Decubitus ulcers
I. Overview
1. Concept: Decubitus ulcers are skin ulcers caused by the heavy pressure and friction of the body in patients who are bedridden for a long time. It is also known as mat sores.
2. Characteristics: They occur in areas that are susceptible to pressure and friction. Such as the sacrococcygeal region, the hip, the heel, and the spine. The lighter ones can be cured by treatment and care, but the heavier ones have localized ulceration, oozing pus and do not heal for a long time.
Second, the etiology of the pathogenesis
The internal cause is due to prolonged lying down and injury to qi, deficiency of qi and poor blood flow.
The external cause is localized compression and friction of the body, resulting in Qi deficiency and blood stasis, local skin loss of nourishment, skin necrosis.
Diagnosis
Clinical manifestations: Most often seen in patients with hemiplegia, lower limb paralysis, prolonged illness and bedridden, and prolonged coma, especially those with achalasia.
IV. Diagnosis
Initially: the skin at the site of pressure appears dark red, gradually becomes dark purple, rapidly becomes black necrotic skin, painful or not, the necrotic skin forms a clear demarcation with the surrounding area, and the surrounding swelling potential is flat and diffuse.
Mid-stage: the boundary between necrotic skin and normal skin gradually liquefies and ulcerates, the pus is foul, the decay expands from around the trauma surface to below the necrotic skin, and after the necrotic skin falls off, a larger ulcer surface is formed, which can probe the fascia, muscle layer and periosteum.
Later: The decayed tissue on the traumatic surface gradually falls off, bright red buds appear, and the skin around the trauma grows faster, and the bedsore is expected to heal. If the decay spreads, the ulcer surface gradually expands, the surrounding swelling continues to develop, the bedsore is difficult to heal, and even the pus and toxins run away and spread to the internal organs of the heavy evidence, the prognosis is poor.
V. Treatment.
Strengthen care, focusing on prevention. External treatment is the main focus, with internal treatment. Actively treat systemic diseases, and give the necessary supportive therapy, pay attention to diet and nutrition.
Treatment
1.Internal treatment
(1) Qi stagnation and blood stasis
Treatment: Regulating qi and activating blood circulation.
(1) Qi stagnation and blood stasis.
(2) evidence of toxicity and decay
Treatment: Benefit Qi, nourish Yin, regulate dampness, and protect toxins.
Treatment: Benefiting Qi and nourishing Yin, regulating Dampness and restoring Poison.
(3) Deficiency of both qi and blood
Cure: Nourish both qi and blood, and promote toxicity and muscle growth.
Remedy: Tory Disinfectant San with addition and reduction.
2.External treatment
(1) Initial external rubbing of red spirit wine or safflower tincture, or external sprinkling of talcum powder followed by local massage. Or irradiate with infrared lamp or spectrum meter, 2 times a day.
(2) Cut away necrotic tissue as much as possible after ulceration, and use Jiu Yi Dan or red oil ointment externally on the decayed area.
(3) When the pus and decay of the sore is removed, use the pads of the sore and the pads of the sore and the pads of the sore, if necessary.
VI. Prevention and care
Long-term bedridden patients should strengthen the skin care of the pressurized area, such as keeping it clean and dry, turning regularly, etc.
If the skin color of the pressure area becomes dark, deal with it as early as possible.
Actively treat systemic diseases and give the necessary supportive therapy, pay attention to diet and nutrition.