I – Introduction:
A- Definition of bedsores:
Pressure sores are skin lesions that form when prolonged pressure on any part of the body restricts blood flow and deprives the skin of oxygen and essential nutrients. They usually occur in people who are bedridden, in a wheelchair, or immobile for long periods of time. Pressure sores start out as reddening of the skin which can develop into an open sore if not treated quickly. The areas most affected are those in contact with a hard surface, such as the heels, buttocks, elbows and shoulder blades. Pressure sores are a serious health problem that can cause pain, infection, and even death if not treated properly. It is therefore essential to understand the cause and prevention of these skin lesions,
B- Importance of the prevention and treatment of bedsores:
The prevention and treatment of pressure ulcers is essential to maintain the health and well-being of people who are bedridden, in wheelchairs or who have reduced mobility. Pressure sores can cause pain, infection and even serious complications like sepsis or tissue necrosis. The treatment of bedsores can be long and painful, and complete healing is not always possible. Therefore, it is crucial to take preventative measures to prevent pressure sores from developing in the first place. This includes careful attention to body position, regular change of position, proper skin care, use of special mattresses and cushions, and appropriate exercises and physical activities. In the case of a pressure sore already formed, Prompt and appropriate treatment is necessary to prevent further aggravation of the wound and to promote healing. The prevention and treatment of pressure ulcers are therefore key elements in maintaining the health and comfort of people with this condition.
C- Objective of the article:
The aim of this article is to provide comprehensive information on pressure sores, also known as pressure ulcers. It aims to make readers aware of the various risk factors for this condition, such as prolonged pressure on the skin, friction and shearing, lack of blood circulation and oxygen, and other factors. The article also presents the main symptoms and signs of a pressure sore, as well as prevention and treatment methods, including frequent position changes, the use of special mattresses and cushions, skin care, adapted exercises and physical activities, the use of specific dressings, medication and complementary treatments, surgery and others. Finally,
II- The causes of bedsores:
A- Prolonged pressure on the skin:
Prolonged pressure on the skin is one of the main causes of pressure sores. This pressure reduces blood flow and deprives the skin of oxygen and essential nutrients, leading to tissue and skin damage. The areas of the body most likely to experience prolonged pressure are those in contact with a hard surface, such as the heels, buttocks, elbows and shoulder blades. People who are bedridden, in a wheelchair or who have reduced mobility are particularly vulnerable to pressure sores due to the constant pressure exerted on these areas. Pressure sores can be prevented by taking steps to reduce pressure on the skin, such as changing position regularly, using special mattresses and cushions to distribute pressure evenly, and avoid hard surfaces. By understanding the importance of reducing prolonged pressure on the skin, it is possible to effectively prevent pressure sores and maintain the health and comfort of those at risk.
B- Friction and shear:
Friction and shear are risk factors for the development of pressure ulcers. Friction occurs when the skin rubs against a hard surface, such as a sheet or mattress, creating an abrasion that can damage the surface layers of the skin. Shearing occurs when layers of skin slide past each other, which can cause damage to underlying tissue. People who are in wheelchairs or who have reduced mobility are particularly vulnerable to friction and shear due to their body movements. Pressure sores can be prevented by reducing friction and shear. This can be done by avoiding rough sheets or blankets, using special cushions and mattresses to reduce friction, positioning the cushions correctly and avoiding sudden movements. By understanding the importance of reducing friction and shear, pressure ulcers can be effectively prevented and the health and comfort of those at risk can be maintained.
C- Lack of blood circulation and oxygen:
Lack of blood circulation and oxygen is another important cause of pressure sores. When the skin is under prolonged pressure, blood vessels can be compressed, reducing the supply of oxygen and nutrients needed to nourish skin cells. Without an adequate supply of oxygen and nutrients, skin cells can die, leading to tissue damage and the formation of scabs. People with chronic conditions, such as diabetes, obesity, or circulatory problems, may be particularly vulnerable to lack of blood flow and oxygen. To prevent pressure sores, it is important to adopt measures to stimulate blood circulation, such as regular exercise, gently massage the skin and maintain a balanced diet. By understanding the importance of blood circulation and oxygen to healthy skin, pressure sores can be effectively prevented and those at risk can be kept healthy and comfortable.
D- Other risk factors:
Besides prolonged pressure, friction, shear, lack of blood circulation and oxygen, there are other risk factors for pressure sores. People with a chronic condition, such as diabetes, arthritis, or circulatory problems, may be more susceptible to developing pressure sores due to decreased pain sensation and ability to change position. People who have poor hygiene, are undernourished or have low immunity are also more likely to develop pressure sores due to the fragility of their skin. Older people are also more likely to develop pressure sores due to loss of skin elasticity and decreased blood circulation. By understanding the risk factors, steps can be taken to prevent pressure sores. These measures may include good hygiene, a balanced diet, regular exercise, regular skin monitoring, and the use of appropriate support devices.
III- Symptoms of bedsores:
A- Redness of the skin:
Redness of the skin is an important early sign of the onset of a pressure sore. The redness is usually localized to the area of the skin subjected to prolonged pressure. This redness is usually caused by blood rushing to the area as the body tries to compensate for the pressure on the skin. If the pressure persists, the redness may intensify and darken, indicating deeper tissue damage. It is essential to identify the redness of the skin quickly and to act immediately to prevent the formation of a pressure sore. Preventive measures may include regular change of position, use of supportive pillows or mattresses, adequate nutrition and good skin hygiene. By understanding the importance of monitoring skin redness,
B- Pain or sensitivity:
Pain or tenderness in a specific area of skin can also indicate a developing pressure sore. This pain or tenderness is usually caused by damage to the tissues and nerves in the skin due to prolonged pressure. Pain can feel like a burning, tingling or itching sensation, while tenderness can make the skin sensitive to touch or pressure. It is important to note that some people with neurological disorders may not experience pain or tenderness, which makes visual skin monitoring even more important. If you notice pain or tenderness in any area of your skin, it is essential to change your position regularly, maintain good hygiene and consult a healthcare professional for further evaluation. By being alert to signs of pain and tenderness, pressure sores can be prevented and promote rapid and effective healing.
C- Changes in skin texture:
Changes in skin texture are another early warning sign for pressure ulcer formation. When the skin is under prolonged pressure, it may become harder, rougher, or stickier. These texture changes are caused by damage to skin tissue and cells that affect the skin’s ability to regulate temperature, moisture, and blood circulation. It’s important to monitor your skin texture regularly, especially in high-risk areas, such as your heels, elbows, and buttocks. If you notice changes in skin texture, it is essential to regularly change position and take measures to relieve pressure on the skin, such as the use of cushions or support mattresses.
D- Formation of ulcers:
The formation of bedsores can lead to skin ulcers, which can have serious health consequences. Ulcers are open sores that form on the skin when tissue is damaged and blood flow is compromised. Skin ulcers are often difficult to treat and can take time to heal. If the prolonged pressure on the skin is not treated, the ulcers can worsen and become infected, which can lead to hospitalization and even serious complications. People who are at risk for pressure sores, especially those who are confined to bed or in wheelchairs, should take steps to prevent their formation. Regular changes of position, proper personal hygiene and the use of support devices can help reduce the risk of prolonged pressure on the skin. If you notice any signs of ulcers forming, such as redness, pain, or changes in skin texture, it’s important to see a healthcare professional for immediate treatment.
IV- Prevention of bedsores:
A- Frequent change of position:
Frequent change of position is one of the most effective strategies for preventing the formation of pressure ulcers. Prolonged pressure on the skin is one of the main risk factors for pressure sores, and simply changing your position regularly can help reduce pressure on high-risk areas, such as heels, elbows and thighs. buttocks. For people who are confined to bed or in a wheelchair, it is important to change positions at least every two hours to avoid prolonged pressure on the skin. Caregivers can help by using cushions and support mattresses to help reduce pressure on high-risk areas. In addition, it is important to keep the skin clean and dry, provide adequate nutrition to promote tissue healing, and encourage exercise and physical activity to improve blood circulation. By implementing regular position changes and other preventative measures, those at risk can reduce their risk of pressure ulcers and improve their quality of life.
B- Use of special mattresses and cushions:
The use of special mattresses and cushions is a common strategy to prevent the formation of pressure ulcers. These devices are designed to reduce prolonged pressure on the skin by distributing body weight evenly. There are several types of mattresses and support pillows available, each with their advantages and limitations. High-density foam mattresses, air mattresses, and waterbeds are all popular options for people who are confined to bed. Wheelchair support cushions are also commonly used to help reduce pressure on the buttocks and hips. It is important to consult with a medical professional to determine which type of mattress or pillow is best for your individual needs. In addition to the use of support devices, it is important to maintain good personal hygiene and change positions frequently to avoid prolonged pressure on the skin. With a combination of preventative measures, you can significantly reduce your risk of developing pressure sores.
C- Skin care:
Skin care is essential to prevent pressure sores in those at risk. Healthy, hydrated skin is less likely to crack and break, reducing the risk of pressure sores. It is important to regularly cleanse the skin with a mild cleanser and lukewarm water. Avoid using hot water as it can dry out the skin. Areas at risk should be inspected regularly for any redness, swelling or sores. If you notice any redness or irritation, apply a skin barrier cream or moisturizer to help reduce friction and pressure on the skin. Areas where the skin is folded or rubbed, such as the armpits and groin, require special attention to avoid maceration and skin irritation. Finally,
D- Exercises and adapted physical activities:
Exercises and appropriate physical activities can play an important role in preventing pressure ulcers in people at risk. Regular physical activity can help improve blood circulation and maintain muscle strength and flexibility. This can help reduce pressure on risk areas and prevent pressure sores from forming. However, it is important to choose the exercises and activities that are appropriate for each individual, taking into account their state of health, mobility and physical abilities. Light exercise, such as walking, stretching, or gentle exercise, can help improve blood circulation and prevent muscle stiffness. More intense physical activities, such as weight training or contact sports, may be contraindicated in certain at-risk individuals. It is important to consult a healthcare professional before beginning any exercise program to prevent pressure sores.
V- Treatment of bedsores:
A- Cleaning the wound:
Cleaning the wound is an essential step in the treatment of pressure sores. An infected wound can cause serious complications and prolong healing time. To clean a pressure sore wound, it is important to follow the recommendations of the healthcare professional supervising the treatment. Cleaning techniques vary depending on the severity of the wound. However, it is common to use antiseptic solutions to clean the wound and prevent the growth of bacteria. Using sterile saline water can help clean soft tissue without damaging surrounding healthy tissue. When the wound is clean, a dressing should be applied to protect the wound from bacteria and excessive rubbing. It is important to carefully monitor the wound and follow the healthcare professional’s recommendations for aftercare. Cleaning the wound can be painful, so painkillers may be prescribed to relieve pain during the healing process.
B- Use of specific dressings:
The use of specific dressings is a common method for treating pressure sores. Specific dressings for pressure ulcers are designed to protect the wound from friction, infection and to promote healing. There are a variety of dressings, including hydrocolloid dressings, foam dressings, and silicone dressings. Hydrocolloid dressings are particularly popular for pressure ulcers because they are designed to absorb wound exudate and create a moist environment conducive to healing. Foam dressings provide extra padding to protect the wound from friction and excessive pressure. Silicone dressings are designed to reduce friction and to minimize scarring. The choice of dressing depends on the severity of the pressure ulcer and the recommendations of the healthcare professional. It is important to follow the manufacturer’s instructions and change the dressing regularly to ensure optimal healing of the wound.
C- Medicines and complementary treatments:
In addition to wound care, position changes, and the use of special mattresses and cushions, there are also complementary medications and treatments that can help treat pressure sores. Pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid painkillers, can help relieve pain associated with pressure sores. Antibiotics may be prescribed to prevent or treat wound infections. Nutritional supplements, such as proteins, vitamins and minerals, can help promote healing by providing the nutrients necessary for tissue repair. Complementary treatments, such as acupuncture, negative pressure therapy, and honey therapy, can also be used to help treat pressure sores. It is important to consult a healthcare professional before taking any medications or using complementary treatments for pressure sores. Proper and regular treatment can help prevent complications and promote healing of pressure sores.
D- Surgery:
In some cases, surgery may be recommended to treat pressure sores. Surgery may be needed if the ulcer is deep and fails to heal despite proper wound care, or if a serious infection has developed. Surgical options include wound closure with sutures, skin grafts, and tissue flaps. In the most serious cases, an amputation may be necessary. Surgery for pressure sores is often considered a last resort, as it can be invasive and risky. It is important to discuss treatment options with a qualified healthcare professional to determine if surgery is an appropriate option for your specific case. In general, prevention is the best approach to avoiding pressure sores,
VI- Conclusion:
A- Summary of the main points:
Pressure sores are potentially serious skin damage caused by prolonged pressure, friction and shearing, lack of blood flow and oxygen, and other risk factors. Early signs of pressure sores include redness of the skin, increased pain or tenderness, changes in skin texture, and feeling hot. To prevent and treat pressure sores, it is important to change positions frequently, use special mattresses and cushions, take care of the skin, do appropriate exercises and physical activities, clean the wound and use specific dressings. In the most severe cases, surgery may be necessary. By taking preventive measures and treating pressure sores quickly,
B- Reminder of the importance of the prevention and treatment of bedsores:
In summary, the prevention and treatment of pressure ulcers are essential to avoid complications and improve the quality of life of patients. It is important to remember that pressure sores can occur in anyone who has been immobilized for a long time, especially in the elderly, people with neurological disorders or chronic diseases. In addition to frequent position changes and the use of special mattresses and cushions, regular skin care, appropriate physical activity and good nutrition can help prevent pressure sores. If a pressure sore develops, immediate treatment is crucial to prevent the wound from getting worse and leading to more serious complications. Treatment options may include wound care, specific dressings, medication, surgery and other complementary treatments. In short, the prevention and treatment of pressure ulcers must be a priority to ensure good health and optimal well-being of patients.
C- Call to action for people at risk of or suffering from pressure ulcers:
If you are at risk of developing pressure sores or already have them, it is essential to take steps to prevent these skin lesions from forming or getting worse. Pressure sores can lead to serious complications, including infections and muscle damage. It is important to follow the advice of your healthcare professional and implement preventive measures, such as changing your position regularly, using special mattresses and cushions, and maintaining good foot hygiene. the skin. By taking care of your skin and being alert to signs of prolonged pressure, you can significantly reduce your risk of developing pressure sores and improve your quality of life.
