Pressure ulcers occur when pressure is placed on the skin, muscles, soft tissue, and bones, affecting those who are bedridden, incontinent, elderly, and in poor health. Treatment depends on the stage of the wound and the patient’s condition, including wound cleaning, topical preparations, surgery, and antibiotics. Turning and repositioning every two hours, special mattresses, and a high-protein diet can promote healing.
A decubitus ulcer refers to pressure sores or pressure ulcers that occur when pressure is placed on the skin, muscles, soft tissue, and bones. When a person’s weight presses against an underlying surface, the skin can begin to break down. Typically, a pressure ulcer affects those who are in poor health, bedridden, incontinent, and the elderly. Additionally, individuals who cannot reposition themselves at least every two hours are also at risk for pressure ulcers.
Typically, limited mobility prevents a person from changing position as needed, which increases the risk of skin breakdown. Additionally, those patients who are neurologically impaired, have dementia, or are heavily sedated are at particular risk. People who have pre-existing conditions, such as diabetes, are prone to a pressure ulcer, and having diabetes can further delay wound healing. Pressure sores are usually classified as mild to severe. A severe or stage IV pressure ulcer can affect muscles and bones and cause gangrene. Treatment for a pressure ulcer depends on the stage of the wound and the general physical and mental condition of the patient.
Wound healing generally cannot begin until the pressure is taken off the pressure ulcer. Additionally, the area of the skin lesion should be kept clean and free of irritating urine and feces. Stage I pressure ulcers, or mild pressure sores, usually respond to topical preparations such as petroleum jelly or diaper rash cream. More severe cases may require more potent preparations that have the potential to remove dead skin, regenerating new skin. Sometimes, in severe cases, surgical debridement will be needed to remove dead tissue and prevent gangrene from developing. Additionally, oral or intravenous antibiotics are needed when pressure sores become infected.
A high-protein diet and increased consumption of vitamin C can promote wound healing in those with pressure ulcers. In addition, immobile patients should be turned and repositioned at least every two hours to maintain pressure on bony prominences such as the hips, ankles, and elbows. Special mattresses, such as air or water mattresses, are also helpful in reducing the pressure on the skin. Incontinent patients need to change their incontinence clothes every two hours and when they get dirty. When patients sit in urine and feces, the skin becomes irritated, this aggravates pressure ulcers.
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