Rizik і stages of development of bedsores, nіzh lіkuvati?
The development of bedsores on the basis of those who are ill in the wards of intensive therapy, in heroic conditions, as well as in the period of rehabilitation in the home, in children, in cases of spinal, folding, backbone injuries,
What are the bedsores?
- a whole pathological change in children, pediatric cells, mucous membranes, cysts, tissues of the body, which develop according to the type of neurotrophic breakdown, the cause of which is the breakdown of the innervations, blood circulation and lymphoma.
A short description of pathological changes on the table:
develop on the sides of the body, so that it lies flat to a hard surface;
characterized by a staged pathogenesis, repaired by stagnation of blood circulation, when there is a day, ending with neurotrophic vologic or dry type, sepsis or gas gangrene;
the best, with a stretch, dob, develop in young women with ailments, with congestive pests in case of heart-vascular insufficiency;
localized on vypiraut dilyanki tila, the most types of dilyanki training:
when a sick person is put on the back, the area is affected (kryzhiv and kuprika, sidnits, spinous ridges of the ridge, the area of the shoulder blades, p'yat);
when a sick person is put on his stomach, the area is affected (colony, combs of the club brush, vipira of the surface of the breasts);
when a sick person is put on the boat or sitting down, the area (sidnichnyh humps) will be affected;
Ridly localize on the folds and folds of milky vines.
Specific localization of bedsores on the school: under the dressings, in the mice of the lingual adherence to materials that are impenetrable for the vologue (glue parts of the pelyushka, gum tubes), folds of the post-bedside, bandages, іnshe.
Specific localization of bedsores on mucous membranes: with dentures, with trivial drainage of the stitch - on the urethra, with trivial catheterization of blood-bearing vessels - on the mucosa.
Decubitus rarely develop in individuals in a young age, being known in witness, without an anamnesis, covered with chronic illnesses. Call at such a category of patients, as bedsores develop, develop in steps, it is great to miss the pathology.
First signs of bedsores
Sub'єktivnі vіdchuttya, as ailments can be seen by persons, with the knowledge in witness and preserving the painful sensitivity of children:
pokryuvannya on shkіrі in mіtsyah ymіrnogo development of bedsores, tied with the stagnation of biological rіdins (shelter, lіmph) to liven up the nerves of the end;
the loss of sensitiveness (oniminnya), approximately in 2-3 years at the time of the day.
We see signs of a pressure sore on the cob, like goiters knitted by the nobility of the individual, who can see for the ailment:
congestion of peripheral blood and lymph, a spot in the vigorous venous cyanotic-worm-colored colora, without clear between, with localization in the microscopy of cysts, malignancies in the presence of an incidence of pain,
scolding the epidrmis of the shkiri with the previous statements of the gnarly pukhirts, for without them.
Tse marks the ear of a bedsore. It is necessary to have a term in order to live in and out of the pathology.
What robiti for usunennya of the first symptoms of a bedsore?
For a person it is necessary:
change the position of a sick skin for two years, as there is no proof, it is recommended to use special pillows for changing the position of the cushions and just on the surface of the lid, as well as to create the gaps in the post;
stitches behind the heads of the sick man, uzgoliv'ya maє buti lower abo time with him;
regulate the health of a sick person with hygienic methods (creamy cream, pink, rosechin, spray, you can warm baths (it is possible to pick up hot water), work out the procedure of two types of defenses, with the maximum amount of damage
I will see a vologue from shkiri and shkirny folds (water, surpluses of rіdkoї їzhі, I cut, early exudate, pit) for the addition of special adsorbing pads, servet diapers, rushniks, floats;
Regularly resupply anyway, or reduce the postal biznu not earlier than once in good time;
do not rob the intensive massage, it is allowed to lightly stroke the dishes of the shkiri with signs of stagnation, carry out the procedure carefully, without rubbing, especially on the dishes with close roasting of the cysts;
vikoristovuvati anti-decubitus mattresses of the balloon-type or porous type, equipped with special silent compressors for the adjustment and change of the hardness of sleep, with the regulated and programmed inflations of the small children.
vikoristovuvati, for the ailments in the іnvalіdnyh crystals, pillows filled with gel pinoyu, fortunately, the stitches for the change of the positioning of the body in the crystals did not grow at least once a year.
What are the unsafe bedsores?
Decubitus ulcers are known to pathologies, such as more beautifully unique. Even though it does not go into the depths of death, then with the establishment of the maceration of the shkiri, the pathogenesis develops even more quickly, with the establishment of the necrosis of the tissue and is characterized by the trivialities of the gnarly wound. Nezavisimye inheritance of bedsores. In some cases, bedsores are caused by:
great hanging of soft tissues and fixing defects in the damaged energy and blood circulation of the lower children,
amputation of lower cuts;
necrotic lesion of the skin and cyst tissue in viglyad, periostitis;
visnazhennya zhisnyh forces to the body, scho accelerating the treatment of the main ailment;
With the development of bedsores for the type of dry necrosis, a protracted pathogenesis develops with trivial periods of the defect.
The reason for the bedsores in the fields is in the offensive. Our tilo is permeated with small blood-bearing vessels. Behind the tsim sudinah - capillaries - the roof goes up to the small organs of the body. As soon as the blood-bearing vessels are passed over, the shelter ceases to come to the tissues, in which case the tissues are deadened.
As soon as the lyudin is perebuva in the unharmed camp, stretching out for two years, his blood-bearing judges are clutching and the shelter ceases to come to the surroundings of the dilyanki of fabrics. To that the bedsores are confirmed. Remember, it’s not safe to sit or lie uncomfortably.
Likewise, bedsores become wet, as a sick person often gets wet. At the same time, the blood-bearing vessels are cut off. The price is inconceivable for the human eye. Ale on the way to the razrivu blood-bearing vessels to fabrics ceases to come to shelter. Bedsores become pretentious.
Similarly, the bloodbathing judges can be torn, as the people cannot, for example, walk and step by step themselves, so that they can take the position.
Factor for the development of bedsores
It is also noted that bedsores develop in bedridden ailments in the development of the term. In dispensaries, for the systematization of the assessment of factors in the development of bedsores, the scale of Norton, Brad and Waterlow is used. Home minds have no stink. On the basis of the significant criteria, the factors are formed, the rizik are tied with the guesswork and the individual features of the sick person, which is a place for home storing.
1. Factories tied to the organisation's mistakes to look for the ailment:
neohayna lіzhko, changed mensh nіzh once for doba;
іdkіsna change of natural bіlizni on dry and clean;
znevaga with hygienic procedures (cleaning of the bed with special razches, drying, massage of dilyanok tila deceptively without additional traumatization of the bedsore);
firm, uneven surface of the bed.
2. Factories, tied with individual features I will become ill:
abduction of vіk;
visnazhennya abo navpaki ogryadn_st of a sick person;
falling ill of the heart-court system;
sickness of tying from damaged innervations (including insults);
the destruction of the interconnection due to the change of the exchange processes in the body (, the destruction of the water-salt exchange, or the destruction of the food);
unbalanced eating habits, or a disruption in the races of bile dystrophy, bile dystrophy (failure of bile exchange);
a sick camp (coma, bewilderment, іnshe) with any fault not to control defecation, sečovidіlennya.
In addition, before the officials, provoking the diagnosis of bed sores, admitting the sickness, the child's diabetes, the shortage of water and the little harboring, if, navpaki, even a small vaga, there is no criticism for the reaction of the almond, the brute Take a look at the shkіroyu, folds, seams, gudziki on the bіlizna, as well as injuries and injuries to the spinal cord and the brain, to see if.
Stages and stages of bedsores
The pathogenesis of bedsores is characterized by staged development. Seeing chotiri stages of pathogenesis.
Stage I bedsores
Visually, it starts with a venous erythema in the place where the shkiri is attached to the outside surface. Venous erythema is the result of a difficult blood flow from the local dilenca.
How does a venous condition arise from an arterial hypertension or a bruise?
Information from arterialgіperemії:
colir venous eritemi - red-cyanotic, colir arterial eritemi - yaskravo-chervonia;
The miscellaneous temperature of the venous erythema depends on the temperature of the shkiri or the lower, the miscellaneous temperature of the arterial hypersensitivity is the warm temperature of the shkiri in the set temperature.
Aspect of bruise:
red-cyanotic color of the shkiri in the finger does not change (bruise)
analogous color of the shkiri in the muscle of the blood (venous hyperemia).
Venous hyperemia (erythema) appear in cyst dylyanoks of people, lying on the side surfaces, without breaking the integrity of the shkiri - the most important sign of the decubitus of the first stage.
Stage II bedsores
Visually, the vitonation of epidermisu begins - the upper ball of the shkirny cover, with the further husked, approved pukhirts. The pathogenesis develops in such a rank: venous congestion provoking destruction of tissue vitality, innervation of dilyanka tila, excess of ridin in the skin, vicious swelling (maceration) and opening of the clitin epidermis.
The upper ear of the shkiri in the eyes of the stonewall and peeling of the epidermis, the deterioration of the integrity, the maceration (malnutrition) are the most important signs of another stage of the bedsore.
Stage III bedsores
Visually, it starts as a wound with suppurations (obstruction of microflora) or without suppuration.
Involvement in the pathogenesis of large spheres of tissue of the skin, pediatric cellulite, of the malignant type of inflammation and repair of the processes of necrosis (removal of tissue) is the most important sign of the third stage of pressure ulcer.
IV stage of bedsores
Visually, it appears as a local empty or defect, assertions as a result of a drop (necrosis), along the edges of the empty viconan with a defect on some of the triple burning.
Necrotized empty and widened for rakhunok burned stinks - the most important sign of the fourth stage of bedsore.
On young children, there may be different stages of bedsores.
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The suppuration of the decubitus ulcer is to be repaired from another stage, to develop in the third and fourth, due to the change of wounds, streptococci, and the most oppressive microorganisms of the deciduous.
Part of the way to the development of a decubitus ulcer is a beshih and phlegmon. In important cases, the bedsore turn into sepsis or gas gangrene.
1. Development of bed sores by the type of madness
strangle the wound microbially.
The revision of the wound, the cleansing of the edges of necrotic tissue, is visible in the minds of the surgical treatment. To drain the pus, tame the drainage tubes and regularly revise.
Passive draining can be carried out in the home minds:
For the whole wound, zapovnyayut with special servetki, leaked warehouses, and spry pus out. Periodically servetki wither. Yak servetki can be vikoristovuvati zvychaynі binti, the edge of which does not fall on strings. For leaked servet vikoristovuyt rozchini and ointment.
Old likarsky zasobi: hypertonic solutions 10% sodium chloride, 3-5% solutions of boric acid and іnshі. In the Danish hour, such differences were interconnected for reasons of little change from 4 to 8 years.
Hydrophobic ointments (lines, emulsions) based on vaseline (line for Vishnevsky, synthomycin emulsion, tetracycline, neomycin and others). There is a shortage in the fact that the stench doesn’t take in it, antibiotics in their warehouses do not work in full force.
Suchasnі lіkarskі zasobi: hydrophilic (hydrochloric ointments) - Levomekol, Levosin and інші water storage storages. The stench is kind to vivodat from wounds, approximately 20-24 years. Uwaga! Hydrophilic ointments vikoristovuvati only when there is pus in the early, in the іnshііy situation (gіy wіdday), the ointments are ineffective.
Enzyme therapy is an offensive method of surgical treatment of wounds (therapy with enzymes).
Proteolytic enzymes (trypsin, chymotrypsin, іnshі). For strengthening of їх dії vikoristovuyut additional values of any enzymes with ointments, for example, additional enzymes and ointments Iruksol.
Antiseptic solutions of the last resort. furacilin, water peroxide, boric acid Indicated for the storage of daily warehouses - 0.5% of iodopyrone, 1% of dioxidine.
Physical methods of treatment. Vikoristovuyu traditional methods (UHF, ultrasound cavitation, oxygenation, vibrophoning, laser therapy and other analogous methods)
II. Have a friend phase
In another phase, when the decubitus ulcers are cleared out with pus, healthy tissues appear. A healthy scab is a thin ball of dry granulation. A rotten scab is a tsetovsta scorinka, which is stored with dry pus. Oduzhannya under a gn_ynim scab is uncomfortable!
When healthy granulations appear, the following symptoms are indicated:
know the fiery appearances;
preservation of health of granulation (health of tissue) as a type of production;
stimulating processes of tissue renewal
For the nobility fired up vikoristovuyt:
ointments (hydrophilic ointments - methyluracil, troxevasin, hydrophilic ointments - bepanten and іnshі);
roslinny preparations - sic, oil (,);
laser therapy with therapeutic effects stimulation of tissue etiology
III. Do the third phase
In the third phase, the regeneration and scarring of the wound process is promoted. Vikoristovuyt uchasnі drugs stimulate the treatment and scar tissue, for example: EDAS-201m, vitamins, immunostimulants. At all phases of the pathogenesis, it is allowed to pick up antibacterial diseases, it is recommended to internally introduce drops of Metrogil, antibiotics.
Defects and traces of bedsores have been recognized in the minds of the stationary.
Statute author: Ph.D. Volkov Dmitro Sergiyovich, lykar-khirurg
