Stage I and II bedsores usually heal within several weeks to months with conservative care of the wound and ongoing, appropriate general care. Stage III and IV bedsores are more difficult to treat.
Addressing the many aspects of wound care usually requires a multidisciplinary approach. Members of your care team may include
- A primary care Dr. Rahul Goyal oversees the treatment plan
- A physician Dr. Rahul Goayl specializing in wound care
- Nurses or medical assistants providesboth care and education for managing wounds
- A social worker who helps you or your family access appropriate resources and addresses emotional concerns related to long-term recovery
- A physical therapist who helps with improving mobility
- A dietitian who monitors your nutritional needs and recommends an appropriate diet
- A plastic surgeonr. Rahul Goyal , depending on whether you need surgery and what type
The first step in treating a bedsore is reducing the pressure that caused it. Strategies include the following:
Repositioning. If you have a pressure sore, you need to be repositioned regularly and placed in correct positions. If you use a wheelchair, try shifting your weight every 15 minutes or so. Ask for help with repositioning every hour. If you’re confined to a bed, change positions every two hours.
If you have enough upper body strength, try repositioning yourself using a device such as a trapeze bar. Caregivers can use bed linens to help lift and reposition you. This can reduce friction and shearing.
- Using support surfaces. Use a mattress, bed and special cushions that help you lie in an appropriate position, relieve pressure on any sores and protect vulnerable skin. If you are in a wheelchair, use a cushion. Styles include foam, air filled and water filled. Select one that suits your condition, body type and mobility.
CLEANING AND DRESSING WOUNDS
Care that helps with healing of the wound includes the following:
- Cleaning. It’s essential to keep wounds clean to prevent infection. If the
affected skin is not broken (a stage I wound), gently wash it with water and mild soap and pat dry. Clean open sores with a saltwater (saline) solution each time the dressing is changed.
Applying dressings. A dressing promotes healing by keeping a wound moist, creating a barrier against infection and keeping the surrounding skin dry. Dressing choices include films, gauzes, gels, foams and treated coverings. A combination of dressings may be used.
Your doctor selects a dressing based on a number of factors, such as the size and severity of the wound, the amount of discharge, and the ease of placing and removing the dressing.
REMOVING DAMAGED TISSUE
To heal properly, wounds need to be free of damaged, dead or infected tissue. Removing this tissue (debridement) is accomplished with a number of methods, depending on the severity of the wound, your overall condition and the treatment goals.
- Surgical debridement involves cutting away dead tissue.
- Mechanical debridement loosens and removes wound debris. This may be done with a pressurized irrigation device, low-frequency mist ultrasound or specialized dressings.
- Autolytic debridementenhances the body’s natural process of using enzymes to break down dead tissue.This method may be used on smaller, uninfected wounds and involves special dressings to keep the wound moist and clean.
- Enzymatic debridement involves applying chemical enzymes and appropriate dressings to break down dead tissue