Pressure Ulcers: Care and Treatment for Bedridden Patients

Pressure ulcer

My mother-in-law is elderly and has been bedridden for a long time, which has led to the development of pressure ulcers.
She is currently receiving treatment at your hospital.
This morning, she had a fever, but Dr.
Yang informed the family that she could be discharged, which I find quite concerning.
Therefore, I have some questions regarding her care at your hospital.
To provide some context, on the morning of July 29, my mother-in-law had a fever, and we administered antipyretics before going to register for an appointment.
She had previously visited the emergency department on July 28, where the doctor advised us to return home after the fever subsided.
Today, we registered for the internal medicine department, and the receipt number is 07290110025.
The internal medicine physician indicated that we needed to see a dermatologist, so I was instructed to register for dermatology.
The dermatology receipt number is 07290210147.
The dermatologist then referred us to the surgical department, and the staff assisted in transferring us there.
The surgical receipt number is 0729-08-10075.
The National Health Insurance Bureau mentioned that we are wasting resources, and I will forward this information to them as well.

Wu, 50~59 year old female. Ask Date: 2002/07/31

Dr. Zheng Lizhen reply Dermatology

The handling has been explained to the patient's family in person.

Reply Date: 2002/07/31

More Info

Pressure ulcers, commonly known as bedsores or decubitus ulcers, are a significant concern for bedridden patients, particularly the elderly. These ulcers develop due to prolonged pressure on the skin, often over bony areas, which can lead to tissue damage and, if left untreated, serious complications such as infections. Understanding the care and treatment of pressure ulcers is crucial for improving the quality of life for patients like your grandmother.

Causes and Risk Factors
Pressure ulcers occur when blood flow to a particular area of the skin is restricted for an extended period. Factors contributing to their development include immobility, poor nutrition, moisture (from sweat or incontinence), and friction or shear forces on the skin. In your grandmother's case, her long-term bedridden status is a significant risk factor.

Signs and Symptoms
The initial signs of a pressure ulcer may include:
- Redness or discoloration of the skin that does not blanch (turn white) when pressed.

- Changes in skin texture or temperature (warmer or cooler than surrounding areas).

- Pain or tenderness in the affected area.

As the ulcer progresses, it can develop into more severe stages, leading to open wounds that may expose underlying tissues, muscle, or bone.

Care and Treatment
1. Regular Position Changes: One of the most effective preventive measures is to change the patient's position every two hours to relieve pressure on vulnerable areas. This can significantly reduce the risk of ulcer formation.

2. Skin Care: Keeping the skin clean and dry is essential. Use mild soap and water to cleanse the skin, and ensure that the skin is thoroughly dried afterward. Moisturizers can help prevent dryness, but avoid applying them to areas at risk of ulceration.

3. Nutritional Support: Proper nutrition plays a vital role in skin health and wound healing. Ensure that your grandmother receives a balanced diet rich in proteins, vitamins, and minerals. If necessary, consult a dietitian for tailored nutritional advice.

4. Use of Support Surfaces: Specialized mattresses and cushions can help redistribute pressure and reduce the risk of ulcers. These include foam, gel, or air-filled devices designed to alleviate pressure on vulnerable areas.

5. Wound Care: If a pressure ulcer has developed, appropriate wound care is crucial. This may involve cleaning the wound, applying dressings, and possibly using topical treatments to promote healing. It's essential to follow the guidance of healthcare professionals regarding wound management.

6. Monitoring for Infection: Since your grandmother has developed a fever, it's important to monitor for signs of infection, such as increased redness, swelling, or discharge from the ulcer. If an infection is suspected, prompt medical attention is necessary.

When to Seek Further Medical Attention
Given your concerns about your grandmother's condition and her recent fever, it is crucial to communicate with her healthcare team. If the medical staff has suggested discharge but you feel uncertain about her readiness, do not hesitate to express your concerns. It is your right as a caregiver to seek clarity on her treatment plan and the rationale behind the discharge decision.

If her condition appears to be worsening or if you notice any signs of complications, such as increased pain, swelling, or systemic symptoms (like fever), it may be appropriate to request a reevaluation. Additionally, if the pressure ulcer is not improving or is worsening, further intervention from specialists, such as dermatologists or wound care experts, may be necessary.

Conclusion
Pressure ulcers are a serious health issue for bedridden patients, and their management requires a comprehensive approach involving prevention, proper care, and monitoring. Your vigilance as a caregiver is vital in ensuring that your grandmother receives the appropriate care and treatment. If you have any doubts about her treatment plan or condition, do not hesitate to seek a second opinion or further clarification from her healthcare providers.

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