How to scientifically understand bedsores

Decubitus ulcers, also known as pressure ulcers, seat sores, and pressure ulcers, are soft tissue ulcers and necrosis caused by prolonged pressure on human local tissues, impaired blood circulation, and persistent local ischemia, hypoxia, and malnutrition. It tends to occur in areas with bony projections, such as the sacrococcygeal region, sciatic tuberosity, greater trochanter of the femur, root of the foot, scapula, and the back of the head. It is commonly seen in comatose and paralyzed (paraplegic, hemiplegic, etc.) patients, bedridden and debilitated patients, and patients who have been immobilized or bedridden for a long time after fracture. The National Pressure Ulcer Advisory Panel (NPUAP) has proposed the following classification for pressure ulcers: Stage I: skin is intact and reddened areas appear (no pallor occurs under pressure). Stage II: Skin damage is in the epidermis or dermis. The ulcers are superficial and clinically visible as epidermal damage, blisters, and shallow crater-like wounds. Stage III: The subcutaneous tissue is invaded, but not yet the fascial layer. Deep crater-like wounds are clinically visible and have eroded the surrounding adjacent tissues. Stage IV: The tissue is completely destroyed or necrotic to the muscular layer, bones and supporting structures (e.g., tendons, joint capsule, etc.). Localized infection, infection progresses deeper and can reach the bones; the necrotic tissue is blackened and purulent secretions increase with a foul odor. In severe cases, it can cause sepsis and septic sepsis, which can be life-threatening. The process of decubitus ulcer healing development is classified according to the color of the wound into red wounds: healthy red granulation tissue at the base of the wound, clean or healing wounds belong to this category; yellow wounds: shedding cells and dead bacteria at the base of the wound, generally yellow wounds also refer to infected wounds; black wounds: wounds with black necrotic tissue and black scabs, such as dry gangrene of the diabetic foot and necrotic scabs on the surface of deep decubitus ulcers; Pink wounds: with new epithelial tissue cover. Treatment: 1. Reduce local friction combined with shear forces; 2. Turn the patient every 2 hours; 3. Use immobilization devices to avoid continued pressure on the pressure sore site; 4. Keep the head of the bed elevated 30 degrees in the supine position and 30 degrees or less in the lateral position; 5. Use pressure-reducing tools, such as a low-pressure mattress or a suspended mattress/bed; 6. Perform a prolonged wheelchair-bound patient every 15 minutes position change; 7, hip decubitus ulcers should be limited to sedentary time or practical pressure-reducing cushions; 8, management of urination and defecation; 9, intake of adequate nutrition to promote wound healing; 10, choice of selecting non-cytotoxic disinfectants to clean wounds during dressing changes; 11, timely removal of traumatic necrotic tissue; 12, heavy infection requires bacterial culture and selection of appropriate antibiotics; 13, selection of traumatic negative pressure suction techniques, growth factors, and 14, conservative treatment is ineffective, the patient’s body allows, consider surgery; 15, many foreign institutions specializing in wound care product development and research also have a variety of products available, such as the foam dressing, ulcer paste, alginate dressing, silver dressing, a variety of gels produced by the company, Pfizer, Johnson & Johnson, etc., the clinical application of good results, the disadvantage The disadvantage is that the price is relatively high, and we hope that domestic enterprises will produce similar products with good quality and low price; Chinese medicine has many methods for treating bedsores, which have achieved good results through clinical practice, such as local use of comfrey oil, comfrey cream, rubberized muscle cream, rehabilitation new, dragon’s blood, Yunnan Baiyao, honey, sugar, etc. However, the key is scientific treatment of the wound in order to have the magic of icing on the cake. The beauty of the application is in the heart. As the saying goes, “There are no bad herbs, only doctors who do not know how to use medicine”.