Bedsore (decubital gangrene) is a serious complication that can occur in patients who remain in bed for a long time or have nervous system disorders. Bedsores develop due to prolonged, continuous pressure on tissue that lies over bony protrusions. They most often appear on the occipital region, the area of the shoulder blades, the sacrum, the ischia, the greater trochanters of the femurs and other places that are subject to constant pressure.
The causes of bedsores can be different. Intrinsic factors that contribute to the development of pressure ulcers include loss of pain and pressure perception, atrophy due to immobility, malnutrition, anemia and infection. External factors such as pressure, moisture due to sweating, urinary or fecal incontinence can also predispose to the formation of bedsores.
Symptoms of pressure ulcers depend on the stage of development. At the first stage, there is redness of the skin, which turns pale or disappears when pressed. The second stage is characterized by hyperemia, swelling and thickening of the skin; Sometimes epidermal blisters form, followed by desquamation of the epidermis. In the 3rd stage, necrosis begins and exudation increases. In stage 4, necrosis reaches muscle tissue. Progression of the depth of necrosis can lead to bone destruction, the development of osteomyelitis, and septic arthritis.
Treating pressure ulcers can be difficult and demanding. The first step is to remove pressure on sensitive areas. If there are no special anti-decubitus mattresses, the patient’s position in bed should be changed every 2 hours, a light massage of dangerous areas should be performed and the skin should be kept dry. Frequent changes of bed linen and the absence of rough seams and folds are also the prevention of bedsores. If the development of a pressure ulcer has not progressed beyond stage 3, spontaneous healing is possible, provided that the affected area is small and the pressure is removed.
Conservative treatment of bedsores includes dressings with treatment of the skin around the bedsore with potassium permanganate or brilliant green, antiseptic hydrophilic ointments or gels for bedsores, combating purulent infection, and stimulating reparative processes. For more severe cases, surgical intervention such as tongue decongestion of the pressure ulcer or skin grafting may be required.
In addition, it is important to prevent the occurrence of pressure ulcers in people who are at risk. This may include regular check-ups, monitoring diet and skin care, the use of special anti-bedsore mattresses and pillows, and regular changes in body position and exercise to improve blood circulation and muscle tone.
At the first sign of a bedsore, you should seek medical help to prevent the development of serious complications and speed up the healing process.