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Bed sore management

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

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Bed sore management

  1. 1. BED SORE MANAGEMENT A PREVIEW KAMRAN YOUSAF FCPS(PAK),MRCS(GLASGOW,UK)
  2. 2. DEFINITION • TERMINOLOGY • BED SORE,,,PRESSURE SORE,,,PRESURE ULCER • DECUBITUS ULCER • INURY TO SKIN AND UNDERLYING TISSUES DUE TO PROLONGED UNRELIEVED PRESSURE
  3. 3. WHY ?
  4. 4. RISK FACTORS • ADVANCED AGE > 70 YEARS • MALNUTRITION AND DEHYDRATION • PHYSICAL DISABILITY • CHRONIC MED ILLNESS
  5. 5. WHAT REALLY HAPPENS ?
  6. 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. 7. FORCES PRESSURE FRICTION SHEAR MOISTURE
  8. 8. COMMON SITES OF BED SORES • BACK OF THE HEAD • SHOULDERS • EAR LOBES • SCAPULAR AREAS • TAILBONE/SACRUM • GREATER TROCHANTERS • KNEE • ANKLE AND HEELS
  9. 9. STAGES OF BED SORES
  10. 10. STAGE 1 • SUPERFICIAL,,,EPIDERMAL • CHANGE OF COLOUR ONLY • DOESN’T BLANCH • DARK SKIN • WARM,,,OEDEMATOUS • NO SKIN BREAK
  11. 11. STAGE 2,PARTIAL THICKNESS SKIN LOSS AND / BLISTER • INVOLVES DERMIS • SKIN BREAKDOWN
  12. 12. STAGE 3,,,FULL THICKNESS SKIN LOSS FAT EXPOSED • EPIDERMIS,DERMIS,SUBCUT TISSUE • FULL SKIN BREAKDOWN • MUSCLE,BONE,TENDON NEITHER EXPOSED NOR DAMAGED
  13. 13. STAGE 4,,,FULL THICKNESS TISSUE LOSS • DEEP ULCER • REACHES MUSCLE • BONE AND • TENDON
  14. 14. UN-CLASSIFIED • OCCASIONALLY,,, A DRY SCAB COVERS MORE SERIOUS AND DEEP INFECTED BED SORE
  15. 15. ASESSMENT FOR BED SORE • BRADEN SCORING SYSTEM • NORTON SCORE
  16. 16. 2 HOURS --- 2 WEEKS
  17. 17. COMPLICATIONS • CELLULITIS/ABSCESS • SEPSIS • BONE AND JOINT INFECTIONS • CANCER
  18. 18. COMPLICATIONS • MUSCLE ATROPHY • JOINT CONTRACTURES • PNEUMONIA • DVT
  19. 19. TREATMENT • ADMIT THE PATIENT • DEVISE A COMPLETE TREATMENT PLAN • MONITOR • FREQUENTLY RE-ASSESS
  20. 20. TREATMENT • SURGICAL • MEDICAL • NURSING CARE
  21. 21. SURGICAL • DEBRIDEMENT AND I/D • AUTOLYTIC • MECHANICAL • ENYMATIC • SHARP • BIOSURGICAL
  22. 22. SURGICAL,,,GRAFT AND FLAP
  23. 23. THE DRESSINGS • HYDOPHYLLIC • HYDROGEL • ALGINATE • FOAM • ACCUZYME • PANAFIL
  24. 24. MEDICAL • CONTROL OF MED ILLNESS • BALANCED DIET • ANEMIA • DEHYDRATION AND ELECTROLYTE IMBALANCE • ANTIBIOTICS
  25. 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. 26. PREVENTION IS BETTER THAN CURE
  27. 27. THE NURSING PERSPECTIVE
  28. 28. BEWARE,,,, • PATIENT IS OLD AGE • LIMITED PHYSICAL MOBILITY • MEDICAL ILLNESSESS • PROLONGED STAY
  29. 29. APPLY BRADEN SCALE
  30. 30. INSPECT • SKIN ,,,,, ESPECIALLY AT THE PRESSURE AREA • BOWEL/URINE • BED SHEET/PILLOW COVERS/DRESS • AIR MATTRESS
  31. 31. STAGE THE BED SORE
  32. 32. ENSURE • REGULAR MEDICATION • TIMELY DRESSINGS • REGULAR POSTURE CHANGE • HYGIENE • DIET INTAKE
  • AshliShaji2

    Oct. 25, 2021
  • JoanneAbdullah1

    Mar. 24, 2021

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

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