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Pressure ulcers, commonly known as pressure ulcers, were renamed pressure injuries in the latest 2016 pressure ulcer guidelines. It refers to localized injury to the subcutaneous tissue caused by pressure or pressure combined with shear forces, and is commonly found at the site of the bony carina. However, pressure injuries can also be associated with the use of medical devices or other devices. It can manifest as an intact ** or open ulcer and may be painful. Internationally, pressure injury is listed as one of the adverse events that seriously endanger the health and safety of patients, and it is also one of the complications with the heaviest medical burden. Therefore, there is an urgent need to address the question of how to prevent pressure injuries in older people who have been bedridden for a long time.
Ms. Fang is a patient with heart failure and a pressure injury. Li Jing, an international ostomy specialist at the hospital, found that Ms. Fang's tail had an unstaged, 7*5cm pressure injury, and the wound continued to ooze foul-smelling pus, which made Ms. Fang's daughter feel painful. After a comprehensive assessment of the wound, Li Jing formulated a ** plan. She instructed the family members to use the turn-over decompression equipment to effectively turn over and keep it clean and dry. At the time of wound debridement, it was found that the injury had reached the muscle layer, and the diagnosis was confirmed as stage 4 pressure injury. Li Jing used the theory of wet healing to care for her patients' wounds, and after a period of time**, Ms. Fang's wound condition improved. However, due to her condition, Aunt Fang needed to be transferred to other hospitals for further **. In view of the fact that there is no professional wound doctor in the transfer hospital, Li Jing used the Internet to remotely guide Ms. Fang to change dressings. After more than 4 months, Ms. Fang's wound was finally cured. Ms. Fang's family said excitedly: "I didn't expect such a serious pressure ulcer to be cured, thank you so much." ”
Taking care of the bedridden elderly needs to be "five diligence and one strengthening". The first is to turn over frequently, for the elderly who are bedridden, turning over is the easiest and most effective way to relieve stress, at least once every 2 hours. The second is to scrub frequently, keep the best clean, and often scrub the body for the elderly. The third is diligent exercise, for the elderly who have been bedridden for a long time and have no ability to move independently, caregivers should carry out passive limb exercises every day to maintain the mobility and muscle tone of the joints as much as possible, promote the blood circulation of the limbs and **, and reduce the occurrence of pressure injuries. The fourth is to change frequently, keep bed sheets, quilts and clothes clean and dry, and change them at any time. Finally, it is diligent observation, scrubbing the body of the elderly every day, changing clothes, carefully observing, paying attention to whether there is redness, blisters, ulcers and other phenomena, once the problem is found, consult professional medical personnel in time, so that the early pressure injury can be professionally cared for. In addition, it is important to strengthen nutritional support. For the elderly who are deficient, emaciated, and frail, the dietary structure should be reasonably adjusted, and high-protein, high-calorie, high-fiber, and easy-to-digest foods should be given, and more vegetables and fruits should be eaten.
It is hoped that the prevention of pressure injuries will be deeply rooted in the hearts of the people and that everyone's awareness and attention to prevention will be raised. Only by working together can we protect the well-being of the elderly and make their lives more comfortable and healthy. According to statistics, the incidence of pressure ulcers in China is as high as 25 among the elderly who need long-term home care8%。However, the public's awareness and attention to the prevention of pressure injuries are far from enough. Therefore, it is necessary to strengthen the publicity and popularization of basic knowledge of pressure injury prevention and treatment. The most effective measure for pressure injuries is early identification of risk factors and early prevention. This work requires not only the efforts of medical staff and patients, but also the active participation of the whole society to jointly create a good environment. By taking appropriate measures, the incidence of pressure injury can be effectively reduced.
Expert profile: Li Jing, deputy chief nurse of the Department of Orthopedics of Shenyang Red Cross Hospital, an international ostomy specialist, a member of the International Association of Ostomy Specialists (WCET), and holds an infusion port technical certificate from the National Nursing Training Center.