Bed Sore

Protocols

Bed Sore:

  • Special type of ulcers due to impaired blood supply and tissue nutrition due to prolonged pressure.
  • Skin overlying sacrum and hips is commonly involved.
  •  Patient is old, paralyzed or unconscious patient.

Bed Sore site:


Investigation:

  • 1)CBC with ESR
  • 2)Serum Albumin 
  • 3)Serum protein
  • 4)Transfering
  • 5)Urine RME
  • 6)Biopsy 


Mx:(Medical Treatment) 

1. Cap.Flucloxacillin (Flubex)(500mg)

  • 1+1+1+1........7-10 days 

2. Tab.Ceevit DS(500mg)

  • 1+1+1.......10 days 

3. Tab.xinc-OT 

  • 1+0+1.......15 days 

4. softi Cream 

  • আক্রান্ত স্থানে দিনে ৩ বার...... ১০ দিন 

5. Burna cream 1%( silver sulphonamide)

  • দিনে ২-৩ বার আক্রান্ত স্থানে....... ১০ দিন 

6. Tab.Baclofen(Beklo)(10 mg)

  • 1+0+1........7 days 


Personal Wound Care:

  •  Good nursing care is needed.
  • Viodin 10% + Usol solution mix করে নিয়মিত dressing করতে হবে। 


Surgical care:

  •  Surgical debridement 
  • Diversion of the urinary or fecal stream 
  • Release of flexion contractures 
  • Wound closure 
  • Amputation 

Options available for surgical management of pressure ulcers are as follows: 

  •  Direct closure (rarely usable for pressure ulcers being considered for surgical treatment) 
  •  Skin grafts 
  • Skin flaps 
  • Myocutaneous (musculocutaneous) flaps 
  •  Free flap 

Prevention: 

  • Shift your weight frequently. repositioning 2 hourly
  • Lift yourself, if possible.
  • Look into a specialty wheelchair. 
  • Select cushions or a mattress that relieves pressure.
  • Adjust the elevation of your bed.
  • Use pneumatic bed