the arms and legs. . Health care professionals use a classification system to describe the severity of pressure ulcers.

The first degree scab is the type of most superficial ulcer. The affected area of ​​skin appears reddish discolored and reddish or bluish in patients with dark skin. In first grade pressure ulcers, the skin remains intact but may be damaged, itchy, and feel warm and fuzzy or hard to the touch.

Then the doctor cleanses the bedsores using local antiseptics. In the treatment of this kind of ulcers, necrolytic drugs (Collagensin, Chymotrypsin, Trypsin), anti-inflammatory drugs (Alfogin, Vulnuzan, Hydrocortisone), stimulators of tissue repair (Vinilin, Bepanten, Methyluracil), drugs for normalizing lymph microcirculation (Tribenoside, Pyricarbate) are used.

What is important to know

In stage two pressure ulcers, part of the outer surface of the skin or the innermost part of the skin is damaged, causing loss of skin tissue. The ulcer appears as an open wound or blister. In third-degree pressure ulcers, skin loss occurs throughout its entire thickness and the underlying tissue is also damaged. Muscles and bones are intact.

The ulcer looks like a deep, hollow wound. Grade 4 eschar is the most serious type of ulcer. The skin is severely damaged and surrounding tissue dies. The underlying muscle or bone may also be damaged. Patients with grade 4 pressure ulcers are at high risk of developing serious infections.

The fourth stage is characterized by deep necrosis with damage to muscle tissue, tendons and bones. Treatment involves excision of dead tissue, absorption of the pressure sore, and hydration of the healing wound. After the acute phase of the necrosis process has ceased, the doctor raises the question of surgical treatment. This cleaning of the ulcer is carried out to preserve the maximum amount of living tissue. At the same time, physiotherapeutic treatment of ulcers is carried out, a course of antibiotics and antiseptics is prescribed.

Since bedsores are a complex health problem caused by a number of interrelated factors, related care can be performed by a team of professionals of various types. This type of equipment is often referred to as a multidisciplinary team.

At home

Moving your body and changing your position at regular intervals is one of the best ways to prevent pressure sores and release pressure in cases of first and second degree ulcers. Once the risk assessment is completed, the care team will develop a “repositioning schedule,” which will include the frequency with which the patient should be moved. For some patients, the frequency may be 15 minutes, while others require position changes every two hours.

Treatment of the disease depending on location

Bedsores form in bedridden patients due to compression of blood vessels and skin, as a result of which blood supply is disrupted and tissue cells die in areas of maximum pressure on the body. So, when lying on your side, ulcers form on the thigh, ankle, and knee. If the patient lies on his stomach for a long time, wounds appear on the cheekbones and pubis. When lying on your back, wounds can open on the heels, sacrum, elbows, back of the head, tailbone, and shoulder blades. Care for bedsores and their treatment is carried out depending on the location of formation.

A range of mattresses and special pillows are available to relieve pressure on vulnerable parts of the body. Your care team will be able to determine which types of mattresses or pillows are right for you. People who are at risk of developing bedsores or who have first or second degree ulcers usually enjoy relaxing on specially designed foam mattresses to release the pressure on their body.

Basic rules of treatment

Patients with level three or four beds require a more complex mattress or even bed. For example, there are mattresses that can be connected to a continuous flow of air that automatically adjusts to reduce pressure at the required time.

How to treat bedsores on the heels

To treat heel ulcers, it is advisable to use special “Comfil” bandages (Denmark), they are glued to the damaged areas of the skin. The bandage has an antiseptic effect and prevents further infection. If the wound becomes dirty or pus forms in it, the ulcer is first cleaned and then disinfected with Proteox or similar means - hydrogen peroxide, tea tree oil, chlorhexidine spray, brilliant green solution.

Bedsores on the buttocks

To cure bedsores and restore blood supply to tissues, it is necessary to stop the negative impact of the damaging force. Until you relieve the affected areas of pressure, no ointments or powders will help. Further, with proper treatment, dead tissue will be rejected, and the wound will gradually heal. Thus, the treatment of ulcers on the buttocks is based on 3 main stages:

Stages of bedsores in bedridden patients, photo

Some of the dressings and special dressings designed to protect pressure ulcers and speed up the healing process are also available among our products. Some examples of this type of product. Hydrocolloids, dressings containing a special gel that promotes the growth of new skin cells in the ulcer while maintaining healthy skin in the area, as well as alginates, dressings made with seaweed containing sodium and calcium, have been proven to speed up the healing process. Topical medications, such as creams or ointments, may be used to speed up the healing process, preventing further damage to the skin.

1. Restoring blood circulation in areas of skin damage.
2. Assisting tissues in the rejection of necrosis.
3. Cleansing the wound and applying healing agents.

Bedsores on the buttocks are often treated with medications containing silver. Such products have antiseptic properties and reduce pain. Creams and ointments that contain silver promote rapid healing of wounds. Alcohol-based medications are often not recommended because they can dry out the skin.

A type of chemical known as oxygen free radical scavengers can also be used to prevent cell damage at the genetic level. If a patient suffers from bedsores, they can take antibiotics to prevent bacterial infection and, as a precaution, also prevent the development of a secondary infection.

Antiseptic ointment can also be applied directly to bedsores to clear them of any bacteria present. Certain dietary supplements, such as protein, zinc, and vitamin C, have been shown to speed up wound healing. If your diet is lacking in these vitamins and minerals, your skin may be vulnerable to developing pressure ulcers.

On the tailbone

To treat wounds formed on the tailbone, use bandages soaked in a solution of cognac and salt (in a ratio of 30 g of salt per 150 g of cognac). It is better to apply bandages under compress paper, changing it as necessary. Before changing the dressing to a new one, be sure to wash off the salt from the bedsores. To heal wounds, you can use products such as Levosin, sea buckthorn oil, Solcoserine. If the ulcers fester, it is necessary to use antiseptic or antibacterial agents (streptocide powder, boric acid).

As a result, you can consult a nutritionist to develop an appropriate nutrition plan. In some cases, it may be necessary to remove necrotic tissue from the ulcer to promote the healing process. This is known as circumcision. If there is a small amount of dead tissue, it can be removed using bandages and special creams.

Copious amounts of dead tissue can be removed mechanically. Some of the machining methods. Pressure cleaning and irrigation - in which necrotic tissue is removed with water under ultrasonic pressure - in which dead tissue is removed by low frequency energy waves, and laser - in which dead tissue is removed by beams of concentrated light. Drug therapy - or worms - is an alternative treatment method. Worms are ideal for treatment because they feed on dead and infected tissue without disturbing healthy tissue.

Methods for treating the disease at home

Treatment of bedsores in patients who are at home presents certain difficulties. At home, it is difficult to carry out high-quality cleaning of a festering wound and ensure good gas exchange necessary for tissue restoration. Along with folk remedies and medications, be sure to use modern means to treat ulcers, for example, a convenient antiseptic patch made from the latest materials, or anti-bedsore mattresses.

They also help fight infection because they release substances that are harmful to bacteria and beneficial to the healing process. During maggot therapy, they are combined with fillings that are applied to the wound and the area is covered with gauze. After a few days, the dressing and worms are removed.

Sometimes it fails to heal a grade three or four ulcer and surgery becomes necessary to seal the wound and prevent further tissue damage. A surgical method commonly used to treat pressure ulcers is called graft replacement. In this technique, the surgeon uses a scalpel to prevent ulceration of necrotic tissue. Skin grafts and part of the body's muscle are taken and used to seal the ulcer.

Medicines

In order for dead tissue to be rejected from the damaged area of ​​skin faster and the healing process to begin, use special medications (for example, Iruksol). If necessary, during the initial treatment of bedsores, remove necrosis using special instruments. When the ulcer is cleared of dead tissue, it is bandaged with bandages with analgesics, covered with hydrocolloid dressings (Hydrosorb, Hydrocol) or a compress is made with a wound-healing drug. When bedsores become infected, local antibacterial agents are used.

External treatment: ointments and creams

To treat wounds, you cannot use softening ointments or apply blind bandages that block the access of oxygen. In the initial stages and during dry tissue death, refrain from wet dressings. All of these actions can lead to the formation of wet necrosis and active cell death. Antibacterial agents are prescribed in case of a wet wound with pus or wet necrosis of skin tissue. To alleviate the patient's condition, it is permissible to use:

• Vishnevsky ointment;
• "Boro-Plus";
• Bepanthena;
• Autenrita ointment.

Anti-decubitus mattresses

One of the most effective means of preventing the formation of bedsores is an anti-bedsore mattress. Such products constantly change the pressure exerted on different parts of the body by frequently inflating and deflating air in special chambers of the mattress. Alternately changing pressure points guarantees the elimination of the causes of bedsores and maintains the normal activity of blood circulation in the compressed tissues.

Folk remedies

Treatment with folk remedies is an auxiliary measure to combat bedsores. Almost all traditional methods of treatment are based on the use of medicinal plants, due to which the patient may experience an allergic reaction. The relevance of using folk remedies depends on the degree of the disease, so before using them you should consult with your doctor about the advisability of such treatment. Here are some alternative medicine methods that help in the fight against bedsores:

• Lubricate the wounds with fresh lungwort juice several times a day.
• Scald 1 tablespoon of crushed young elderberry leaves with boiling milk and apply it to the ulcer twice a day.
• Cut the Kalanchoe leaves lengthwise, apply a fresh cut to the wounds, secure with a plaster or bandage and leave overnight.
• If bedsores have formed on the head, mix vodka with shampoo (1:1) and wash your hair with this solution.
• Make a mixture of a tablespoon of crushed calendula flowers and 50 g of petroleum jelly, apply it to the ulcers twice a day.
• Make lotions from fresh potatoes 1-2 times a day. To do this, pass it through a meat grinder (or use a food processor) and mix the pulp with honey (1:1). Place the mixture on a thin cloth and apply it to the ulcer.
• At night, make a compress with fish or bear fat using a sterile bandage.
• To make a wet bedsore dry out faster, sprinkle it with starch once a day.
• Systematically tie fresh cabbage leaves to the wounds at night. After 10-14 days, red spots should appear around the bedsores - this indicates the healing process of the ulcers.
• Treat bedsores daily with a strong solution of potassium permanganate (add enough powder to the water so that it turns bright pink).

Surgical treatment

Surgical intervention occurs only after a doctor’s prescription and according to strict indications. Incorrect or inappropriate surgical treatment can aggravate the disease, for example, increase the area of ​​bedsores. First of all, doctors assess the likely effectiveness of surgical treatment methods, and only if the prognosis is positive, one of the treatment methods is used: free skin grafting, plastic surgery with local tissue, excision of the ulcer with comparison of the edges of the bedsore.

Surgical treatment does not always give the expected results. It happens that the transplanted skin tissue does not take root well in the affected area of ​​the body due to its insufficient blood supply. Early complications after surgery include fluid accumulation under the skin tissue, suture dehiscence, wound or skin necrosis, and bleeding. In the future, an ulcer may form, which often leads to a relapse of the bedsore.

Prevention of bedsores

The basic rule for preventing bedsores is proper patient care. It is necessary to ensure that the patient has normal blood supply to all areas of the skin. The patient should not lie in one position for a long time, so turn him over every couple of hours, even though this process is painful. Otherwise, the ulcers will appear constantly and worsen to such an extent that the damage reaches the bone. To take preventive measures, it is necessary to take into account the provoking circumstances and risk factors for the occurrence of bedsores:

• insufficient hygiene of the patient's skin;
• the presence of folds, protruding seams, buttons on clothes or in bed;
• enuresis, fecal incontinence;
• an allergic reaction in a patient to care and treatment products;
• active sweating, diabetes, obesity;
• poor nutrition, lack of fluid in the body;
• Parkinson's disease;
• diseases of the vascular system or spinal cord;
• smoking or alcohol abuse;
• physical inactivity, bone fractures;
• anemia;
• the presence of malignant tumors;
• swelling, dry skin.

Preventive measures to prevent the occurrence of bedsores should be carried out from the first day of illness or placing the patient in a supine position. As practice shows, once the process of ulcer formation has begun, it is almost impossible to prevent its further development, which is why prevention is so important. With each subsequent stage of development of pressure ulcers, the likelihood of prompt treatment of the pathology decreases. Prevention includes the following measures:

• Systematic cleansing of the skin, non-contact drying (without using towels or napkins) and disinfection using antiseptics.
• Frequently change the patient's bed linen, straighten wrinkles in clothes and beds.
• Purchase of a special mattress (anti-decubitus, pneumatic, water, vibration).
• Frequent changes in the patient's position.
• Proper diet and drinking regime.
• Stimulation of the patient's muscle activity (electric underwear, massage).

In every medical institution, doctors use those methods that they consider the most effective. The difficulty of treating the pathology lies in the fact that when a person lies motionless for a long time, the blood supply to the places of compression is disrupted.

Causes of bedsores formation

When the protrusion of the bone comes into contact with the hard parts of the bed, compression of the blood vessels and skin occurs. Normally, when a person sleeps, the fat pad (subcutaneous fat layer) prevents stagnant changes. However, its reserve capabilities are not unlimited.

When a person does not move for a long time, fat cells are absorbed, resulting in stagnant changes in certain areas of the skin.

Locations of pressure ulcer swelling:

• When positioned on the back - heels, sacrum, shoulder blades, ischial tuberosity, back of the head, elbows.
• Lying on your side - thigh, knees, ankles.
• On the stomach - cheekbones and pubis.

It is believed that these formations are caused by excessive moisture or dryness of the skin. Factors lead to exfoliation of the stratum corneum of the skin, which has protective properties. Beneath it is the “tender and vulnerable” dermis. Humidity allows bacteria to become infected in the damaged area. The process is also complicated by impaired blood supply in the area of ​​compression.

How to treat bedsore swelling

Preventive measures include the use of special creams and patches that maintain normal levels of acid-base condition of the skin. They should also eliminate excess moisture and prevent excessive drying of epithelial cells.

There are special pharmaceutical films for applying to pressure points in bedridden people, which remove excess moisture and “breathe” well. As a rule, they contain alcohol to prevent skin infection. This dressing also helps remove infiltrative fluid from the wound contents.

Dermatovenerologists do not recommend treating bedsores with brilliant green or iodine. These dyes promote rapid healing of the upper part of the wound surface, and the process of decay is activated in the deep layers of the dermis.

Please note that at the final stage of bedsore healing, a white coating forms, which should not be removed with peroxide or alcohol. To remove it, decoctions of anti-inflammatory plants (St. John's wort, chamomile) will be sufficient. If there is pus, apply a compress soaked in saline solution to the damaged area.

Plasters for the treatment of bedsores

Plasters are an effective means of permanent protection of the wound surface. When cleansing a wound, they help remove purulent contents, and when used daily, they help cracks heal faster.

Before using the product, warm it up for 30 minutes in your hands. This will allow the patch to become more elastic. It must be changed after 2-3 days, since particles of desquamated epithelium are adsorbed on the product.

For dry bedsores, before applying the patch, it is necessary to lubricate the wound with gel or paste with zinc oxide. This microelement helps the skin heal quickly and prevent the formation of microcracks.

You can use the patches until a large amount of liquid content appears underneath them. Exudate from the skin cavity must be effectively removed, so the wound should always be kept in a moist environment. For these purposes, you can use not only pharmaceutical gel, but also fir oil.

Basic principles of treatment of pressure wounds

To effectively treat bedsores, 3 basic principles must be followed:

• Ensure removal of dead tissue,
• Restore blood supply to the affected area,
• Carry out wound healing.

Restoring blood supply to a bedridden person is a difficult procedure, but it must be done. Several times a day the patient must be turned into different positions (from back to side and to stomach).

If patches, ointments, compresses and other conservative methods are ineffective, dead tissue can only be eliminated surgically. The essence of the operation is to open the abscesses and ensure drainage of the wound by cleaning it, antiseptic treatment and providing access to it from the outside.

At home, Iruksol ointment or other folk remedies help to reject dead tissue. For example, you can prepare a solution of salt (30 grams) diluted in 150 grams of cognac.

Antibacterial agents to treat bedsores are used 1-2 weeks after using anti-exudative substances. Many experts consider Fusicutan the best antibacterial cream. It is applied to the area of ​​pressure ulcer edema 3 times during the day.

Delaskin is considered a good remedy for removing exudate from a wound. It “takes care” of the skin and “pulls” infiltrative fluid from the deep layers of the skin outward. Compresses with Delaskin are used for a week.

From 9-10 days, “Vulnostimulin” is used in the treatment of bedsores. It should be applied to the skin twice daily, every 6-8 hours.

Now readers know how to treat bedsores, but the above methods should be used wisely. With irrational therapy, excessive moisture in the skin may occur, which will increase swelling. The horny epithelium should also not be allowed to dry out. Choose the dosage and duration of use of pharmaceuticals wisely.

The problem of many bedridden patients is the formation of bedsores, when some areas of the skin begin to die and necrosis, reaching deep tissues. Therefore, it is necessary to use special ointments for bedsores. They prevent the appearance of skin lesions and eliminate already formed areas of tissue necrosis.

Why do bedsores appear?

Bedsores usually appear where bony protrusions touch the skin. Often, deep bedsores go unnoticed until the lesion reaches the skin. As a result, blood flow in these places is disrupted.

Due to the disruption of the patency of small vessels, gradual death of cells in this area occurs. Such dead cells are easily exposed to pathogenic microorganisms, resulting in an infectious process.

Bedsores are mostly observed in places where the skin rubs against bedding. In most cases, these are elbows, knees, shoulder blades, hips, and back.

The trigger for the development of bedsores is poor nutrition. As a result, muscle and soft tissue volume is reduced due to weight loss.

Increased body temperature, swelling and other related ailments also contribute to their occurrence.

First, individual areas on the body become pale, followed by swelling and blistering formations. If a complication begins, doctors often diagnose gangrene, sepsis, or erysipelas.

According to medical data, not all bedridden patients develop bedsores; the risk group includes the following categories of people:

• Elderly patients.

• Those diagnosed with diabetes.

• If you are overweight.

• People with pathologies of the heart and blood vessels.

• Patients who find it difficult to control the process of urination and bowel movements.

External irritants that accelerate the process of bedsores include:

• Reduced or increased temperatures.

• Exposure to various chemicals.

• Mechanical effects such as friction, prolonged pressure or trauma.

Names of the most effective ointments for treating illness

There are a large number of different ointments for bedsores.

They relieve a person from such troubles with great effect, as they have a number of advantages:

1. They speed up the healing process.
2. They are not that expensive.
3. Improve tissue trophism.
4. I help eliminate pain and other unpleasant sensations.
5. Effectively eliminate bacteria.

Attention! Bedsores must be treated at all stages. The drugs are used both in the early stages of wound formation and at the time of their activation. The only difference will be in the drug prescribed.

It is worth considering the list of the most popular and effective ointments of our time:

Iruksol

Main active ingredients of Iruksol:

1. Enzyme collagenase.
2. Antimicrobial additives.

Iruksol deeply and gently cleanses the contents of bedsores. At the same time, the integrity of healthy tissues is not compromised. The antimicrobial components included in the drug enhance the process of wound cleansing and also promote the rapid formation of healthy cells.

After applying Iruksol, a bandage is applied to the skin, and the latter is fixed tightly to the bedsore itself. The bandage must be changed to a new one every day. The course lasts no more than 10 days. The next use of Iruksol is permissible only after 2 weeks in order to avoid addiction to this drug.

The ointment supplier is the English company Smith & Nephew. The cost of the ointment is around 1800 rubles.

With silver

This is a series of medications that contain silver elements. They are quite effective when used at the very beginning of the formation of bedsores. The most popular ointments include:

• Dermazin- antibiotic ointment. The main active ingredient is silver sulfadiazine. This ointment can be used with or without a bandage. If a dressing is used, it should be changed daily. The drug is not recommended for people with intolerance to the components of the ointment, children under 1 year of age, and pregnant women. Sometimes the product causes itching and burning.

• Sulfargin– antimicrobial agent. The ointment is also based on silver sulfadiazine. If there is pus on the necrotic area, it must be removed and only then ointment should be applied. During the day, ointment with silver can be applied up to 2-3 times, both with and without a bandage. The product is applied in a thick layer. The duration of the course is calculated by the doctor and is at least 3 weeks. Contraindications are the same as for Dermazin. Side effects are rare and include gastrointestinal upset, nausea, allergic reactions, itching and burning.

The cost of these drugs is relatively low (Dermazin costs about 600 rubles, Sulfargin – about 300 rubles, the cost depends on the volume of the ointment).

Argosulfan

This is an antibacterial agent. It contains sulfathiazole. This substance can inhibit the activity of bacteria and reduce their numbers. The characteristics of sulfathiazole are enhanced by silver ions, which are also contained in the ointment.

The drug can relieve pain. If desired, the product should be applied together with a bandage. This is done up to several times a day.

If the patient does not tolerate the main component of the ointment, then the use of the drug is discontinued. The drug is also prohibited for very young and premature babies. Side effects may develop, such as itching and burning, as well as allergic reactions.

Argosulfan is a Polish drug that costs around 600 rubles.

Stellanin

The ointment has a triple effect on wounds:

1. Provides antimicrobial effects.
2. Relieves the inflammatory process.
3. Regenerates tissue.

When applying the ointment, it is necessary to ensure that the product covers the entire area with bedsores. The duration of treatment and dosage of the medication will be determined by the doctor depending on how far the destructive process has progressed.

There are also contraindications to the use of Stellanin:

1. Thyrotoxicosis.
2. Acute renal failure.
3. The period of bearing a child.
4. Infancy up to 1 year.

Allergies are quite often a side effect when using this drug.

The approximate price of the drug is 450 rubles.

Watch a video about the treatment of bedsores using the innovative Stellanin-PEG ointment and gives feedback on it:

Levosin

Main components of the ointment:

1. Levomycetin.
2. Sulfadimethoxine from microbes.
3. Methyluracil for wound healing.
4. Trimecaine is an anesthetic.

Levosin is successfully used in the fight against bedsores, as it has a pronounced therapeutic effect. The wounds are gradually cleared of purulent formations and dead skin. After which the healing process occurs faster.

The drug is not very expensive, around 72 rubles.

With zinc

Zinc-based ointment, in addition to relieving inflammation and eliminating bacteria, can dry out weeping wounds and protect them from adverse effects. Apply the product in a thin layer to the skin. Course duration is 60 days.

The product is relatively cheap; you can buy it at any pharmacy for 15-20 rubles.

Solcoseryl

The ointment is based on the blood of dairy calves. Thanks to this composition, the drug is able to regenerate tissue. When the medicine is applied to the skin, a film is created that is invisible to the human eye. It serves as a barrier to destructive influences from the outside.

Solcoseryl is used in the presence of dry rather than wet wounds. The product is used twice a day, it is applied to the affected area that has been previously treated with an antiseptic composition. The ointment can be used until the bedsores go away.

Online pharmacies offer the product at a price of 224 rubles.

Levomekol

The ointment base consists of the following components:

1. Chloramphenicol.
2. Methyluracil.

Levomekol improves tissue restoration processes and is a good antiseptic. This is especially true for infected bedsores.

The cost of levomekol is approximately 98 rubles.

Methyluracil

The basis of the ointment is a substance of the same name, which has a healing effect. The product is able to normalize intracellular metabolism and initiate regeneration processes. Due to these properties, the processes of granulation and tissue healing begin.

The price of the drug is within 70 rubles.

Metrogyl gel

The drug contains the antibiotic metronidazole. It stops the growth and further development of bacteria. In particular, this ointment must be used at a time when anaerobic microorganisms begin to develop. The foul odor is eliminated, the release of fluid and pus from open wounds is reduced.

The cost of the medicine in pharmacies is 105-167 rubles.

Menalind

This medicine is used as a preventative against bedsores. The substance itself is produced not only in the form of an ointment, but also in the form of foam, lotion, sanitary napkins, etc. All these products are produced for the purpose of high-quality care for bedridden patients.

Menalind has a bactericidal property; when applied, small wounds do not have time to fester, and their healing accelerates. The product enhances local defense mechanisms and eliminates unpleasant odors. After applying the cream, a film is created on the skin that protects against the penetration of microbes.

The cost of Menalind cream is in the range of 400-500 rubles.

Prevention against skin lesions

If there is a bedridden patient in the house, then in addition to treatment, it is also necessary to take care of the prevention of bedsores. There are potentially dangerous places where bedsores most often form. As already mentioned, this is where the bones come into contact with the tissue surfaces, that is, the elbows, hips, shoulder blades, etc. These areas should be regularly wiped with camphor alcohol, vinegar solution, and a mixture of ammonia and water (1 to 4).

If bedsores have already formed, care must be taken to ensure that a secondary infection does not occur. To do this, treat diseased areas with antiseptics and antibacterial solutions. They are usually prescribed by a doctor.

Caring for a person who cannot get up should include the following:

• Constant change of body position of a bedridden patient. If the patient's condition is stable, then it is advisable to do this every 2 hours.

• Bed linen is changed every day.

• If a person lies on his back for a long time, then it is advisable to place a rubber circle in this area.
• If redness is noticed in a dangerous area, then it should be wiped with a dry towel, or it is better to immediately carry out quartz treatment.
• You can wash these areas with warm water and soap, then wipe dry or wipe with alcohol.
• It is necessary to use a special mattress for bedridden patients. It consists of certain longitudinal sections. The anti-decubitus mattress is covered with one sheet so as not to lose its therapeutic effect.

• It is necessary to regularly ventilate the room, since the process of tissue destruction begins against the background of humid and stale air.

• The patient should eat well if the body allows it. This way, recovery from injury or illness will be faster.

You will learn more about preventing bedsores from this video:

You need to know that bedsores appear unnoticed and sometimes unexpectedly. Therefore, if there is a bedridden patient in the house, care for him must be thorough. Then recovery will come faster and without consequences.

– a serious and common complication of diseases associated with limited mobility of the patient. Due to prolonged pressure on soft tissues with forced immobility, blood supply and nutrition are disrupted, which leads to necrosis (death). Manifestations and symptoms depend on the disease. At the initial stage, local skin hyperemia and minor damage appear. Then, if no measures are taken, non-healing ulcers appear on the skin, gradually involving deeper layers - subcutaneous fat, muscles and even bone tissue.

The patient’s general condition also suffers – there is a general weakening of the body’s defenses, and signs of intoxication appear. A serious complication of the necrotic process is sepsis, which can lead to. It is important to diagnose the process at the initial stage; in this case, it is enough to remove the cause and use antibacterial agents to treat bedsores. In this case, folk remedies give a good effect. If necrotic ulcers appear, it is necessary to undergo a course of antibiotics, and sometimes surgical intervention is required, which is performed in a hospital.

Home treatment for bedsores

It must be taken into account that at any stage of treatment it is important to eliminate. Therefore, it is recommended to use a functional bed during the treatment of bedsores. It is selected individually, depending on the patient’s weight. This stimulates blood circulation in the tissues, thanks to the constantly changing pressure in it. This redistribution of pressure plays a role and significantly reduces the development of necrosis. For maximum convenience, they are used, thanks to which the patient can take the most comfortable body position.

Taking care of the patient's cleanliness and skin is important. should be done with sterile dressings and gloves in order to prevent re-infection of the wound.

When treating bedsores at home, folk remedies are widely used. These methods give the maximum effect in the initial stages of necrosis, but traditional medicine recipes are also used in complex therapy. Most herbs and natural elements have a pronounced wound-healing, drying or antibacterial effect, which has a good effect and significantly accelerates tissue regeneration.

The following folk remedies are most often used to treat bedsores:

• honey and bee products,
• essential oils,
• camphor alcohol,
• soda,
• laundry soap,
• onions,
• starch,
• medicinal herbs.

Honey and bee products

Product	Properties	Application
Honey	Bactericidal Nutritious Enhances regeneration Anti-inflammatory	Treatment of eczema, bedsores, burns, wounds, psoriasis, furunculosis. Treatment and prevention of infectious diseases. As a general tonic.
Propolis	Antimicrobial Antifungal Stimulating	Treatment of skin tuberculosis, gastrointestinal diseases, teeth. Treatment of eczema, hyperkeratosis, fungal diseases.
Wax	Emollient Anti-inflammatory Stimulates regeneration	Treatment of burns, wounds, bedsores, strengthening of teeth and gums.
Royal jelly	Stimulates immunity Enhances hematopoiesis Increases the body's resistance	General strengthening agent. Treatment of skin, eczema, neurodermatitis, focal baldness.

Ointment for bedsores with wax

Heat 1 tablespoon of vegetable oil, then cool to 70 degrees. Add 2 tablespoons of animal fat (you can use ghee or butter), 100 grams of beeswax and 10 grams of pine resin. Stir until the consistency of the ointment, store the resulting product in a cool place, and before use, heat in a water bath until the wax melts.

Before applying the ointment, the wound is cleaned of necrotic plaque with tampons soaked in and dried. Apply, cover with cling film and wrap with a warm cloth on top. After a day, remove the compress, clean the wound (if necessary) and reapply the ointment. At the first signs of healing of the ulcer, young skin is lubricated with emollients, and treatment with ointment is stopped.

Honey remedy

Chopped fresh potatoes and honey should be mixed in a 1:1 ratio. Soak a gauze bandage with the resulting mixture and apply it overnight. This mixture relieves pain and hyperemia, softens the skin, and promotes tissue regeneration.

Melt 10-15 grams of propolis and add 30 grams of vegetable oil. Stir the mixture, cool and store in a cool place. Ulcers should be wiped with the cooled mixture at least three times a day. This helps remove pus and plaque and stimulates tissue repair well.

Onion-based product

Thanks to the volatile substances - phytoncides included in its composition, onions have an antimicrobial and anti-inflammatory effect. This property is successfully used in the treatment of bedsores in folk medicine.

To make the composition you will need:

• 2 medium sized onions;
• 40 grams of vegetable oil;
• ¼ part of a church candle.

Finely chop the onion and simmer in vegetable oil for 20 minutes until golden yellow. The dishes must be enameled. Then strain the resulting mixture and mix with melted candle wax. Store the resulting mixture in a cool place.

Lubricate necrosis with the product 2 times a day. The ointment should be used to treat shallow wounds that have not been aggravated by fungal, viral or bacterial infections.

Starch in the treatment of skin lesions

Starch for bedsores is used for preventive purposes, as well as to eliminate the first signs of the disease. After hygiene procedures, the skin is dried, the hyperemic areas are sprinkled with starch and wrapped with a fabric bandage.

This allows and does not allow the process to progress.

Using laundry soap

Simple laundry soap has a strong antibactericidal, decongestant and drying effect. It has long been noted that its use reduces pain and accelerates the healing of wounds and cracks in the skin.

To prepare a medicinal paste, the soap must be crushed (grated). Then mix 150 grams of dry matter with triple cologne so that a homogeneous mixture is obtained, the consistency of which resembles an ointment.

Soda against ulcers

It is necessary to dissolve a teaspoon of soda in a glass of boiling water and soak fabric (preferably linen) in the resulting solution. Allow the product to cool slightly, wring out the fabric slightly and apply to the wound. This compress draws out pus from the wound and removes necrotic plaque. It is better to soak several napkins at once and change them as they cool. This method allows you to quickly clean the wound, which promotes its healing.

Calendula flower remedies

The plant has an antimicrobial effect, neutralizes inflammation, and accelerates the healing of ulcers. For severe skin lesions, fresh calendula leaves are applied directly to areas of necrosis; the leaves should first be crushed.

In the treatment of necrotic skin lesions, various dosage forms based on calendula flowers are used:

• Ointments and lotions;
• Decoctions and infusions;
• Alcohol tincture;
• Applications and compresses.

Calendula flower ointment

Grind dried flowers (a heaping tablespoon) and mix with Vaseline, 50 grams. Store the resulting ointment in a cool place. It should be applied to a previously cleaned ulcer, 2 times a day. Treatment can be continued after the wound has begun to epithelize.

Calendula tincture

Infuse dried flowers for 14 days in vodka, in a ratio of 1:2. Strain the resulting product and store it in a cool place. Before use, dilute the tincture with water - 1 tablespoon of tincture in ½ cup of boiled water. Use the resulting product to wipe the areas of hyperemia. Can be used as a lotion up to three times a day for 20 minutes.

Herbal infusions and decoctions

Treatment of bedsores with folk remedies is not complete without using the power of medicinal herbs. Using proven recipes, you can not only prevent the development of necrotic changes, but also cure superficial ulcers.

Compound	How to cook	How to use
· Chamomile 50 grams · Sweet clover 50 grams · Boiling water ½ cup	Mix chamomile and sweet clover, pour boiling water and leave for 30 minutes.	Wrap the resulting pulp in gauze and apply to affected areas of the skin 2-3 times a day. Used in the initial stages.
· Horsetail 30 grams · Chamomile 30 grams · St. John's wort 40 grams · Water 0.25 liters	Pour boiling water over the herb mixture, heat in a water bath for 15 minutes and strain.	Wipe the wounds with the infusion, use it as a lotion, and also take 1/3 cup orally 3 times a day. Has a general strengthening effect.
· Dry crushed oak bark 40 grams · Water 0.2 liters	Pour hot water over the oak bark. Bring to a boil and keep for 20-30 minutes over low heat, then cool and strain.	, moistened with bark decoction, apply to the wound 3 times a day for 10 minutes.
Lungwort officinalis (all except the root) 2 tablespoons Water 0.5 liters	Pour boiling water over the crushed dry substance and heat in a water bath for 15 minutes. Cool and strain.	Rinse and ulcers 2-3 times a day.

Camphor

In folk medicine, camphor alcohol and camphor oil are often used for bedsores. Its source is Japanese laurel wood. Pharmacies offer dosage forms:

• Camphor ointment;
• Oil solution;
• Alcohol solution.

When applied topically, camphor oil gives the following effect:

• Bactericidal and bacteriostatic;
• Relieves itching and irritation;
• Reduces tissue inflammation;
• Enhances regeneration.

The most effective use of camphor is to prevent skin necrosis, when camphor oil is used to rub the areas subject to the greatest pressure - the back, shoulder blades, etc. However, if the process has already begun, the product can also be used as a treatment for stage 1 and stage 2 bedsores. It must be remembered that camphor is not used when the process has affected subcutaneous fat, muscles, and bone. In this case, using the medicine can only worsen the situation, causing tissue burns.

There are several effective recipes for treating bedsores using camphor alcohol.

Chatterbox

Mix camphor alcohol, medical alcohol or vodka and shampoo (preferably for children), 100 ml each, and lubricate the areas of hyperemia with the prepared product. This mash is applied at night; in the morning, the skin must be wiped with a clean, damp sponge. Effective at the initial stage of the disease.

Oil lotions

If blisters have not yet appeared on the skin, the following procedure will give a good result: treat the skin with a sterile swab dipped in an oil solution of camphor, do not wipe the skin. Apply sea buckthorn oil or rosehip oil on top.

Camphor with yarrow

For minor damage to the skin and the formation of blisters on the skin, the following remedy helps: pour 20 grams of dry matter of yarrow herb into 1 liter of boiling water, leave for an hour, then strain. Add calendula alcohol tincture, 20 drops, to the resulting decoction. Lubricate the blisters that have formed on the skin with camphor oil, and place gauze soaked in medicinal infusion on top. leave until the product is completely absorbed. The procedure should be carried out 5 times a day for 10 days.

Products based on plant juice

In folk medicine, not only decoctions and infusions of dried herbs are used to combat bedsores. The juice of some plants has good wound-healing properties.

Aloe

Freshly chopped leaves of aloe, which is rightfully considered a medicinal plant and is used in the treatment of many diseases, help cleanse ulcers of pus and necrotic decay products. It is the leaves that should be applied to the wound, since tissue soaked in juice do not have such a pronounced effect.

Kalanchoe

Kalanchoe has a pronounced wound-healing effect. The leaves of the plant should be cut with a knife and applied to the ulcers, after cleaning them with sterile swabs with hydrogen peroxide. Kalanchoe milk, getting into the wound, promotes its epithelization.

Millet therapy

Steamed millet helps relieve pain and reduce signs of inflammation. To do this, you need to take 50 grams of millet and steam it in a water bath until it becomes mushy. Place the resulting mass in a fabric bag, which should be applied to the bedsore for 2-4 hours. Continue the procedure for a week.

Features of treatment at home

In folk medicine, not only treatment, but also prevention of bedsores is important. It should be remembered that this disease can be treated independently only at stages 1 and 2, until necrotic ulcers have formed. When the process moves into stages 3 and 4, you must urgently consult a doctor.

In the treatment of necrotic wounds, folk remedies are used as an addition to complex therapy and help strengthen the patient’s immunity and accelerate the healing process on the skin. But it is the doctor who must prescribe the correct treatment and decide whether to hospitalize the patient.

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Anti-decubitus ointments, gels and creams must be selected depending on the problem. To improve microcirculation in tissues, products with camphor or guarana are suitable; for a diaper, it is better to choose creams based on zinc oxide; to maintain healthy skin of the whole body, products based on almond or linseed oil are suitable. Remedies for diaper rash are presented separately. A wide range of products will allow you to choose the right product. Call our consultant so you don’t make a mistake with your choice.

• Badyaga Forte gel helps to activate local blood supply to tissues, so it can be used not only as an effective remedy against bruises, contusions, and varicose veins, but also to activate tissue nutrition in areas at risk of developing bedsores. Regularly treat the areas of the shoulder blades, sacrum, buttocks, and heels with gel to prevent the formation of bedsores. It is also recommended to use the gel in those areas where the formation of a bedsore begins - a bruise occurs (usually on the heels)

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  150 rub.

• Powder "Silver powder", bactericidal with sorbing effect, 8 g

  Silver powder has a double effect: it has pronounced sorbent properties (removes excess moisture) and at the same time exhibits bactericidal activity, has an anti-inflammatory and tonic effect, stimulates reparative and metabolic processes in the skin, promotes the rapid healing of microtraumas, abrasions and other skin damage. Recommended for treating areas exposed to excess moisture instead of regular powder

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  165 rub.

• Calendula balm is made on the basis of concentrated aqueous extract of calendula. The properties of calendula have long been known in medicine: calendua has a pronounced anti-inflammatory, antibacterial, antiviral, antifungal, wound healing and analgesic effect. For the production of Altai Calendula balsam, only freshly harvested calendula is used, an extract that preserves all the beneficial substances and healing properties of the plant. The fast-healing properties of calendula, as well as its anti-inflammatory, antibacterial and antiseptic effects, allow the balm to be used to combat various skin diseases and accelerate the healing of skin lesions.

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  175 rub.

• 
  

  Seni cream with L-arginine is intended for the treatment of bedsores at the red spot stage. L-arginine helps improve local immunity, significantly increases the ability of skin cells to regenerate, and promotes rapid healing of skin microdamages. The cream has ideal absorption.

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  217 rub.

• Seni zinc cream is intended for the care of areas of the body exposed to high humidity: in the intimate area under the diaper, in the back area. It has an antimicrobial effect and prevents the formation of diaper rash. Forms a protective film on the skin.

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  217 rub.

• Propolis oil is a real gift of nature for caring for damaged skin. The oil has a pronounced bactericidal and bacteriostatic effect, has local anesthetic and analgesic effect (the anesthetic effect of propolis exceeds the effect of using novocaine solution by 3.5 times). It has antiviral, mycostatic (antifungal); anti-inflammatory, wound healing, regenerating effects. Recommended for the care of irritated skin, for the treatment of stage 1 bedsores (at the level of the red spot), for the treatment of any microdamage to the skin.
  

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  219 rub.

• Fir gel is a product based on 100% natural fir oil in a convenient form. The gel is applied to damaged areas of the skin several times a day. It has pronounced anti-inflammatory and antibacterial properties, helps restore the skin. Recommended for the care of skin with microdamages (diaper rash, damage, abrasions), dry, cracked skin, for the treatment of stage 1 bedsores.

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  222 rub.

• Seni cream for intensive moisturizing of keratinized skin on heels, elbows and knees contains 10% urea. Urea intensively softens dead skin formations and makes the skin soft and elastic. Especially recommended for patients with diabetes. Visible effect after the first 2-3 applications.

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  271 rub.

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  Skin care oil "Seni Care". For care and massage for dry, sensitive subject to influence of irritating factors skin. Apply to pre-cleaned dry skin and distribute with light massaging movements.

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  310 rub.

• 

  Lotion for the prevention of bedsores Menalind, compact package 250 ml, is used to care for the skin of the entire body: actively nourishes, moisturizes and protects the skin. Contains creatine, essential fatty acids, amino acids and almond oil. Helps maintain the skin's natural defense mechanisms. Water-in-oil emulsion. Absorbs very well.

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  314 rub.

• 

  Protective skin cream with zinc Menalind is recommended for the care of healthy skin in areas subject to friction and high humidity, as well as in the intimate area - as a protective and preventive agent (including protection against the irritating effects of urine and feces) . Forms a protective film on the surface of the skin.

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  315 rub.

• 
  

  The cream is used to care for skin with mild damage (scuffs, microcracks, minor inflammations, etc.). Actively moisturizes the skin and protects against infection, providing an antibacterial effect. Recommended for caring for the entire body in areas that require special care.

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  327 rub.

• Seni light tonic gel with guarana and caffeine, with the addition of camphor, is designed to improve blood microcirculation in areas at highest risk of developing bedsores: the back of the head, shoulder blades, sacrum, buttocks and heels. Creates a pleasant feeling of coolness. It is recommended to treat individual areas of the body more often 1-2 times a day.

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  334 rub.

• An active restorative balm based on pork fat has a pronounced effect that improves local blood circulation. ABOUT It has a mild warming effect, increases the activity of metabolic processes in tissues, and helps reduce inflammatory manifestations. Can be used as a natural remedy to prevent and prevent bedsores.

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  350 rub.

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  Menalind (Menalind) transparent gel for the prevention of bedsores: contains camphor, menthol, panthenol and almond oil. Tones and refreshes the skin, increases blood flow to the skin, maintaining tissue nutrition. The gel is intended for rubbing into areas at greatest risk of developing bedsores: the back of the head, arms, legs, lower back, buttocks, heels.

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  355 rub.

Update: October 2018

Bedsores are a serious complication of many diseases associated with tissue malnutrition or resulting from external compression with displacement. In medical practice, bedsores are often called ulcers.

This complication is by no means the fate of only bedridden patients; bedsores can form under any external pressure, especially often at the sites of bone protrusions.

Patients suffering from impaired tissue innervation due to pathology or damage to the spinal cord are susceptible to pressure ulcers. In such patients, treatment of bedsores on the heels and buttocks becomes relevant, i.e. places receiving the greatest pressure from body weight.

In bedridden patients, compression of the skin and blood vessels occurs, resulting in stagnant processes and tissue death in places of maximum contact of the body with the hard parts of the bed, therefore bedsores are formed depending on the position of the body:

• When lying on your stomach, the pubis and cheekbones are affected
• When lying on the side - knees, hips, ankles
• Lying on your back – sacrum, heels, ischial tuberosity, elbows, shoulder blades, back of head

This process is facilitated by overdrying or, conversely, excessive moisturizing of the skin. Dryness leads to exfoliation of the stratum corneum (protective) layer of the skin, and humidity provokes infection of the affected areas, all this is aggravated by impaired blood supply to areas of compression.

Such a complication as bedsores, their prevention and treatment are relevant to this day - the search for new means of treatment and prevention of these formations is constantly underway. Bedsores form quite quickly, but their treatment is problematic and does not always bring the desired effect.

70% of patients who develop bedsores are elderly:

• 66% - older people with hip (femoral neck) fractures
• 60% - patients with tetraplegia
• 33% patients in intensive care units
• 9% of hospitalized patients
• 3-25% - people at home (bedridden patients)

General approach to treating pressure ulcers

Methods and means of treating bedsores vary depending on the degree of the pathological process. Of great importance is the prevention of bedsores, which is actively carried out from the first days of the disease, which contributes to the appearance of this complication.

Treatment is divided into: conservative and surgical. The latter is indicated for severe bedsores that are difficult to treat and do not heal. All conservative treatment measures are aimed at achieving the following key points:

• Improving trophism (blood supply) of tissues.
• Cleaning the surface of bedsores from necrotic masses.
• Healing of the surface of bedsores.

Principles of pressure ulcer therapy:

• At each stage of development of a pressure ulcer, prevention of its progression is carried out.
• It is unacceptable to use softening ointments, blind dressings that block the access of oxygen and evaporation of moisture, wet dressings in the initial stages and during dry necrosis - all this leads to the formation of wet necrosis and tissue death.
• Ointments with antibacterial action are prescribed when a wet wound with purulent contents forms, or when there is wet tissue necrosis.
• General antibacterial therapy is carried out taking into account the sensitivity of the pathogenic flora.

Superficial bedsores - stage 1-2

Treatment of bedsores 1st and 2nd degree

Anti-bedsore pillow with shape memory

So, how to treat grade 1 bedsores? When bedsores begin to develop, active prevention of the progression of necrotic tissue changes should be carried out, since at this stage only thickening and hyperemia of the skin occurs:

This event involves the use of special means:

• plastic tires;
• special anti-decubitus beds;
• pillows, mattresses, pads, circles with gel, foam, air, water filling or a combination of several fillers;
• systems with adjustable vibration and pressure.

An anti-bedsore mattress is the most effective means of preventing bedsores. Such mattresses constantly change pressure on the body at different points, thanks to the deflation and inflation of air every 7 minutes in special chambers of the mattress. Alternately changing pressure points eliminates the cause of bedsores and maintains normal blood circulation in the compressed tissues. Cellular type mattresses are used for the treatment and prevention of stages 1-2 (price 2000-2800 rubles), balloon type mattresses stage 3-4 bedsores (approximate prices 4800-9000 rubles).

You should also know simple rules when caring for bedridden patients:

• The patient's skin should always be clean, not damp, and not dry - do air baths. For hygiene, do not use antibacterial soap (it also kills beneficial, protective bacteria), use plain soap, a natural sponge (or cotton washcloth) and clean water. Do not rub the skin, but gently wipe it; after washing, do not wipe the skin, but blot it.
• Carefully monitor the condition of the skin - if it is dry, then use moisturizers (moisturizing hypoallergenic creams, preferably baby cream) to which the patient is not allergic.
• If the skin is too wet, without fanaticism you can use powders, talc or ointments that dry out the skin - a 1% potassium permanganate solution, zinc ointment or brilliant green solution, but only for prevention or at stage 1, in the future you should not use ointments containing zinc and a solution of potassium permanganate.
• Oily skin can be treated with alcohol-containing products.
• If you find redness, do not massage it, massage only around the damaged skin. You can specially make a mitten from a terry towel and use it to massage.
• If the patient has urinary incontinence, diapers or homemade pads made of cotton fabric should be regularly changed and the perineum should be toileted; for men it is better to use a urine collection system. At high temperatures, or when the patient sweats profusely for other reasons, it is better to wipe the sweat with a weak solution of table vinegar - 1 tbsp. spoon for 250 ml. water than soap and water.

Local treatment of developing bedsores

This event requires a competent approach, since incorrect actions can provoke further development of necrosis.

Previously, the treatment of bedsores in bedridden patients was erroneously carried out with ion exchange drugs, such as chlorhexidine, iodinol, etc. However, these drugs change the permeability of cell membranes, kill leukocytes and reduce cellular resistance to bacteria.

A modern scheme for local treatment of pressure ulcers includes:

• Toilet the skin using saline or drugs that do not have ion-exchange properties - camphor alcohol.
• Drying the skin and treating with drugs that improve local tissue circulation (Solcoseryl).
• Xeroform powder helps with bedsores.
• Applying a polyurethane film dressing. This modern dressing material is produced in the form of a transparent film with an adhesive surface and provides protection against bacteria, access of oxygen to tissues and evaporation of moisture, and also allows visual monitoring of the condition of the skin. When gluing such bandage patches, excessive tension should be avoided, since small folds form when the patient moves, which aggravates the condition.
• A technique such as washing the skin with cold water also works well. The contraction of blood vessels and their subsequent compensatory expansion leads to improved local blood flow and increased tissue nutrition.

How to treat stage 2 bedsores?

This stage represents a transitional state of the skin, when minor superficial damage is already visible. At this stage, minimal surgical intervention and measures are carried out to stop tissue necrosis and promote regeneration of damaged areas:

• Toilet the formed wound by removing dead epidermis from the blistered areas. Ideally, it is carried out in a dressing room: cutting off dead epithelium with surgical scissors, washing the wound with saline solution, hydrogen peroxide.
• Observation of pressure ulcers in dynamics with assessment of the development of the process.
• Antibacterial therapy in case of progression of bedsores and the onset of an inflammatory reaction.
• Applying antiseptic dressings to bedsores devoid of epidermis, after consulting with a doctor, which dressing is best to use for treating a given wound surface, taking into account the stage (presence, absence of necrosis), area of ​​damage:

Treatment of bedsores 3 and 4 degrees

At stage 3 of pressure ulcer development, necrosis of the dermis and subcutaneous fatty tissue to the fascia occurs. Treatment of grade 3 pressure ulcers is aimed at surgical cleansing of the wound from necrosis and purulent exudate and further absorption of wound discharge while preventing drying.

The peculiarity of necrotic changes in bedsores is the rapid spread of the pathological process to adjacent tissues with poor blood supply. The wrong tactic in this case is to expect the dead tissue to be rejected on its own and the wound to cleanse. Necrectomy with opening of purulent cavities is recommended to be carried out before the appearance of capillary bleeding.

After necrectomy, the pressure ulcer is sanitized using antibiotic therapy, local antiseptics and other drugs. Groups of drugs used in the treatment of pressure ulcers:

Complex treatment allows you to stop the septic condition and achieve cleansing of the ulcer. Local treatment is carried out using the following popular drugs of choice:

Argosulfan cream The active basis of which is the antibiotic sulfathiazole, which inhibits the growth and further reproduction of pathogenic microorganisms. An auxiliary active ingredient is silver ions, which enhance the therapeutic effect of sulfathizole and at the same time reduce its sensitizing (allergic) effect. action, and also inhibit the growth of bacterial flora. The hydrophilic base of the drug provides an analgesic effect, moisturizes the wound and accelerates its healing. The concentration of the active cream base in the wound remains at the same therapeutic level for a long time, and minimal resorption ensures the absence of toxic effects. Formed bedsores can be treated with Argosulfan ointment in an open manner or used with an occlusive dressing. The drug is applied to the entire surface of the cleaned wound, 2–3 mm thick, twice or thrice a day. Can be used for up to 2 months. Ointments Sulfargin (50g 200 rubles) and Dermazin (50 grams 200 rubles, 250 grams 530 rubles), Argosulfan (15 grams 200 rubles, 40 grams 350 rubles) have a similar effect.

Ointment Iruksol The active composition of the ointment contains: collagenase, chloramphenicol and related enzymes. This enzymatic preparation ensures the cleansing of bedsores, the breakdown of anesthetized tissue, which deprives bacteria of a nutrient medium, as well as a bacteriostatic effect. The use of Iruksol on cleaned tissues ensures their rapid granulation. Apply to a cleaned or moistened wound with saline solution twice a day until the wound is completely cleansed and tissue granulation. Iruksol ointment, price approximately 1300 rubles. for 30 gr.

Levosin ointment The drug is based on the antimicrobial substances chloramphenicol and sulfadimethoxin, the wound-healing component methyluracil and the local anesthetic trimecaine. The ointment has high hydration activity, thereby providing a rapid therapeutic effect. The use of ointment leads to cleansing of the pressure wound from pus and necrotic masses and subsequent healing of the wound. Apply daily to a cleaned surface, which is loosely filled with ointment and covered with a dressing. It is possible to administer it into purulent cavities through a syringe. Levosin price for 40 g. 80 rub.

Levomekol — in addition to methyluracil, the composition includes chloramphenicol. This drug improves tissue regeneration and has antibacterial properties. Used for infected bedsores in the purulent-necrotic phase of the wound process. Levomekol (price 80-100 rubles)

Metronidazole gel 0.75% Metrgil is based on a substance with an antimicrobial effect, metronidazole. The gel is used with dressing material and provides relief from the stench of pressure ulcers and inhibition of microbial growth. For bedsores with copious discharge, foam dressings with metronidazole are used, for dry bedsores or with insignificant discharge, hydrogel dressings with metronidazole are used. Metrogyl gel price 100-120 rub.

Hydrogel Intrasite - for cleansing the skin of necrotic tissue For gentle cleaning of necrotic skin tissue in bedsores. The hydrogel is recommended for use with an external dressing, the frequency of change of which and the choice of dressing depend on the condition of the pressure ulcer. It provides gentle, quick cleansing of the wound from necrotic tissue, as it adsorbs excess exudate and wound detritus. Intrasite is a pure amorphous hydrogel containing water, propylene glycol and a modified carboxymethylcellulose polymer. Price: Gel INTRASITE 2100 rub. (United Kingdom)

At stage 4 of the formation of a pressure sore, deep necrosis occurs with the involvement of muscles, tendons, joint capsules and bones in the pathological process. Treatment includes excision of necrosis, absorption of pressure ulcer fluid, and moistening of the healing ulcer.

With conservative treatment, if the size of a deep pressure ulcer does not decrease by 30% in 14 days, then the extent and severity of the patient’s condition should be re-evaluated and the treatment method should be changed. After stopping the acute phase of the ulcerative process, the issue of surgical treatment is decided.

Complete surgical excision of all dead tissue is impossible and impractical (it is quite difficult to accurately determine the border of necrosis). Surgical cleansing of the wound is carried out with the maximum possible preservation of living tissue in the areas of the articular capsules of the neurovascular bundles.

Drug therapy is similar to that used in the treatment of grade 3 pressure ulcers.

During surgical treatment and to stimulate tissue repair, physiotherapeutic treatment of bedsores is carried out:

• Reducing microbial contamination of ulcers - ultrasound, UHF in a thermal dose, phonophoresis of antiseptics.
• Stimulation of reparative processes - darsonval of healthy tissues surrounding the bedsore (see), low-intensity laser, mud applications, direct current, electroacupuncture.
• Stimulation of blood supply and microcirculation - massage of healthy tissues bordering bedsores.

Surgical treatment

Surgical treatment is carried out according to strict indications, since improper and inappropriate intervention is likely to increase the area of ​​the bedsore. The effectiveness of surgical treatment methods is assessed in order to avoid further complications.

Free skin plasty (autodermoplasty), excision of a bedsore with comparison of the edges of the wound, and plasty with local tissues are used. Unfortunately, this treatment is not always effective, since the transplanted tissue does not take root well in a place with insufficient blood supply, and the pressure ulcer is a priori non-sterile.

Early surgical complications include accumulation of exudate under the skin flap, suture dehiscence, marginal necrosis of the skin flap, wound necrosis, and bleeding. In the future, a fistula may form, forming a purulent cavity and leading to a relapse of the bedsore.

Treating bedsores at home

Treatment of bedsores in bedridden patients at home is very important and presents certain difficulties. At home, it is difficult to fully clean a purulent wound and ensure good gas exchange for drying the surface and repairing tissue. Modern industry produces convenient disposable antiseptic self-adhesive dressings, made of innovative materials and applicable for different stages of bedsores, infected or not, which must be taken into account when choosing them.

Proteox-TM with trypsin and mexidol Used to treat infected bedsores in the final stages. Clears ulcers of purulent masses, necrosis, stimulates the repair process, relieves inflammation. (price 180 rubles).	Multiferm - complex of enzymes and chitosan (Moscow) Treatment of bedsores with and without slight exudation, infected or not, grades 1 and 2. Exposure time of 1 bandage (10x10cm) 24-48 hours (price 180 rubles)	Biaten AG (Denmark) Treatment of bedsores with a large weeping surface, infected. The course of treatment is 1-10 dressings, the frequency of changing dressings is once every 1-7 days (as they become soaked). Price 950 rub.	Comfil plus (Denmark) Treatment of large bedsores with and without slight exudation, uninfected. (price 140 rubles)

Traditional treatment of bedsores

When bedsores have formed, treatment with folk remedies is an auxiliary measure that helps cleanse the wounds and form new tissues. It should be remembered that almost all traditional methods involve the use of medicinal plants, which can cause an allergic reaction in case of hypersensitivity in the patient, and also depend on the stage of the process, therefore, before using them, you should consult a doctor about the advisability of such treatment. Do not use herbal products with a tanning effect - willow bark, green walnut infusion, oak bark, acorn oil, etc.

• Freshly squeezed juice from lungwort leaves is applied to the area of ​​the bedsore several times a day.
• Leaves of Kalanchoe officinalis, cut in half, are applied with the cut to the bedsore and secured with a bandage overnight.
• Young black elderberry leaves, scalded with boiling milk, are applied to the surface of the bedsore 2 times a day.
• Ointment from calendula flowers (1 tablespoon of crushed flowers mixed with 50 grams of petroleum jelly) is applied to bedsores 2 times a day.
• Lotions of fresh crushed potatoes mixed with honey in a 1:1 ratio are applied to areas prone to the formation of bedsores.
• Places with bedsores are lubricated with tea tree oil or several times a day (stage 1-2).
• and, mixed with honey in a ratio of 2:2:1, applied to areas with bedsores 2 times a day.
• A compress of sterile fish oil based on a sterile napkin is left overnight.
• Sprinkling bedsores with starch.

Complications of bedsores

Bedsores can lead to purulent arthritis, phlegmon, wound myiasis (when adult flies lay eggs on the wound surface). When the walls of blood vessels are corroded, arrosive bleeding can occur, and with long-term non-healing bedsores, the risk of skin cancer increases.

The most severe complication of bedsores is sepsis, when infection from the wound spreads through the bloodstream throughout the body, leading to multiple organ failure and death.

Prevention of bedsores

When preventing bedsores, it is worth considering the provoking factors and risk factors for their occurrence:

• Dirty skin, crumbs and other particles, folds, buttons, rough seams on bed linen
• Fecal and urinary incontinence, allergic manifestations in a patient to hygiene products
• Obesity, diabetes mellitus, ),
• Poor nutrition, exhaustion of the body, insufficient drinking
• Smoking, diseases of blood vessels and heart, brain and spinal cord
• Fecal and urinary incontinence
• Continuous pressure, humidity, friction
• Men are more likely to suffer from bedsores
• Age: over 70 years old
• Immobility or broken bones
• Low blood pressure, anemia, malignant tumors, stroke
• Dry skin, swelling

Prevention of bedsores should be carried out from the first day of the disease, with special persistence and thoroughness. As practice shows, if a bedsore has already begun to form, it is quite difficult to prevent its progression, and each subsequent stage of a bedsore increasingly reduces the chance of spontaneous resolution of the pathological process.

Prevention includes the following activities:

• Thorough skin care - cleansing, non-contact drying and disinfection.
• Regular change of bed linen, even stretching of sheets without wrinkles.
• The use of special mattresses (water, pneumatic, vibration), circles and pads.
• Constant change of position of the patient (every 2 hours).
• A balanced diet with proper drinking regime.
• Imitation of muscle work - massage, special electric underwear.