Decubitus ulcer or pressure ulcer is a wound due to prolonged pressure on the skin due to lying down constantly. Wound the most frequently appear on the skin area depressed when lying down, such as heels, elbows, hips, and tailbone. Ulcus decubitus also known as bed afternoon.
Decubitus ulcers are at risk for people who suffer from a disease that causes limited body movement. The patient will lie in bed or sit in a wheelchair for a long time, so that there are parts of the body that are constantly under pressure and sores appear.
To prevent the appearance of pressure sores, someone who is unable to get out of bed is advised to use an antidecubitus mattress.
Symptoms of Decubitus Ulcer
Decubitus ulcers can appear on a number of areas of the body, depending on which part of the body has been stressed for a long time.
In wheelchair users, decubitus ulcers usually appear in the buttocks, tailbone, spine, shoulder blades, back of the arms, and legs that lean on a wheelchair.
In people who just lie in bed, usually will form sores on the back and sides of the head, shoulder blades, hips, tailbone or lower back, heels, ankles, and the back of the knees.
Based on the level of severity, the following are characteristics of wounds that appear in patients with pressure ulcers:
- Grade 1: discoloration of certain areas of the skin, such as redness or bluish color, accompanied by pain or itching in those areas.
- Grade 2: abrasions or open sores in the affected area.
- Grade 3: open sores to several deeper layers of skin (skin ulcers).
- Grade 4: an open wound that is so deep that it reaches the muscles and bones.
When to go to the doctor
A person who is unable to move for a long time, either in bed or in a wheelchair, needs to be checked regularly by family members or the nurse who looks after him, so that it can be identified early if he has a pressure ulcer.
If first-degree pressure sores appear, consult a doctor immediately. Doctors and medical teams will perform wound care, as well as teach family members and caregivers how to treat wounds.
During wound care at home, immediately return to the doctor for treatment if signs of infection appear in the form of:
- Fever
- Swelling or discharge of pus in the wound area
Causes of Decubitus Ulcers
Decubitus ulcers are caused by pressure and friction on the skin that blocks blood flow to the skin. This condition generally occurs in someone who cannot change body position or move for a long time.
In addition, there are several factors that can also increase a person's risk of developing pressure ulcers, namely:
- Ability sense of taste decreaseSpinal cord injury and nerve disorders can cause decreased sense of taste so that the patient does not feel the wound. This makes the wound not treated immediately and becomes deeper.
- Not enough fluid intake and nutritionThis condition makes the resistance and health of the skin disturbed, so that it is easy to damage skin tissue.
- Ablood flow disturbedImpaired blood flow due to diabetes, heart disease, kidney failure, or multiple sclerosis can increase the risk of tissue damage due to lack of oxygen and nutrient supply to the area.
In addition to the factors above, urinary and stool incontinence, obesity, and being over 70 years of age can also make a person more at risk of developing pressure ulcers.
Decubitus Ulcer Diagnosis
In the early stages of diagnosis, the doctor will examine the patient's body parts that are prone to developing pressure ulcers. If a pressure ulcer is found, the doctor will determine the severity of the wound and provide appropriate treatment.
If necessary, the doctor can carry out supporting examinations, such as blood tests, to determine the general condition of the patient, as well as detect other diseases that may be suffered by the patient.
Decubitus Ulcer Treatment
The initial stage of treating pressure sores is to reduce pressure and friction on the wound. After that, the doctor will proceed with wound care and removal of the damaged tissue. The following is a series of treatments to treat decubitus ulcers:
Change position body
The patient's body position needs to be changed periodically. If using a wheelchair, shift your weight to the other side every 15 minutes or change positions every hour. If the patient is in bed, change positions every 2 hours.
The doctor will also suggest the use of an antidecubitus mattress. This mattress can reduce pressure on certain areas of the skin, and maintain good airflow to those areas. Even so, the patient's position still needs to be changed periodically.
Maintenanceluka decubitus
If the wound does not open, clean the area of skin with a non-alcoholic, fragrance-free soap, then dry immediately. If an open wound appears, the pressure ulcer needs to be covered with a bandage, so that the wound does not become infected and the surrounding skin remains dry.
Change the bandage regularly, and clean the wound with physiological saline (saline infusion) every time the bandage is changed.
Surgery to remove dead tissue
In order for pressure sores to heal quickly, scabs and dead tissue need to be removed through minor surgery (without general anesthesia). This action aims to stimulate the growth of new, healthy skin. If necessary, the surgeon will use skin tissue from other parts of the body to close the pressure ulcer.
Negative pressure therapy
Negative pressure therapy is also known as vacuum assisted closure (VAC). This method is done by using a special tool to clean the wound.
Drugs
In the treatment of pressure sores, doctors also usually give drugs, such as:
- Ibuprofen or diclofenac to relieve pain, especially when the patient is being treated for a wound or needs to be changed position.
- Antibiotic drink or ointment to fight bacterial infection, if the pressure ulcer has caused an infection in the patient.
In addition to the several treatment methods above, sufferers also need to fulfill their nutritional intake and consume enough water to speed up the skin healing process. Drinking enough water can help prevent dehydration, which can slow down the wound healing process.
Complications of Decubitus Ulcer
There are several complications that can arise if pressure ulcers are not treated immediately, namely:
- Cellulitis, due to infection of the skin and soft tissues. This condition can cause redness and inflammation in the area around the wound.
- Bone and joint infections, due to the spread of infection from the skin and soft tissues.
- Sepsis, which is a condition in which the infection spreads to the bloodstream and causes an immune system reaction throughout the body.
- Cancer, due to a wound that does not heal (Marjolin's ulcer).
Decubitus Ulcer Prevention
Decubitus ulcers are caused by long-term pressure on the skin. This condition can be prevented by changing the position of the body periodically to reduce pressure continuously on certain areas of the body.
Patients with diseases who are at risk of developing pressure ulcers also need to get adequate nutrition and fluid intake, not smoke, and manage stress well to prevent the appearance of pressure sores or ulcers. bed afternoon. Using an anti-decubitus mattress and applying lotion to the skin to keep the skin moist can also help prevent pressure ulcers.