Beware of winter's uninvited guest, "pressure sores"! Here's what we can do

As the Minor Cold approaches, the weather is getting colder, and people are wrapping themselves up tightly and reducing outdoor activities as much as possible. Especially for people with limited mobility, turning over in the cold weather has become a big problem for them.

Pu Qunwang, deputy chief physician and director of the General Surgery Department of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (affiliated hospital of Hunan Provincial Institute of Traditional Chinese Medicine), reminded that during this special period, family members need to pay special attention to the physical condition of this group of people. Because of long-term bed rest or long-term sitting in a wheelchair, the body will be under continuous pressure, and the heavy winter clothing makes the body's perception relatively dull. These factors combined make pressure sores slowly come to the door without knowing it.

1. What is a pressure ulcer?

Pressure sores are also called pressure injuries, pressure ulcers, and bedsores. They are caused by long-term pressure on local tissues of the body, especially on bony protrusions, resulting in continuous ischemia, hypoxia, and malnutrition, leading to tissue ulceration and necrosis.

Due to reduced activities in winter, pressure sores develop quickly and are difficult to detect. By the time they are discovered, the skin has already rotted for several days, causing great pain to the patients and increasing the difficulty of care.

2. What are the common areas for pressure ulcers?

1. Sitting position: ischial tuberosity, shoulder blades, feet, elbows, etc.;

2. Supine position: occipital protuberance, scapula, elbows, sacrum, heels, etc.;

3. Prone position: forehead, cheeks, elbows, ears, chest, male genitals, iliac spines, knees, toes, etc.;

4. Side-lying position: ears, acromion, ribs, greater trochanter of femur, medial and lateral malleolus, etc.

3. Who are the groups of people most susceptible to pressure ulcers?

People who are weak, malnourished, lack muscle and fat protection, the elderly, obese people, long-term bedridden patients, edema patients, and patients with incontinence are all prone to pressure sores.

4. How to identify and prevent it in daily life?

Deputy Chief Physician Pu Qunwang suggested that the following three steps can be taken to prevent and treat pressure sores:

Step 1: Identify the severity of your symptoms

Stage I: Intact skin with erythema that does not fade with pressure. Treatment: Reduce pressure, remove risk factors, and avoid further pressure.

Stage II: blisters, skin breaks or partial skin loss. Treatment: hydrocolloid dressing or foam dressing for protection.

Stage III: The wound surface has yellow exudate and is covered with pus after infection. Treatment: Remove necrotic tissue, control infection, promote granulation growth, and protect new epithelium.

Stage IV: The wound surface is black and smelly, with visible fascia, muscle, tendon, ligament or eschar, accompanied by undercover or sinus tracts. Treatment: Remove necrotic tissue, control infection, promote granulation growth, and protect new epithelium.

Unstageable: Covered by eschar, unable to be staged. Treatment: Remove necrotic tissue, control infection, promote granulation growth, and protect new epithelium.

Deep tissue pressure injury: The skin is intact, but purple or brown color changes occur, or blood-filled blisters appear. Treatment: Observe skin changes closely. If blisters or eschars appear, treat them as above.

Step 2: Check and seek medical treatment, go to the hospital for examination in time

1. Skin examination to determine the grade of pressure sores;

2. Culture the secretions from the sore surface to check for infection;

3. Check blood routine to see if there is any infection and nutritional status.

Step 3: Preventive treatment, and achieve six diligences and one good

First, be active. Do not lie in the same position for more than 2 hours. Avoid rough movements such as pushing, pulling, dragging, and pulling when turning over. Use pressure relief tools such as air mattresses and turning pillows. When lying on your side, try to choose a 30° side-lying position. You can use a 30° body position cushion (R-type cushion) or pillow for support. The order of turning over is left side - right side - supine.

Second, be diligent: Scrub frequently. Avoid moist stimulation: Patients with incontinence should be scrubbed clean in time, kept clean and dry, and should not lie on non-breathable cloth.

Three diligences: Frequent activities. Passive limb exercises can be performed to maintain joint mobility, promote blood circulation in the limbs and skin, and reduce the occurrence of pressure sores.

Fourth, change frequently. Keep bed sheets, quilt covers and clothes clean and dry, and change them as soon as they get wet.

Fifth diligence: observe diligently. When washing the elderly and changing their clothes, observe carefully to see if there are any redness, blisters, or ulcers on the skin. If any problems are found, consult professional medical staff in time, and early pressure sores should receive professional treatment as soon as possible.

Sixth diligence: Regularly organize. Make sure the sheets and clothes are flat to avoid wrinkles that may damage the skin.

One good thing: good nutrition. Strengthen nutritional support. For the elderly who are malnourished, thin, and weak, their diet should be adjusted reasonably, and they should be given high-protein, high-calorie, high-fiber, and easily digestible foods, and eat more vegetables and fruits.

Expert reminder:

**Pu Qunwang, deputy chief physician and director of the General Surgery Department of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (affiliated hospital of Hunan Provincial Institute of Traditional Chinese Medicine), reminds: **Although the quilt is warm in winter, don't be greedy. Long-term inactivity will undoubtedly provide an opportunity for pressure sores. Turning the body more and moving more can prevent pressure sores from coming. Skin protection needs to start immediately.

Hunan Medical Chat Special Author: Jiang Minna and Tan Yanmei, General Surgery, Hunan Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine)

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(Edited by YT)