PRESSURE ULCERS

Pressure ulcers occur when the pressure on the skin reduces the blood flow to the area.

Some risk factors include:

-          Malnutrition

-          incontinence

-          Disease That Affects blood flow, vascular disease or diabetes Including

-          Stay in bed for a long time

-          Fragile skin

Valuation

The patient must be evaluated through the scales valuation of risk for identify the elderly patient with risk of developed a pressure ulcer.

The Braden and Norton's scales are the most used.

When already has developed a pressure ulcer need a comprehensive evaluation that includes the location and number of lesions. The most common sites of pressure ulcers are the trochanters, sacrum, buttocks and heels.

Pressure sores are grouped by their severity.

-          Stage I: A reddened area on the skin that, when pressed, does not turn white.

-          Stage II: ulcer-like abrasion bleb or shallow crater

-          Stage III: There is damage to the tissue below the skin.

-          Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes to tendons and joints.

The worst complication in this hurt is the infection, bacteria multiply, the healing is disrupted and damaged tissues.

The symptoms typical are inflammation, pain, hot and blush.

The cleaning must be realised with physiological saline.

Debridements are the removal of necrotic tissue by a surgical technique. This technique is not performed if there are circulation disorders, infection...

The dressings used in pressure ulcers depends wound exudate and the presence or absence of infection.

-          Hydrogels are used in necrotic tissue must be covered with a secondary dressing.

-          Hydrocolloids are used in the treatment of vascular and pressure ulcers. These dressings form a gel to absorb the wound exudate.

-          Alginates not be used on dry wounds, are very absorbent so used to heavily exuding wounds.

-          Foam may be adhesives or not. Retain large amounts of exudate.

-          Hidrocapilares serve low and high level of exudate, are very adaptable. They have a pad covered with a water resistant material, their most important characteristic is that they are capable of absorbing large amounts of exudate

In my opinion is very important know all the different characterist dressing to can choose the better in which tipe of ulcer. Also it is important change the dressing when it is necesary.
I think that will be important stabilish a norms of the ulcers´s traments for all the healh peronal could be trated the same form.

As we have seen most importantly in pressure ulcers is from my point of view, the prevention of the same. Preventing ulcers is much easier to treat, for it can be proposed guidelines:

-          Change position At least every 2 hours to relief pressure

-          Use items That Can help reduce pressure: pillows, sheepskin, foam padding, and powders from medical supply stores

-          After urinating or having a bowel movement, clean the area and dry it well

-          Keep skin clean and dry

When the ulcer is already the most important thing will be treated as early as possible and so we will have to assess the ulcer, cleaning and studying the best way to act.

In my view thanks to the advances that have occurred in the different types of dressings and different techniques, has helped to work more efficiently.

But we must not forget that the best treatment is prevention.

Bibliography

http://www.nlm.nih.gov/medlineplus/ency/article/007071.htm