Bed sore management

KAMRAN YOUSAF
FCPS(PAK),MRCS(GLASGOW,UK)
Meeqat Hospital

1. BED SORE MANAGEMENT A PREVIEW KAMRAN YOUSAF FCPS(PAK),MRCS(GLASGOW,UK)

2. DEFINITION TERMINOLOGY BED SORE ,,, PRESSURE SORE ,,, PRESURE ULCER DECUBITUS ULCER INURY TO SKIN AND UNDERLYING TISSUES DUE TO PROLONGED UNRELIEVED PRESSURE

3. WHY ?

4. RISK FACTORS ADVANCED AGE > 70 YEARS MALNUTRITION AND DEHYDRATION PHYSICAL DISABILITY CHRONIC MED ILLNESS

5. WHAT REALLY HAPPENS ?

6. MECHANISM OF INJURY PROLONGED SUSTAINED PRESSURE LEADS TO EXCESS PRESSURE THAN NORMAL CAPILLARY PRESSURE THUS NARROWS THE SMALL VESSELS OF SKIN THEREFORE REDUCED TISUE PERFUION & SKIN BREAKDOWN

7. FORCES PRESSURE FRICTION SHEAR MOISTURE

8. COMMON SITES OF BED SORES BACK OF THE HEAD SHOULDERS EAR LOBES SCAPULAR AREAS TAILBONE/SACRUM GREATER TROCHANTERS KNEE ANKLE AND HEELS

9. STAGES OF BED SORES

10. STAGE 1 SUPERFICIAL,,,EPIDERMAL CHANGE OF COLOUR ONLY DOESN’T BLANCH DARK SKIN WARM,,,OEDEMATOUS NO SKIN BREAK

11. STAGE 2,PARTIAL THICKNESS SKIN LOSS AND / BLISTER INVOLVES DERMIS SKIN BREAKDOWN

12. STAGE 3,,,FULL THICKNESS SKIN LOSS FAT EXPOSED EPIDERMIS,DERMIS,SUBCUT TISSUE FULL SKIN BREAKDOWN MUSCLE,BONE,TENDON NEITHER EXPOSED NOR DAMAGED

13. STAGE 4,,,FULL THICKNESS TISSUE LOSS DEEP ULCER REACHES MUSCLE BONE AND TENDON

14. UN-CLASSIFIED OCCASIONALLY,,, A DRY SCAB COVERS MORE SERIOUS AND DEEP INFECTED BED SORE

15. ASESSMENT FOR BED SORE BRADEN SCORING SYSTEM NORTON SCORE

16. 2 HOURS --- 2 WEEKS

17. COMPLICATIONS CELLULITIS/ABSCESS SEPSIS BONE AND JOINT INFECTIONS CANCER

18. COMPLICATIONS MUSCLE ATROPHY JOINT CONTRACTURES PNEUMONIA DVT

19. TREATMENT ADMIT THE PATIENT DEVISE A COMPLETE TREATMENT PLAN MONITOR FREQUENTLY RE-ASSESS

20. TREATMENT SURGICAL MEDICAL NURSING CARE

21. SURGICAL DEBRIDEMENT AND I/D AUTOLYTIC MECHANICAL ENYMATIC SHARP BIOSURGICAL

22. SURGICAL,,, GRAFT AND FLAP

23. THE DRESSINGS HYDOPHYLLIC HYDROGEL ALGINATE FOAM ACCUZYME PANAFIL

24. MEDICAL CONTROL OF MED ILLNESS BALANCED DIET ANEMIA DEHYDRATION AND ELECTROLYTE IMBALANCE ANTIBIOTICS

25. NURSING CARE REGULAR POSTURE CHANGE,,, 2 HOURLY REGULAR DRESSING DAILY INSPECTION OF SKIN EARLY CHANGE OF PAMPERS/NAPKINS HYGIENE CARE DIET FOLLOW UP FAMILY EDUCATION/TRAINING

26. PREVENTION IS BETTER THAN CURE

27. THE NURSING PERSPECTIVE

28. BEWARE ,,,, PATIENT IS OLD AGE LIMITED PHYSICAL MOBILITY MEDICAL ILLNESSESS PROLONGED STAY

29. APPLY BRADEN SCALE

30. INSPECT SKIN ,,,,, ESPECIALLY AT THE PRESSURE AREA BOWEL/URINE BED SHEET/PILLOW COVERS/DRESS AIR MATTRESS

31. STAGE THE BED SORE

32. ENSURE REGULAR MEDICATION TIMELY DRESSINGS REGULAR POSTURE CHANGE HYGIENE DIET INTAKE