Pressure ulcer, is also called ‘bedsore’, is tissue damage and necrosis caused by long-term compression of local tissues, blood circulation disorders, sustained ischemia, hypoxia and malnutrition. Bedsore itself is not a primary disease, it is mostly a complication caused by other primary diseases that have not been well cared for. Once pressure ulcer occurs, it will not only increase the patient’s pain and prolong the rehabilitation time, but also cause sepsis secondary to infection in serious cases, and even endanger life. Pressure ulcer often occurs in the bone process of long-term bedridden patients, such as sacrococcygeal, vertebral body carina, occipital tuberosity, scapula, hip, internal and external malleolus, heel, etc. Common skillful nursing methods are as follows.
The key to the prevention of pressure ulcer is to eliminate its causes. Therefore, it is required to observe, turn over, scrub, massage, clean and replace frequently, and supplement sufficient nutrition.
1. Keep the bed unit clean and tidy to avoid moisture irritating the patient’s clothes, beds and beds. The bed sheets should be clean, dry and free of debris; Change the contaminated clothes in time: do not let the patient lie down directly on the rubber sheet or plastic cloth; Children should change their diapers frequently. For patients with urinary incontinence, special attention should be paid to the protection of the skin and the drying of the bed sheets to minimize local skin irritation. Do not use porcelain urinals to prevent abrasion or skin abrasion. Regularly wipe yourself with warm water or massage locally with hot water. After defecation, wash and dry them in time. You can apply oil or use prickly heat powder to absorb moisture and reduce friction. You should be careful in summer.
2. To avoid long-term compression of local tissues, the bedridden patients should be encouraged and assisted to change their body positions frequently. Generally, they should be turned over once every 2 hours, no more than 4 hours at most. If necessary, they should turn over once every hour. Avoid dragging, pulling, pushing, etc. when helping to turn over to prevent skin abrasion. In the parts prone to pressure, the protruding parts of bones can be padded with water pads, air rings, sponge pads or soft pillows. For patients who use plaster bandages, splints and traction, the pad should be flat and moderately soft.
3. Promote local blood circulation. For patients prone to bedsore, often check the condition of compressed skin, and use warm water to wipe the bath and local massage or infrared radiation. If the skin at the pressure part turns red, dip a little 50% ethanol or lubricant into the palm after turning over, and then pour a little into the palm. Use the thenar muscles of the palm to cling to the pressure skin for cardiotropism to massage. The strength changes from light to heavy, from heavy to light, for 10 ~ 15 minutes each time. You can also massage with an electric massager. For those who are allergic to alcohol, apply it with a hot towel and massage with lubricant.
4. Increase nutrition intake. Eat foods that are high in protein, vitamins, easy to digest and rich in zinc, and eat more vegetables and fruits to enhance the body’s resistance and tissue repair ability. Those who cannot eat can use nasal feeding or parenteral nutrition.
5. Apply 0.5% iodine tincture locally. After the patient is admitted to the hospital, for the parts prone to pressure ulcer, such as the arm, iliac part, sacrococcygeal part, auricle, occipital tubercle, scapula and heel, dip 0.5% iodine tincture with a sterile cotton swab after turning over each time, and smear the protruding parts of the pressure bone from the center outward. After drying, apply it again.