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Decubitus ulcers,
pressure sores
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Normal |
Abnormal |
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- These are ulcers (sores) caused by
prolonged pressure on the skin. The most susceptible places
are areas with prominent bones or cartilage. Usually, when a
patient is on prolonged bed rest due to illness or
paralysis, he is likely to exert pressure over a bony site.
Here, friction develops when the patient moves around,
causing moisture to build up on the skin.
- The elderly, who tend to have thin skin, poor circulation, and suffer from incontinence, Dementia, low body weight, and Malnutrition, are
especially at risk.
- The ulcers are divided into 4
stages, depending on the depth and size (stage I is the most
superficial, stage IV the deepest).
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- Change to high protein diet rich in
vitamins and minerals (e.g., Zinc, vitamin C, and iron)
- Whirlpool may be used to help remove
dead tissue and stimulate circulation.
- Prolonged pressure on the ulcer will
make it worse, so frequent turning (every 2 hours) may be
done by the patient, nurses, or special beds.
- Irrigation of the wound with saline
solution
- Topical antibiotic ointments
- Gel-foam bandages
- Hydrocolloid dressings such as
Duo-Derm (clean ulcers only)
- Surgical cleaning and debridement
(removal of dead tissue) may be needed
- Antibiotics are given orally or
intravenously for deeper infections
- Analgesics are needed if there is
pain.
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- Good nutrition
- Good hygiene
- Linens should be kept clean and dry
- Frequent turning of immobilized (bed
bound) individuals
- Special mattress may
help
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- Shingles
- Skin cancer
- Pyoderma gangrenosum
- Ecthyma
gangrenosum
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Common Areas
of Involvement
- Tail bone area
- Hips
- Back
- Elbows
- Heels
- Ankles
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