The best way to prevent bedsores is by moving around frequently to avoid constant pressure against your body and to redistribute your body weight and promote blood flow to the tissues. If you can't move, you should be helped to reposition at least every 2 hours if in a bed or every 15 minutes if you are seated in a chair. Pillows or foam wedges can help shift your weight if you're unable to move. Range-of-motion exercises can help prevent contractures; improve circulation; and maintain joint integrity, mobility, and muscle mass.
Your bed should not be elevated more than 30 degrees (except when you're eating) to reduce shearing forces. For the same reason, a pull-sheet should be used to help repositioning in bed.
A convoluted "egg-crate" foam pad is an inexpensive and lightweight solution for some people. This high-density, solid, 5 cm to 10 cm foam pad is less likely to be compressed by your body weight and may help redistribute body weight effectively. Unfortunately, these pads provide only minimal pressure relief and may cause retention of body heat, thereby increasing perspiration. They're useful if your activity is limited to a short time. Alternating pressure mattresses and water mattresses may also help.
Although sheepskin is not thick or dense enough to reduce pressure, some people find it useful if they are predisposed to skin breakdown from friction. For example, a sheepskin at the foot of your bed may decrease friction against your heels if you have vascular disease.
Splints can also be used and should be placed at pressure points. In addition, special anatomically shaped cushions help to distribute your weight more evenly and keep pressure from building in one spot. Heels and elbows may require specially designed pads. Some medical supply stores carry bed cradles that raise the weight of covers off your body and create a tent-like structure.
Your skin should be inspected and cleaned regularly. Keeping it dry and clean helps prevent infection and potential sores from developing. Affected skin should be gently washed with plain water or a small amount of mild soap and water, applying minimal force and friction. Soap removes the skin's natural protective oils, and the cleaning action may irritate already damaged tissues. Next, a thin layer of moisturizing lotion should be applied, massaging gently around, rather than over, the reddened area or bony prominence. Vigorous massage may increase tissue damage by creating shearing forces. After moisturizing the area, a thin layer of a petroleum-based product should be applied. These water-resistant products provide a protective barrier. Heavier agents such as zinc oxide and aluminum paste aren't recommended, because although they are protective, they are also difficult to remove.
Use caution with absorbent incontinence briefs, indwelling bladder catheters, or condom catheters. Although helpful, these devices shouldn't be substituted for efforts to help regain continence through bowel and bladder management programs.
A nurse or doctor should treat bedsores. Healing may take a long time, and thus prevention is the preferred approach.
The treatment of bedsores depends on the severity (i.e., the stage) of the wound to the skin. Depending on the severity, a variety of approaches may be used to promote healing. They include hydrocolloid dressings, synthetic dressings, saline dressings, acetic acid compresses, radiant heat dressings, and various antibiotic dressings (bedsores are particularly prone to infection). For more severe wounds, surgery may be necessary to remove areas of dead skin. The most important step in both treating and preventing bedsores is relieving pressure by frequent repositioning. Treatment also includes management of pain, and the prevention and treatment of infections.
Eating a protein-rich diet may improve wound healing. Your body needs proper nutrition to heal, and adding protein supplements to a balanced diet may increase your chances of a full recovery.
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