Can topical ointments be used for bedsores?

Bedsores are a type of blister, ulcer, or gangrene caused by long-term compression of blood circulation. Generally, comatose or paralyzed patients, those who are bedridden for a long time, and those with mixed physical constitutions are more likely to develop bedsores. Topical ointments can be used, but the main thing is care. If the care is adequate, bedsores will generally not occur.

Symptoms and signs

It often occurs at the site of pressure on bony protrusions and can be divided into three degrees according to its occurrence and development process: First degree: Local manifestations are only erythema and edema, or pale, bluish-gray, with clear boundaries. Numbness or tenderness. If treated promptly, the condition can improve within a few days. Second degree: The skin color is dark purple or purple-black, blisters may appear, and superficial erosions form after the blister walls rupture. Third degree: Ulcers are formed, the shallow ones reach the subcutaneous tissue, and the deep ones can reach the bone tissue. After secondary infection, there is a lot of pus and a foul odor.

Medication

Treatment of bedsores should start early. The principle is to relieve pressure on the affected area, promote local blood circulation, and strengthen wound treatment. First-degree bedsores should be treated with regular massage, changes of body position, local application of alcohol or infrared irradiation. If inflammation is severe, 0.5% neomycin solution can be used for wet compresses. Second-degree bedsores can be treated with antibiotic ointment and covered with sterile gauze. Third-degree bedsores should be cleaned and treated. For small ulcers, 0.5% silver nitrate wet compresses can be applied externally to remove infection. At the same time, drugs that promote the formation of granulation tissue can be used externally. If the ulcer is large and clean, split-thickness skin grafts or full-thickness skin flaps can be used. For gangrenous ulcers, necrotic tissue should be removed and the above treatment should be performed after sufficient drainage. It is advisable to regularly culture and perform drug sensitivity tests on the pus on the wound surface to guide the selection of sensitive antibiotics for external use. If there are no signs of systemic infection, systemic antibiotics are generally not required. In addition, supportive therapy should be strengthened for critically ill patients.

1. Traditional Chinese Medicine:

Treatment method: Invigorate Qi, dredge meridians, nourish blood and moisturize the skin.

Prescription: 15g of Astragalus, 15g of Codonopsis, 10g of White Peony Root, 15g of Millettia Spatholobi, 10g of Angelica Sinensis, 5g of Ligusticum chuanxiong, 10g of Carthamus tinctorius, 15g of Salvia miltiorrhiza, 15g of Lycopodiella Cervi Pantotrichum, 15g of Lonicera japonica, 15g of Forsythia suspensa, and 10g of Tangerine Peel. If the flesh is rotten and festering, add Angelica dahurica and Platycodon grandiflorum to draw out the toxins and discharge the pus. If the flesh is rotten and does not fall off, add fried pangolin and fried soapberry.

Single prescription medicines: You can take Bazhen Pills and Ginseng Yangrong Pills.

2. Local treatment

(1) For local redness and swelling, apply lithospermum officinale oil or apply a thin layer of purple anti-edema ointment.

(2) In the early stages of ulceration, if the wound is superficial, apply Huadusan ointment or purple swelling-reducing ointment externally.

(3) For wounds, use the traditional Chinese medicine method of removing dead tissue and regenerating new tissue:

① If there is necrosis (dead flesh) on the sore surface and the inflammation is still spreading, and the boundary between the necrotic tissue and the healthy skin is unclear, it is advisable to use equal amounts of purple carbuncle ointment and detoxification ointment, mix well and apply externally.

② When the necrotic tissue (dead flesh) has reached deep into the muscle, or even deeper and formed a sinus tract, it is advisable to use a red blood medicine twist, dip it in purple carbuncle ointment and insert it into the sore, and then cover it with Huadusan ointment.

③ When the necrotic tissue is clearly separated from the normal skin and begins to fall off, it is advisable to use equal amounts of purple carbuncle ointment, Huadusan ointment, and Ganru ointment, mix well and apply externally.

④ When the necrotic tissue has fallen off and new granulation tissue begins to grow on the wound surface, it is advisable to use 80g of sweet milk ointment and 20g of purple carbuncle ointment, mix well and apply externally.

⑤ When the new granulation tissue grows well and epithelium has grown on the edge of the sore, it is advisable to sprinkle a thin layer of pearl powder on the sore surface, and then cover it with an oil gauze strip made of sweet milk ointment.

⑥ During the medication period, if eczema-like changes appear around the sore surface, you can use Qushisan and licorice oil to apply.

Diet and health care

Choose fresh and nutritious food to supplement every day, eat small meals frequently, 5-6 meals a day. Don't eat spicy food or some hairy foods.

Preventive Care

The key to preventing bedsores is to do the following:

1. Medical staff should increase their sense of responsibility.

2. Avoid long-term local pressure. Patients with decreased muscle tone, cerebral hemorrhage and deep coma should be turned over every 30 to 60 minutes, and those with normal muscle tone should be turned over every 2 hours. If conditions permit, various medical devices can be used to reduce local tissue pressure or make it alternately pressurized, such as pulse air pressure cushions and jet medical air cushions.

3. Keep your skin clean and dry.

4. Keep the bed surface flat, clean and soft.

5. Change local blood circulation, such as frequently massaging the area with 50% alcohol, and then applying talcum powder 2 to 4 times a day.