Stages and nursing measures for pressure sores

Clinically, patients who lie in bed for a long time and are unable to move often suffer from a disease called pressure sores. As the name suggests, pressure sores refer to long-term local compression caused by the patient lying in bed for a long time, which makes the blood circulation in the part poor, causing ischemia and hypoxia. We usually call it bedsores. Patients with pressure ulcers need good care, including turning them over frequently, cleaning them frequently, and massaging them more often to keep the local blood flowing.

Pressure sores are divided into four stages: congestion and redness stage, inflammatory infiltration stage, shallow ulcer stage, and necrotic ulcer stage.

The first stage (congestion and redness stage) is the early stage of pressure sores. After the local soft tissue is compressed, redness, swelling, heat, numbness or tenderness appears. This stage is a reversible change, and active measures should be taken to prevent the local area from continuing to be under pressure, avoid stimulation such as friction and moisture, keep the area dry, and increase the number of turning over.

In the second stage (inflammatory infiltration stage), if the red and swollen area continues to be under pressure, the local blood circulation will not be improved in time, and the local redness and swelling will infiltrate outward and harden. The surface of the compressed skin will turn purple-red, small blisters will form, and they will easily rupture. Nursing principles: prevent blisters from rupturing, protect the wound surface, and prevent infection. For small unbroken blisters, reduce friction to prevent rupture and promote self-absorption of the blisters. For large blisters, use a sterile syringe to extract the liquid in the blister, disinfect the local skin, and then bandage with sterile dressings. The focus of care is to protect the skin and avoid infection.

In the third stage (shallow ulcer stage), the blisters continue to expand, the epidermis breaks down, and the wound surface is exposed with yellow exudate. After infection, the wound surface is covered with purulent secretions, causing necrosis of the superficial tissue and aggravated pain. Treatment principles: Clean the wound, remove necrotic tissue and promote the growth of granulation tissue, and change the dressing frequently.

In the fourth stage (necrosis and ulcer stage), the necrotic tissue invades the subcutaneous layer and muscle layer. In severe cases, it can extend to the deep and surrounding tissues. The purulent secretions increase and have a foul odor, and the necrotic tissue appears black. If the infection is not controlled in time, it may cause sepsis and endanger the patient's life. Treatment principles: Use Puxutang Regenerating Ointment in time to avoid further deterioration. The use of Chinese herbal medicine is currently the most effective method. If there is infection, treat it according to surgical dressing. Many hospitals use local continuous oxygen blowing after air isolation. If you have an oxygen cylinder at home, you can use this method. Put the oxygen tube towards the sore surface.

The key to preventing pressure sores is to eliminate the inducing factors. Nurses should be diligent in their work: observe frequently, turn over frequently, massage frequently, scrub frequently, tidy up frequently, and change frequently.

Key points of care during the congestion and redness period: During this period, the cause of the disease should be removed in time and various preventive measures should be adopted to stop the development of pressure sores. When massaging the area, use the tip of your thumb to make circular movements, massaging from the area near the pressure sore outwards. Infrared irradiation can also be used.

Key points of care during the inflammatory infiltration period: During this period, the skin should be protected to avoid infection. In addition to strengthening decompression measures, infrared irradiation can be used locally. For small blisters that have not broken, you can use a thick layer of talcum powder to bandage them to reduce friction, prevent rupture and infection, and allow them to absorb on their own. For large blisters, extract the fluid from the blister with a sterile syringe, apply disinfectant, and then bandage with sterile dressings.

Key points of care during the ulcer period: In addition to systemic and local measures, the wound should be treated according to surgical dressing methods based on the condition of the wound. When the wound is infected, the principle of local treatment is to relieve pressure, clean the wound, remove dead tissue and promote new tissue, so as to promote healing. During this period, infrared irradiation can also be used to dry the wound surface, which is conducive to tissue repair.