What helps against decubitus?
This pressure sore is often connected to the term “bed sore” as it often occurs with sick people or people in need of care who spend a lot of time in a lying position. It is assumed, that on average every second or third person in need of care is affected by decubitus.
Pressure reduction in case of decubitus.
In order to avoid decubitus, one should relieve the affected skin area of any pressure as it is lasting pressure that causes decubitus. People predominantly lying in bed should change their position in frequent intervals. How often a person affected should change position varies from person to person. Therefore the affected person should be closely observed in the decubitus care, so that the necessary period for the change of position can be diagnosed. The mobilization should generally be actively conducted by the patient. Only when the person concerned is no longer able to do so, a passive rearrangement must occur. Micro stimulation systems can be utilized to facilitate self-movement. They are also known as movement beds. As the name suggests, the system triggers movements through which decubitus may be avoided. Simple tools would be rolled up blankets or certain pillows, only that the position change might have to be observed or even carried out by a third party. One can furthermore increase the supporting surface.
Wound treatment in case of decubitus
The most important step of the treatment of decubitus is pressure relief as decubitus may occur again and again. Additionally, the wound has to be supplied. For an appropriate wound treatment, it must first be examined in detail. The wounds are harshly different depending on the severity and may thus require a different treatment depending on the extent of the injury. Important in every case is the application of a moist wound treatment. Decubitus often leads to the formation of so called necrosis, which becomes visible by a blackening of the wound. They boost the risk of infection and must therefore be removed. Necrosis larger in size is being removed surgically. Smaller shaped necrosis may be treated with enzymatic, bio surgical and other procedures. The infection risk is, in case of decubitus, generally very high. A sufficient supply of oxygen is thus imperative for prevention purposes. If the wound is already affected by an infection, it should be disinfected with a 0,9% NaCI solution. Like any healing process, the healing process of decubitus also takes place in the three stages of cleansing phase, granulation phase and epithelialization phase. The wound treatment varies depending on the stage. One should ensure a moist wound environment if necrosis have already been formed. A cover band with hydrogels is suitable for this purpose.
- The tissue is newly formed during the granulation phase. During the granulation, one should utilize hydro-colloid wound dressings, bandages with calcium alginate or collagen sponges. The wound has to be additionally protected from drying up.
- This protection has to occur during the epithelialization as well, so that hydro-colloid wound dressings, procedure dressings with hydro gels are especially recommended.
The wound has to be meticulously observed not only before, but also after the wound treatment. Since decubitus and a possible incorrect treatment can have serious consequences, it is advisable to consult a doctor. The best possible result can only be reached by co-operation between medical staff, the afflicted person and nurses.