Definition
Also called decubitus ulcers or compression sores, bedsores are difficult to heal skin lesions: these are wounds involving both the superficial layers of the skin (epidermis, dermis), and the musculature and bones (in extreme cases).
Causes
Pressure sores are the consequence of the subject's forced immobility, caused, in turn, by plastering, severe obesity, risky pregnancy (which forces the woman to remain in bed), bone breakage.
- When a patient is forced to remain immobile, the blood vessels undergo compression. The consequent pressure increase could degenerate in the obstruction of the vessels, in the coagulation and in the tissue necrosis.
Symptoms
Bedsores can cause abrasions in the epidermis and dermis, localized erythema, skin thickening, lesions, and skin discoloration; in the advanced stages, pressure sores can cause a real necrosis of the subcutaneous tissue, up to affect even the bones, muscles, tendons and underlying cartilage.
- Complications: anemia, bone decalcification, dehydration, electrolyte imbalance.
Natural Care
Information on bedsores - Medicines for the treatment of bedsores is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Decubitus Sores - Decubitus Treatment Medications.
drugs
Pressure sores are incapacitating, annoying and very painful wounds, especially when the deeper layers of the skin are also involved; however, these injuries can be prevented with the help of family members or competent health personnel, attentive to the patient's needs:
- Change the patient's position often → circulation stimulation
- Careful and scrupulous body hygiene → to avoid bacterial infections
- Following a healthy and balanced diet → a diet rich in liquids, proteins, vitamin C, zinc and other minerals promotes wound healing
- Make use of pillows, adequate mattresses, bandages and sterile gauzes, dressings
- Pay attention to any pre-existing pathologies (eg liver, kidney, gastric disorders, etc.) → always remember to take specific medicines to treat these diseases
Remember that pressure sores cannot regress spontaneously: therapeutic aids are in fact indispensable for wound healing and to reduce the risk of complications.
The damage caused by pressure sores is proportional to the period of forced immobility: the lack of care and neglect of the patient can also lead to the death of the same. The care of patients suffering from bedsores is essential.
Therapeutic aids for pain control : pressure sores are painful and extremely annoying, therefore a pharmacological treatment based on NSAIDs and locally applied analgesics can be an excellent aid to give relief to the patient
- Ibuprofen (eg. Brufen, Moment, Subitene): take on the palate 200 to 400 mg of active ingredient (tablets, effervescent sachets) every 4-6 hours, as needed. In some cases, the analgesic can also be taken intravenously at a dose of 400-800 mg every 6 hours, as needed.
- Naproxen (eg. Aleve, Naprosyn, Prexan, Naprius): indicatively, to reduce the pain associated with bedsores, take 250-500 mg of naproxen or 275-550 mg of naproxen sodium orally, twice a day. For the maintenance dose, it is possible to increase the dosage up to 1500 mg of naproxen or 1650 mg of naproxen sodium, fractionated in two doses, for a period of six months.
- Lidocaine (eg Xylocaina, Lidofast, Luan CHIR): it is a local application anesthetic, widely used in therapy to reduce the pain associated with bedsores. It is often formulated together with steroids such as hydrocostisone (eg Proctosedyl), useful for enhancing the anti-inflammatory effect. Lidocaine is often also associated with prilocaine (eg Emla).
Antibiotics and disinfectants : to be used exclusively in case of proven bacterial infection in the context of bedsores: wet or not thoroughly cleaned wounds can in fact become an excellent breeding ground for bacteria, which can create even more damage.
The choice of the most suitable antibiotic depends on the pathogen involved in the infection.
- Nano silver crystals (eg Katoxyn Spray): disinfectant substance (antiseptic). The administration of these active ingredients is indicated to disadvantage the formation of necrotic bodies and fibrin, in addition to creating a balance of bacterial load, thus reducing the frequency of wound dressing (decubitus sores, diaper rash, burns, skin maceration etc.). ).
- Becaplermin (eg. Regranex gel): indicated for the treatment of ulcers in the area of pressure sores; it is a recombinant platelet growth factor, used also and above all for the treatment of diabetic ulcers. The drug is not allowed in Italy.
- Cadexomer iodine (eg lodosorb): healing substance indicated to speed up wound healing in the context of bedsores. The bactericidal power of the drug is enhanced by the presence of iodine. The treatment with this drug is indicated to avoid the chronicity of the sore and to reactivate the repair mechanisms of tissues damaged by bedsores.
Muscle relaxants : they inhibit muscle spasms and promote the healing of pressure sores, which can be accentuated by involuntary muscle contractions.
- Diazepam ex. (Micropam, Ansiolin, Diazepam FN, Valium, Diazepam, Valpinax): indicatively, take 2-10 mg of drug 3-4 times a day orally; alternatively, administer the active ingredient intravenously or intramuscularly at a dose of 5-10 mg in 3-4 hours, as needed. This dosage is indicated to reduce muscle spasms in the context of pressure sores.
- Dantrolene (eg. Dantrium): start therapy to combat spasms with a dose of 25 mg, to be taken once a day for 7 days; continue taking the same dose 3 times a day for 7 days. The third week, continue therapy with 50 mg, to be taken 3 times a day for another 7 days. During the fourth week it is possible to increase the dose up to 100 mg, three times a day. Consult your doctor: dantrolene is not used as a first-line drug to reduce muscle spasms in the context of pressure sores.
- Tizanidine (eg. Sirdalud, Navizan): indicatively, take 4 mg orally, once a day. If necessary, repeat the administration every 6-8 hours, up to a maximum of three doses in 24 hours. It is possible to increase the dose by 1-2 mg every 4-7 days, until the desired therapeutic response is obtained. Do not exceed 36 mg per day and 12 mg per single dose. Always consult your doctor before taking this medication.
- Baclofen (eg. Baclofen MYL, Lioresal): start taking the drug orally at a dose of 5 mg, three times a day for 3 days. Continue with 10 mg, 3 times a day for another 3 days; increase the dosage by 5 mg for another two weeks. The maintenance dose is expected to take 40-80 mg of the drug a day. The active ingredient can also be taken intrathecally.
Natural remedies to treat pressure sores : in some patients, pressure sores are not a real concern, because they are shallow and easy to heal. In this case, it is possible to resort to natural therapy by applying ointments, creams, oils, sprays or powders to the skin to speed up the healing of wounds, nourish the skin and ignite the injured part. Here are some examples:
- Corn starch and zinc oxide: their astringent, soothing and anti-itching properties are indicated to treat bedsores, especially those that suppurate.
- Hypericum oil ( Hypericum perforatum ): first line natural drug for the treatment of mild pressure sores. The phytocomplex consists mainly of hyperforin (natural antibiotic) and hypericin (very useful for inflammation). The hypericum finds indication as wound healing. It is recommended to cover with a sterile gauze or a bandage the part treated with the hypericum oleolite: in fact, the drug could create photosensitization of the skin.
- Aloe vera (aloe vera gel): for the treatment of bedsores, the topical application of products formulated with aloe vera is indicated due to its re-epithelizing, anti-inflammatory and refreshing properties, useful to give a pleasant feeling of relief immediately after the application on the sore.
For further information: see the article on natural remedies for bedsores
It is recommended to keep the wound clean, to change bandages several times a day and to thoroughly dry the wound after cleaning and disinfecting it. Each time a bandage is changed, the wound must be cleaned with a physiological solution (for open wounds) or with water and neutral soap (for non-deep wounds).
