The presentation talks about BED sore, most common complication of spinal Cord Injury.
Definition
cause
Prevention
and Treatment
---------------------------------------
Video Links:
https://youtu.be/56sHJ3g_-Bw
https://youtu.be/wOq_4X2M_gY
https://youtu.be/tG3_1xvLo8I
https://youtu.be/pW88OX5mAqc
https://youtu.be/UGmwYCJiyz4
Burn is coagulative necrosis of the skin’s tissues, usually caused by excessive heat
Excess heat causes rapid protein denaturation and cell damage
Wet heat (scald) travels more rapidly into tissue than dry heat (flame)
A surface temperature of over 60˚C produces immediate cell death as well as vessel thrombosis
The dead skin tissue is known as Eschar
PRESSURE SORE/BED SORE/DECUBITUS ULCER
#surgicaleducator #pressuresore #bedsore #decubitusulcer #usmle #surgicaltutor #babysurgeon
• Dear Viewers
• Greetings from “Surgical Educator”
• Today in this episode I have discussed about Pressure Sore also known as bed sore or decubitus ulcer
• It is common in bed riddened patients who are having neurological problems like hemiplegia or paraplegia
• I have discussed about the overview,etiology,pathology,staging,clinical features,complications and treatment of Pressure Sore
• I hope this video is interesting and also useful to all of you
• You can watch the video in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thnak you for watching the video.
The presentation talks about BED sore, most common complication of spinal Cord Injury.
Definition
cause
Prevention
and Treatment
---------------------------------------
Video Links:
https://youtu.be/56sHJ3g_-Bw
https://youtu.be/wOq_4X2M_gY
https://youtu.be/tG3_1xvLo8I
https://youtu.be/pW88OX5mAqc
https://youtu.be/UGmwYCJiyz4
Burn is coagulative necrosis of the skin’s tissues, usually caused by excessive heat
Excess heat causes rapid protein denaturation and cell damage
Wet heat (scald) travels more rapidly into tissue than dry heat (flame)
A surface temperature of over 60˚C produces immediate cell death as well as vessel thrombosis
The dead skin tissue is known as Eschar
PRESSURE SORE/BED SORE/DECUBITUS ULCER
#surgicaleducator #pressuresore #bedsore #decubitusulcer #usmle #surgicaltutor #babysurgeon
• Dear Viewers
• Greetings from “Surgical Educator”
• Today in this episode I have discussed about Pressure Sore also known as bed sore or decubitus ulcer
• It is common in bed riddened patients who are having neurological problems like hemiplegia or paraplegia
• I have discussed about the overview,etiology,pathology,staging,clinical features,complications and treatment of Pressure Sore
• I hope this video is interesting and also useful to all of you
• You can watch the video in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thnak you for watching the video.
Cardiovascular history taking is an important skill that is often assessed in bedside teaching . It’s important to have a systematic approach to ensure you don’t miss any key information. The guide below provides a framework to take a thorough cardiovascular history.
this topic is on bed sores. discusses the definition, etiology , pathophysiology of bed sore development as well as prevention and managemene of pressure sores
Cardiovascular history taking is an important skill that is often assessed in bedside teaching . It’s important to have a systematic approach to ensure you don’t miss any key information. The guide below provides a framework to take a thorough cardiovascular history.
this topic is on bed sores. discusses the definition, etiology , pathophysiology of bed sore development as well as prevention and managemene of pressure sores
NRS international is an NGO, work for Disaster Affected people.NRS-International
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3. INTRODUCTION
• Pressure ulcers = damage of soft tissue that get
compressed between bony prominence and external
surface for prolonged period of time
• Risk groups: people who cannot avoid long-term
uninterrupted pressure over bony prominences
• Elderly
• Neurologic impairment
• Acute hospitalization
4. COMMON LOCATIONS
• Hip and buttock 70%
• Ischial tuberosity,trochanteric and sacral locations
• Lower extremities 15-25%
• Malleolar, heel, patellar and pretibial locations
• Others
• Nose, chin,forehead,occiput,chest,back, elbow
ทุกที่สามารถเกิด pressure sore ได/
5. ETIOLOGY OF PRESSURE SORE
• Impaired mobility
• prolonged uninterrupted pressure
• Muscle and soft tissue atrophy à bony prominences got less protection
• Inability to perceive pain: most important stimuli for repositioning
• Friction and shear forces: eg. Spasticity,moving of patient
• Skin tear à bacterial contamination, water loss, maceration and adherence to clothing
• Quality of skin
• Atrophy, decrease rate of turnover, loss of vascularity,flattening of dermal-epidermal
junction
6. ETIOLOGY OF PRESSURE SORE
• Incontinence or fistula
• moist à maceration (ผิวเป34อย) + bacterial reservoirs
• Bacteria: contamination à delay or prevent wound healing
• Poor nutrition
• Malnutrition, hypoproteinemia, anemia à contribute to tissue
vulnerability and delayed wound healing
8. n
• Complex process
• External forces to the skin (Host-specific factor)
PATHOGENESIS
9. n
Pressure
PATHOGENESIS
Excess of arteriolar pressure > 32 mmHg
Venous capillary closing pressure > 8-12 mmHg
Oxygen and Nutrient to tissue
Tissue hypoxia
Wasted product and free radical
10. n
• Most susceptible tissue to pressure – induced injury
Muscle >> Subcutaneous fat >> Dermis
• Greatest pressure at bony prominence area
cone - shaped distribution
PATHOGENESIS
11.
12.
13. n
• Sitting position : ischial tuberosity (100mmHg)
• Supine position : sacrum (150mmHg) and heel
(40mmHg)
• Prone position : knee and chest (40mmHg)
• Lateral decubitus position : greater trochanter
PRESSURE DISTRIBUTION
INTERIOR
15. n
• Body Level One
• Body LevelTwo
• Body LevelThree
• Body Level Four
• Body Level Five
Eros et accumsan et iustoodiodignissimquiblandit praesent luptatum
INTERIOR
29. GENERAL PRINCIPLES
◦multidisciplinary of wound care teams
◦debridement of necrotic tissue
◦maintain moist wound environment (healing,
relief pressure)
◦Address host issues (nutrition, metabolic,
circulatory status)
◦Promote healing of the wound bed
◦appropriate dressings or wound packing
◦Prevent recurrence
35. POST OPERATIVE CARE
• Continuous care similar to pre-operative care
• Relief pressure
• Psychosocial
• Rehabilitative care
• Drain
• Prevent contamination (feces, urine)
• Prevent recurrence
36.
37. SPECIFIC TREATMENT - GUIDED
BY STAGE
• Stage 1 :
• covered with transparent film
• protection & prevent from more serious ulcer
38. • Stage 2 ulcers
• Require moist wound environment & little debridement
• avoid wet-to-dry dressings.
• Semi-occlusive (transparent film) or occlusive dressings (hydrocolloids or hydrogels)
•Enzymes normally present in the wound
base—>digest necrotic tissue
•Contraindication:infection
39. • Stage 3 and 4 ulcers
•Debridement of necrotic tissue
•cover with appropriate dressings
•treat infection.
51. SECONDARY FACTORS
• Illness or debilitation
• Fever àincreases metabolic demands
• Predisposing ischemia
• Diaphoresis àskin maceration
• Incontinence àskin irritation and contamination
• Other factors:edema,jaundice, pruritus, and xerosis (dry
skin)
52. INTERVENTIONS
• Scheduled turning and body repositioning
• Appropriate bed positioning
• Protection of vulnerable bony
• Skin care
• Alertness for skin changes
• Use of support surfaces and specialty beds
• Nutritional support - enteral or parenteral nutrition or vitamin therapy
• Maintenance of current levels of activity,mobility,and range of motion