What are the treatments for bedsores?

  Decubitus ulcers are soft tissue ulcers and necrosis caused by prolonged pressure on local soft tissues, impaired blood circulation, persistent local ischemia, hypoxia, and malnutrition.  Prevention of decubitus ulcers: relieving pressure, avoiding continued pressure, and promoting skin circulation are the keys to cutting off the vicious cycle of decubitus ulcers; in addition, attention should be paid to strengthening nutrition to enhance the patient’s resistance.  2, diagnosis: decubitus ulcers can be divided into 4 degrees according to the degree of tissue damage. Most of them occur at the bony bulge where there are no muscles or the muscle layer is thin and there is a lack of tissue protection and frequent pressure. The degree of decubitus ulcer: degree I: no damage to the epidermis, only redness of the skin, but no improvement in redness for more than 30 minutes after lifting the pressure; degree II: redness of the epidermis, vesicles, tissue defects not reaching the dermis, moist pink trauma, accompanied by pain, no tissue necrosis. Degree Ⅲ: from the dermis to the subcutis, a spitfire-like tissue defect, with exudate and infection, but almost no pain, with tissue necrosis. Degree IV: deep into the tendon and bone, with exudation and infection, necrotic tissue, if there is nerve damage, accompanied by severe pain. From clinical statistics, the sciatic bone is the most common, accounting for 28%; followed by the sacrococcygeal region, accounting for 27%; the rest of the bony prominence: such as the scapula, elbow, greater trochanter, hip, the inner and outer knee, internal and external ankle, etc.. In severe cases, decubitus ulcers occurred in many parts of the body.  (1) Systemic treatment: For systemic infection, the necrotic tissue and exudate of the ulcerated surface of the decubitus ulcer should be taken for bacterial culture and drug sensitivity test, and sensitive antibiotics should be selected until 3 days after the fever subsides.  (2) Local treatment: Growth factor, tincture of iodine, decubitus decay and muscle, cure decubitus spirit, Jingwanhong ointment, comfrey oil, burn cream and other traditional Chinese ointments can be used externally to treat decubitus ulcers with certain effect.  (3) Physiotherapy: air cushion bed, infrared lamp to irradiate the traumatic surface, regular turning, massage of the compressed skin, and regular skin cleaning for the patient.  4.Surgical treatment: For patients with Ⅲ and Ⅳ degree decubitus ulcers, there is often a large amount of necrosis of deep and superficial fascia, separation of subcutaneous tissue from muscle, submerged skin edge, muscle necrosis, formation of thick hard scabs of necrotic skin and subcutaneous tissue, and septic infection often forms under the scabs. Free skin graft, skin flap and myocutaneous flap should be used for repair.