The ulcers Pressure paper n, also known as bedsores or sores are lesions occurring in the skin to remain in the same position for periods long time, often occur in areas of the body where the bone is closer to the skin, as in the ankles, heels, hips, elbows, sacrum, etc.

The pressure ulcers are a major health problem, both for people who suffer because they worsen their state and therefore their quality of life; as for its environment.

Pressure ulcer grades

Knowledge of the different degrees in which it can present is important, since a different treatment is required at each stage.

  • Grade 1: Intact skin. Discoloration: the skin appears pale or red, as a result of local pressure and friction
  • Grade 2: Partial lesion of the epidermis: the altered areas present ulcers and blisters, which break the continuity of the skin.
  • Grade 3: Lesion in skin and subcutaneous tissue: a major lesion, sometimes in the shape of a crater, including even the hypodermis and subcutaneous cellular tissue.
  • Grade 4: Tissue necrosis: deep tissues such as muscles, joints, tendons, bones are also affected, associating the presence of cavernous tracts and infections.

The risk of developing pressure ulcers is higher in people with reduced mobility, people who stay in bed for long periods of time, or people in wheelchairs. Some ways to avoid them are examining the skin at least once a day, paying attention to bony prominences in heels, hips, ankles, elbows and sacral area, areas exposed to incontinence of body fluids, urine, feces, sweat, etc; which can injure the skin and cause injury.

Keep the skin clean and dry using soaps or cleansing substances with low irritation power, wash the skin with lukewarm water, rinse and dry meticulously, but without friction, do not use alcohols or colonies (since they can dry out the skin), apply creams moisturizers. If there is a problem of incontinence or excessive sweating, use barrier products, such as those containing zinc oxide, as they protect and isolate the skin from moisture.

Good pressure management can be carried out, considering some elements such as mobilization, and developing a care plan that encourages and improves the mobility and activity of the person. Postural changes are advised, which should be done every 2-3 hours following a rotating schedule of changes and local protection with dressings of different shapes that adapt to the shape of the body and the use of mattresses, mattress toppers, cushions and other relief devices of pressure.

How to choose a suitable mattress

The use of an anti-bedsore mattress should not suppress mobilizations and postural change, since they are the main technical aid in the prevention of ulcers or scarring in patients. The mattress is effective, but it is only an aid and not the remedy to forget about the necessary changes in posture.

There are various types of anti-bedsore mattresses on the market:

Foam mattresses: they are made of polyurethane foam, made up of cubes or square cells that adapt to the general contours of the body, allowing better weight distribution and reducing excessive pressure in risk areas and are differentiated by their various shapes, and especially by the density of its foam. These mattresses are covered by a protective film against humidity, preventing the mattress from storing liquid or germs.

Air mattresses: due to their properties and easy handling, they are undoubtedly the most widespread on the market, they are placed on the normal mattress providing a pneumatic base on which the body rests, making the support surfaces extensive and the pressure in the points of greatest risk, favoring circulation at the level of the bony prominences. They are made up of blocks of cells made of neoprene or other flexible material, which are inflated with air and communicate with each other through small internal ducts located at the base, allowing the slow circulation of air between the cells, giving a good distribution of the cells. pressure and adaptation in postural changes as well as ventilation that avoids humidity and maceration.

Water mattresses: are made of a plastic material that is filled with water, allowing the patient to float on this surface. They are usually equipped with a thermostat to keep the water at a constant and adequate temperature, they are used according to the size of the patient or the areas that require treatment.

Gel mattresses : this viscous gel-based mattress adapts to the contours of the body and provides excellent cushioning between the bed and the patient, in this way the upper part of the mattress acts as if it were a layer of fat that provides a better distribution of the pressures and damping of the weight in the bony prominences, in addition it allows to reduce the friction forces. The mattress is divided into compartments.

Silicone mattresses : These mattresses located between the static mattresses and the tires, enjoy greater stability than polyurethane foams and distribute the pressures well on the body surface, however, they are heavy and difficult to clean.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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