Common Mistakes in Treating Pressure Ulcers (Bedsores)
Pressure ulcers are localized damage to the skin and underlying tissues caused by prolonged pressure on specific body areas. So much has been written about treating bedsores that it seems impossible to add anything new. Here, I will share the typical mistakes made in their treatment.
Mistakes in treating pressure ulcers can significantly worsen the patient’s condition and delay skin healing. I have written about proper treatment elsewhere; here I focus on errors.
Using coloring solutions (e.g., brilliant green, fucorcin). Many believe that the skin around the bedsore should be dried with brilliant green or fucorcin. What is the mistake? For a surgeon, it is crucial to see the natural color of the bedsore and the surrounding skin. If it is painted green, you deprive the surgeon of that information. Also, why does the skin around the bedsore become wet? Because the adhesive tape used to secure the dressing constantly traumatizes it. If the bedsore is on the sacrum, I recommend fixing the dressing with a diaper rather than adhesive tape.
Using «miracle» ointments. Yes, the instructions for these ointments contain wonderful promises, but they have no real effectiveness. Moreover, the ointment prevents fluid from draining out of the bedsore – it seals it shut. Using such ointments is at best useless, and at worst it deepens the ulcer.
Using hydrocolloid and polyurethane dressings. They claim these can be changed once every three days – pure marketing and business. Dressings should be changed every day. I have never seen a positive result from using such dressings.
Relying on various «miracle» remedies in the hope of speeding up healing. No. A bedsore, like pregnancy, must go through its own stages and timelines. There will be no miracle. No one would think of taking «miracle vitamins» to make a pregnancy develop in six months instead of nine. You can harm and delay recovery by wrong actions, but you cannot accelerate it.
Following advice from the Internet. Apart from me, such articles are written by non‑specialists or by artificial intelligence. They simply repeat what is already in other articles.
Lack of understanding of factors that hinder healing. These include:
-
Low hemoglobin. Few realize that the very presence of a bedsore leads to a drop in hemoglobin. Under anemic conditions, no wound heals.
-
Low total protein in the blood. Total protein is the building material for wound healing. If it is insufficient, how can healing proceed?
-
Low blood pressure. With blood pressure below 100 mm Hg, blood supply to the bedsore area is impaired.
Who is at risk for developing bedsores?
The highest risk is in patients with limited mobility, because prolonged pressure on certain skin areas impairs normal blood circulation. I repeat a hundred times: bedsores must be prevented. Once they appear, the care effort increases tenfold.
Bedsores most often occur in bedridden patients, people with paralysis, after severe trauma or surgery, and in comatose patients.
Elderly people, especially those with chronic diseases such as diabetes and circulatory disorders that impair skin regeneration, are also at risk.
Reduced sensitivity is another important factor – patients do not feel discomfort from prolonged pressure, making it difficult to change position in time and prevent skin damage.
Prevention of bedsores.
It is simpler than steamed turnips. If you have a bedridden patient, place them on an anti‑decubitus (pressure‑relieving) mattress immediately. Just spend the 5,000 rubles – it is worth it.