CARE OF SWEDEN

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Treating Pressure Ulcers

Prevention is better than cure and we realized on our last feature that it was all the more true when it came to pressure ulcers due to the massive opportunity costs involved for the healthcare segment. Having said that, we cannot ignore the reality that a vast majority of patients still contract pressure sores. The causality may be attributed to multiple factors from lack of high-quality medical devices to inaccessibility of standardized care on a global scale. But that is a discussion for another time, for now, we choose to be content in exploring the distinct methods of treatment for pressure ulcers.

The recovery journey of any patient starts from diagnosis. Identifying the problem and measuring its severity is vital in charting a course for the patient’s recovery. In our case identifying the patient’s history with pressure sores and classifying its degree can be considered a breakthrough that allows healthcare professionals to prescribe the right treatment.

Once the diagnosis is complete the first line of defense is to reduce the pressure and friction on the area of effect. This can be accomplished through frequent repositioning and/or making use of special surfaces/cushions to support the area of vulnerability. Frequent repositioning is often taken care of by the staff at the care facility. But if the patient in question is cared for at home, those responsible must ensure that they are repositioned from time to time. The interval in between depends on the condition of the patient and the quality of the surface. Therefore it varies on a case-to-case basis. Cushions and other support surfaces specially made to redistribute pressure and reduce friction are readily available in the market. A study on the effectiveness of support surfaces published in 2015 urges high-risk patients to use foam mattresses of higher specification as opposed to the ones provided by the hospitals. Patients undergoing critical care may also require sophisticated mattress setups that constantly pump air into them.

The next step in the care continuum is attending to the wound caused by the ulcer. Wounds should be cleaned with water and saline solution and this practice needs to be repeated whenever the dressing is changed. If the pressure ulcer has not caused the skin to break, wash it gently and dab it dry. Dressings are used to speed up the healing process, keep the area moist, and prevent other infections by keeping areas adjacent to the wound dry. Alginate dressings that induce faster healing and hydrocolloid dressings that act as catalysts for new skin growth are some of the popular dressings used. Personalized dressings and/or creams may be prescribed by health professionals based on the characteristics of your wound. 

The final step in a generic case scenario is the removal of damaged tissue. This stage is referred to commonly as debridement and is often performed by flushing water on the wound or slicing off damaged tissue. If the pressure ulcer fails to heal and develops into a large wound- surgery is often the last resort. Flap surgery is one such example wherein a patch of healthy skin, muscle, or other tissue is surgically used to cover up the wound and assist healing. However, surgery should only be recommended as a last resort due to the immense risks they pose including blood poisoning, abscesses, and osteomyelitis.

Supplementary means of care assistance include using pain killers before or after repositioning to help reduce pain. Ibuprofen is one such anti-inflammatory drug used to reduce pain. At times, antibiotics may also be prescribed for treatment if you contract other infections like blood poisoning or bone infection. Additionally, patients should be advised to get plenty of sleep and eat nutritious foods to induce faster healing. Losing excess weight and light exercises to enhance blood circulation may also be done if permitted by doctors.

Having read through all the various methods of treatment that scale alongside the category of pressure ulcers- the only thing all patients have in common is pain. That is why I emphasized the need for taking as many precautions as possible to prevent such an outcome. But those who are infected need to be extra vigilant and seek professional help from healthcare workers. Doctors or healthcare experts can guide you to specialized cushions for pressure redistribution, advise you on the most effective combination of dressings to use, and also ensure that advanced forms of care including debridement and surgery are made available when required.  Additionally, we must enquire about the risks involved in each treatment method especially for acute cases where surgery is prescribed.

Haanie Bilal