Bedsore Management

Bedsore Management

An ulceration of the skin and subcutaneous tissue caused by poor circulation due to prolonged pressure on body parts

The most common places

  • hips
  • back
  • ankles
  • buttocks

This condition is common among:

  • elderly people
  • people with decreased mobility
  • people who spend long periods in bed or a wheelchair
  • people who can’t move certain body parts without help
  • people with fragile skin

Sign Symptoms :

  • skin discoloration
  • pain in the affected area
  • infection
  • open skin
  • skin that doesn’t lighten to the touch
  • skin that’s softer or firmer than the surrounding skin

Treatment:

Changing position

  • Second hourly positioning

Mattresses and cussion

  • Air mattress/Alfa Bed
  • Water bed

Dressings:

  • Alginate dressings –  to speed up the healing process
  • Hydrocolloid dressings –  encourages the growth of new skin cells in the ulcer, while keeping the surrounding healthy skin dry 
  • Other dressing types – such as foams, films, hydro fibres /gelling fibres, gels and antimicrobial (antibiotic) dressings may also be used

“Gauze dressings aren’t recommended for either the prevention or treatment of pressure ulcers.”

Creams and ointments:

  • Topical antiseptic or antimicrobial (antibiotic) creams and ointments aren’t usually recommended for treating pressure ulcers.
  • But barrier creams may be needed to protect skin that’s been damaged or irritated by incontinence. 

Antibiotics

  • Antibiotics may be prescribed to treat an infected ulcer or if you have a serious infection, such as
  • Bacterial infection of tissues under the skin (cellulitis)
  • Infection of the bone (osteomyelitis)

Diet and nutrition

  • Eating a healthybalanced diet that contains enough protein and a good variety of vitamins

Removing damaged tissue (debridement)

  • A local anaesthetic should be used to numb the area around the ulcer so debridement (if not being treated with a dressing) doesn’t cause you any pain.

Surgery

  • Surgical treatment involves:
  • Cleaning the wound and closing it by bringing the edges of the ulcer together
  • Cleaning the wound and using tissue from healthy skin nearby to close the ulcer
  • Implanted skin tissue dying

To read more on Patient Care, click on the link below.

Patient Care

Pre Surgery Knowledge

Pre surgery steps to take to cut complication risks and help healing.

Preparation for Surgery

  • As a general rule, you should not eat or drink anything after midnight before your surgery. Under some circumstances, you may be given permission by your anesthesiologist to drink clear liquids up to a few hours before your anesthesia. If you smoke, quit smoking sooner before your surgery for better outcome or healing.
  • You must make arrangements for a responsible adult to take you home after your anesthetic or sedation. You will not be allowed to leave alone or drive yourself home. It is strongly suggested that you have someone stay with you during the first 24 hours. If you have local anesthesia only, with no sedation, it may be possible to go home without someone to accompany you. Check with your doctor first.
  • Some laboratory test should be done before surgery related to your illness as prescribed by your anesthesiologist/Surgeon.
  • Some medications should be taken and others should not. It is important to discuss this with your anesthesiologist. Do not interrupt medications unless your anesthesiologist or surgeon recommends it.
  •  Wear loose-fitting clothes that are easy to put on and will fit over bulky bandages or surgical dressings. Leave your jewelry and valuables at home.
  • Details about hospital stay should be briefly provided before surgery.
  • Both written and verbal instructions will be given. Most facilities have both general instructions and instructions that apply specifically to your surgery.

In general, for 24 hours after your anesthesia:

  • Do not drink alcoholic beverages or use nonprescription medications.
  • Do not drive a car or operate dangerous machinery.
  • Do not make important decisions.
  • You will be given telephone numbers to call if you have any concerns or if you need emergency help after you go home.

To read more on Patient Care, click on the link below.

Patient Care

Content Courtesy : Portea

BACKPAIN

It’s Causes And Treatment

Pain in the back can be due to issues arising from the skin,
ligaments, muscles, bones or nerves in the back. Some people are more
prone to backaches. Those who spend their whole day crouched over
a computer screen, people who stay indoors the whole day, older people
and even people who over train at the gym are more likely to get
repeated backaches

 

Backpain

Backpain by Famhealth

What are the causes of backpain?

There could me many reasons for backpain.

  • Backpain could be due to poor posture where the back is kept at an awkward angle and the muscles and ligaments get strained as a result.
  • A poor diet lacking in calcium or lack of vitamin D
  • Backpain could be as a result of injury due to lifting heavy weights or a fall
  • Sometimes, back pain can be due to medical reasons like a slipped disc- a condition where the nerves of the back get compressed and there tends to be pain and numbness in the back and legs.
  • Even a kidney infection or a urinary infection can cause backpain.
  • In women, a gynecological infection might be the reason
  • Other reasons could be an infection involving the back muscles or bones
  • Sometimes even tumours that can target the bones of the back can cause backpain
  • Skin eruption like herpes can cause backpain too

How can backpain be relieved?

esp-frm.com
  • There are some simple remedies to try at home which might help a backpain
  • Cold compresses with an ice pack can help in numbing the area and relieve pain
  • A pain reliever like paracetamol, if you’re not allergic to it, might help if the pain is due to an injury
  • Resting the back for a couple of days can help the pain to settle
  • A gentle application of a pain relieving balm containing ingredients like camphor or peppermint essential oils might be beneficial.

When should I see the doctor?

It would be best to see your doctor if:

  • The pain is sharp and unbearable
  • The pain is going down one or both legs
  • There is numbness in the legs
  • There is weakness while walking
  • Any loss of bladder or bowel control is also a serious warning sign
  • Fever along with the pain might signal an infection

How is the cause of backpain diagnosed?

  • Your doctor will ask you in detail about the pain, how it started and some lifestyle questions as well.
  • This is generally followed by an examination wherein your doctor might check your nerves and also check your back movements.
  • Based on this, there might be some investigations prescribed. These might include a urine examination, kidney function tests, vitamin D levels and X rays or CT scans for the spine.
  • The doctor will probably prescribe a pain reliever, maybe in combination with a muscle relaxant, till the results come in. Do share any previous drug allergies and it’s a good idea to confirm if it’s safe to drive while on the relaxants, as some can be sedating.

What is the treatment of backpain?

Most acute back pain gets resolve with a few weeks of home treatment. Over-the-counter pain relievers and the use of heat or ice might be all you need. Bed rest isn’t recommended.

Continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain. If home treatments aren’t working after several weeks, your doctor might suggest stronger medications or other therapies.

Medications

Depending on the type of back pain you have, your doctor might recommend the following:

Over-the-counter (OTC) pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), might relieve acute back pain. Take these medications as directed by your doctor, because overuse can cause serious side effects.

If OTC pain relievers don’t relieve your pain, your doctor might suggest prescription NSAIDs.

Muscle relaxants. If mild to moderate back pain doesn’t improve with OTC pain relievers, your doctor may also prescribe a muscle relaxant. Muscle relaxants can make you dizzy and sleepy.

Topical pain relievers. These are creams, salves or ointments you rub into your skin at the site of your pain.

Narcotics. Certain drugs, such as codeine or hydrocodone, may be used for a short time with close supervision by your doctor.

Antidepressants. Low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline — have been shown to relieve some types of chronic back pain, independent of their effect on depression.

Injections. If other measures don’t relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.

Education

There’s no commonly accepted program to teach people with back pain how to manage the condition effectively. So education might involve a class, a talk with your doctor, written material or a video. Education emphasizes the importance of staying active, reducing stress and worry, and teaching ways to avoid future injury.

Physical therapy and exercise

Physical therapy is the cornerstone of back pain treatment. A physical therapist can apply a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain.

As pain improves, the therapist can teach you exercises that can increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.

Surgery

Few people need surgery for backpain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgery. Otherwise, surgery usually is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn’t responded to other therapy.

Can backache be prevented?

Some simple precautions on a daily basis can actually help in preventing back problems

  • While working at a computer, ensure that your feet are comfortably on the ground or a stool, your back is erect and arms are resting on the desk.
  • Take breaks every hour to loosen up the ligaments and walk where possible.
  • Always bend your knees to lift anything, before bending your back.
  • If your job involves being indoors, it might be a good idea to take vitamin D supplements after consulting with your doctor.
  • Some back strengthening yoga exercises, if done regularly, can keep back issues at bay.

We advocate medical advice before starting any treatment regime.