Compression ulcers: learning how to avoid this complication

I hope you are all having a good start of the week and that this week will be of much benefit to everyone. Do not neglect your health, it is always a good time to stay healthy.

Today I want to talk about a topic that affects the health of many patients who for various reasons are bedridden, that is, they cannot move around on their own. Obviously, if they cannot do so, it is because they already have a disease or condition that limits them, but this same condition can cause other situations to affect them, and that is precisely what I want to talk about, the Compression ulcers, which are so common in immobilized patients.

I would like to share in this publication some interesting points such as the reason why they are formed, the complications they can produce but above all how to avoid them. If you have a family member who is immobilized or know someone who is, I invite you to read on because what I have to tell you will surely interest you.

Compression ulcers are wounds that occur due to prolonged pressure on an area of the body. That is why it is -unfortunately- common to find them in people who are bedridden, but who are not given the respective maneuvers to avoid them, which will be emphasized later on.

Before continuing, I would like to make a parenthesis here, and that is that in general these maneuvers are known to the nursing staff, and in general it is these professionals who are in charge, however, I consider that it is not logical that a physician, knowing that this can happen, does not warn the relatives, and can also give them the respective orientations to avoid possible complications.

Let us remember that every part of our organism is irrigated by blood and lymphatic vessels, which, when suffering constant pressure are compressed and the blood flow is compromised, which on the one hand would prevent cellular metabolic waste and remain concentrated in a specific space, and on the other hand, nutrients, oxygen, nor anything necessary for tissues to stay healthy arrive.

This is why when pressure is exerted on the same body space for hours, days, weeks, the tissue will be highly affected and necrosis will occur, with ulcer formation as a result. The most common compression points are the following:

The consequences of this constant pressure on a particular area are very strong and usually require months or even years to heal once they are established, therefore, it is best to avoid it. Among the main complications of compression ulcers are the following:

• Tissue necrosis: as I mentioned earlier, tissue necrosis is usually common in view of the fact that the blood supply is limited, which in itself will bring consequences.

• Infection: As it is a wound in the skin, with diminished circulation, which means that the defense mechanisms are diminished, the predisposition to infections is high.

• Difficulty in healing:without adequate blood circulation, the necessary nutrients do not arrive for the tissues to be restored, which is why healing is usually very limited.

• Amputation: if complications occur where the most superficial tissues are highly compromised, for example muscle and bone in the lower limbs, amputation may be the only way to avoid systemic complications.

• Sepsis: is a systemic response to infection that can lead to organ failure and death. It is characterized by a systemic inflammatory response, which can cause changes in heart rate, respiratory rate, blood pressure and body temperature, as well as dysfunction of various organs and systems. (I will be talking about this in my next post, so don't miss it) The same infection that occurs at the site of the ulcer can cause a septic condition to develop.

I know it is not nice to see certain images, but it is even less nice to have a person who can be spared a problem like this suffer from it.

Image for free use / Large ulcer in sacral region

In these cases the main thing is to prevent them from appearing because it is really very difficult to eliminate them. And I can tell you from my own experience that depending on the patient's condition they can begin to appear in a matter of hours, where we can see a reddening in the areas of compression.

The best thing to do is to avoid it, and we can do it by considering the following:

• Avoid prolonged pressure on an area of the body, especially in areas of greater vulnerability such as the heels, buttocks and lower back.

• To avoid the above, it is important to move the patient, to change position frequently, at least every 2 hours if the patient is in bed, and every hour if the patient is sitting.

• Use an air mattress or a foam pillow to redistribute pressure.

• Use graduated compression stockings if you have circulation problems.

• Keep skin clean and moisturized, and detect and treat injured or irritated areas of skin promptly.

• Weight control and physical activity are also important to prevent compression ulcers. Mobilizing the upper and lower limbs is important.

• Constant monitoring and evaluation of the patient to detect any changes in health status and prevent possible complications.

Pixabay/ Author: AlexanderGrey

I wanted to share information about this because just yesterday I was consulted by a friend in a case that has been complicated with this situation of compression ulcers at the level of her father's left heel.

I took a long time to guide her, she was already with an infection that deserved antibiotic treatment, and this is something that has been avoided, however, there is nothing left but to deal with the current reality, and hope that the situation can soon be solved, although I know that it will not really be something fast.

I know that this is not a purely medical issue, but it is about human health and above all about prevention. I hope that this post works for all of you and that you can guide other people with the information that I have provided here. If you have something to add you can leave it in the comments and we can all help each other.

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• Links consulted

• Pressure ulcers: prevention and management

• Pressure ulcers

• Preventing Pressure Ulcers: A Patient’s Guide