Long-term bed rest has risks. How much do you know about preventing pressure sores during home care?

Pressure ulcers are a common but preventable skin injury, especially in patients who are bedridden for a long time. Home care is a treatment option chosen by many patients, but the risks of long-term bed rest cannot be ignored. This article will explore the importance of preventing pressure ulcers in a home care environment and provide some effective methods to reduce the risk of patients developing this condition.

1.What is a pressure ulcer?

Pressure sores are caused by blood supply obstruction due to compression of surface tissues, leading to tissue ischemia and hypoxia, and eventually developing into necrosis. According to the depth and degree of injury, pressure sores are divided into four different stages: Stage I, the skin is red but not damaged. Prevention at this stage focuses on reducing local pressure and improving blood circulation; Stage II, the epidermis and part of the dermis are damaged, and shallow ulcers or blisters may appear. The focus is on keeping the wound clean and avoiding infection; Stage III, the damage extends to the subcutaneous fat layer and forms ulcers. Prevention focuses on preventing infection and promoting wound healing; Stage IV, the damage is deep to the muscles and bones, and may be accompanied by infection. The key to prevention is early detection and effective treatment.

2. Risk factors for pressure ulcers in bedridden patients

In home care, patients who are bedridden for a long time are more likely to develop pressure sores. The following are some factors that increase the risk of patients: (1) Pressure. Continuous pressure on a part of the body for a long time can easily lead to poor local blood circulation and cause pressure sores. (2) Humidity. Wet skin is more susceptible to damage, so keeping the skin dry is one of the preventive measures. (3) Weight. Due to the uneven distribution of weight, obese patients are prone to excessive pressure in specific parts of the body, which increases the incidence of pressure sores. (4) Age. The skin elasticity of elderly patients is weakened, and coupled with the presence of chronic diseases, they are more likely to develop pressure sores.

3. Measures to prevent pressure ulcers

The occurrence of pressure sores not only causes physical pain to patients, but also brings financial burden to the family. For patients who are bedridden for a long time, the prevention of pressure sores is crucial. During home care, the measures to prevent pressure sores are as follows: (1) Turning the patient frequently. Turning the patient frequently is a simple and effective way to prevent pressure sores because it helps to reduce pressure on specific parts of the body, promotes blood circulation, and reduces the risk of tissue ischemia and hypoxia. A reasonable turning plan should be developed for the patient based on individual conditions and the doctor's advice. Generally, it is recommended to turn the patient over every 2 to 4 hours to ensure that all parts of the body can get enough rest. When turning the patient over, some auxiliary tools, such as turning pads and nursing pads, can be used to reduce the burden on the caregiver and ensure the safety of the patient. If the head of the bed is raised when the elderly patient eats, shear force may occur in the sacrum and coccyx of the elderly patient. If shear force exists for a long time, it may cause the blood vessels between tissues to twist or even break, thereby causing pressure sores in the deep tissues of the sacrum and coccyx. To prevent this from happening, the head of the bed should not be raised more than 30 degrees, and the time the head of the bed is raised should be controlled. Such preventive measures can help reduce the force on the deep tissues of the sacrum and coccyx, and reduce the risk of pressure sores. For patients who are bedridden for a long time, an air mattress or other mattress that prevents pressure sores can be considered. There are many related products on the market. It is recommended to choose products from well-known brands and turn the patient over regularly during use to avoid irreversible pressure sores. When using an air mattress, it is necessary to regularly check the functional status of the air mattress and inflate it with appropriate pressure according to the requirements of the instructions. When choosing bed sheets, it is recommended to use cotton fabrics, keep the bed clean, flat, and dry, and avoid wrinkles and debris. In order to ensure the hygiene of the bed, it needs to be cleaned and tidied regularly. When using a toilet, a smooth and undamaged toilet should be selected. At the same time, the patient's lumbar sacral area should be lifted to avoid forced insertion or hard pulling. This helps avoid additional friction and pressure on the patient's skin and reduces the occurrence of potential skin problems. (2) Protect the skin. When assisting the patient to turn over, it is necessary to carefully observe the condition of the skin, including whether there is redness, swelling, or ulceration, and whether there are nodules when touched. In particular, it is necessary to avoid further pressure on the previously stressed area. If the patient's skin is relatively dry, moisturizer should be used in time after cleaning the skin to keep the skin moist and soft. If the patient is incontinent, the local skin is prone to moisture. Such a moist environment is prone to breeding bacteria, making the skin soft and easily damaged by friction. Therefore, after cleaning the patient's skin in time, you can consider using skin protection products with isolation function to prevent the skin from being overly exposed to a moist environment. This care measure helps reduce skin problems caused by a moist environment. (3) Balanced nutrition. For malnourished patients, the stressed area lacks the protection of fat and muscle, which can easily cause blood circulation disorders and lead to pressure sores. For obese patients, the blood supply of fat tissue is less, which will affect the local blood circulation. In addition, the inability to move freely increases the risk of pressure sores. Therefore, it is necessary to pay attention to the patient's nutritional status. Patients are advised to consume enough protein, including meat, fish, eggs, dairy products, beans and nuts. These foods are rich in amino acids, which help promote wound healing and maintain skin elasticity. Vitamins and minerals are also essential for skin health. Nutrients such as vitamin C, vitamin A and zinc help promote wound healing and enhance immunity. Adequate water intake helps maintain the moisture of the skin. Water is very important for the body's metabolism and waste elimination. The right amount of fat is also critical for maintaining skin elasticity and moisturizing. Try to choose healthy sources of fat, such as olive oil, fish oil, nuts, etc., which help maintain the health of the skin. Certain foods may have adverse effects on the skin, such as spicy foods, caffeine and high-sugar foods. Therefore, consuming moderate amounts in the diet and avoiding overeating can help maintain the stability of the skin. In short, balanced nutrition is essential for preventing pressure sores. When formulating a diet plan, a scientific and reasonable approach should be adopted based on the individual differences of the patient and the doctor's advice to ensure balanced and adequate nutrition, thereby promoting the health of the skin.

In home care, preventing pressure sores is a vital task, especially for patients who are bedridden for a long time. Through the above effective preventive measures, the risk of patients developing pressure sores can be significantly reduced. (Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Chang Xiuyan)