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Relieving and spreading out
pressure is the most important part of both preventing and treating pressure sores.
Putting pressure on one spot for long periods of time decreases blood flow to that
area. This damages or kills the cells and creates a sore.
Pressure can be relieved and spread in several ways. Often a combination of
these is best.
To relieve and spread pressure:
Take good care of your skin.
Good health habits can also help protect your skin.
If a pressure sore forms, keep using the prevention steps listed above to relieve pressure and protect the skin. It's also important to keep the sore clean, covered, and slightly moist. Used together, these steps can help keep the sore from getting worse and help your skin heal.
The pressure sore must be cleaned every time
the bandage (dressing) is changed. Saline is often used for cleaning. This is a saltwater solution that you can buy at a drugstore. But there are many cleansing
products for wounds. Your doctor will recommend a cleansing solution for you. In some cases, it may be okay to use tap water to clean the wound.
doctor will recommend a bandage for the pressure sore. There are
many types of bandages. Over time, your doctor may use several different kinds of bandage as the
pressure sore heals.
The general idea is to keep the wound a little moist
and not let it dry out between bandage changes.
Pain may or may not be a
problem with pressure sores. Some
people who have pressure sores do not need any pain medicine. Some need it just when the sore is being treated, and some need it on a regular schedule. If you have pain, talk to your doctor.
Often a doctor will remove (debride) the dead tissue in a pressure sore. Dead tissue gives bacteria a
good place to grow and can cause infection. It can also
slow the growth of healthy tissue.
But sometimes it is best to leave the dead
tissue or scab in place and let it act as a sort of bandage. Your doctor may do
this if the tissue is very stable or if the sore is not likely to heal.
grafts or surgical flaps are sometimes needed. Skin
grafts help new skin grow at the site of the sore if the wound extends into
muscle and deeper tissues. The wound may be surgically closed to promote
healing after a skin graft.
Several other treatments are sometimes used in treating
pressure sores. These are done most commonly in clinics that specialize in
treating serious wounds. They include:
Researchers continue to study these and other
treatments for pressure sores and other wounds.
As you treat a pressure sore, you will know
it is healing correctly if:
After a pressure sore is healed, the skin is still very fragile. It is easy for the skin to break down again, especially in the first month after the sore is healed. To decrease the risk that the pressure sore will come back, slowly return to the positions that put pressure on the area where the sore was. For example, apply pressure for no more than 15 to 30 minutes at first. Then check to see if the redness fades within 15 minutes after you take the pressure off. Talk to your doctor or nurse about a plan for returning to your normal positions and activities after a pressure sore is healed.
Open wounds, such as
pressure sores, are easy places for infections to start. Your doctor will be
watching for signs of infection, and you can help watch for these signs. Tell
your doctor if you notice:
To treat an infection, you may use medicine, such as
antibiotics, along with special care of the wound. You
and the people around you will also be taught to take steps to keep germs from
spreading to other parts of your body or to other people. These steps include
keeping the sore covered at all times except during treatment, good
hand-washing before and after caring for the pressure sore, and properly
wrapping and throwing away used bandages.
How well a pressure heals depends in part on its stage.
July 24, 2013
E. Gregory Thompson, MD - Internal Medicine
& Margaret Doucette, DO - Physical Medicine and Rehabilitation, Wound Care, Hyperbaric Medicine
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