Categories
Herbs & Plants

Arizona poppy

Botanical Name :Kallstroemia grandiflora
Family: Zygophyllaceae
Subfamily: Tribuloideae
Genus: Kallstroemia
Kingdom: Plantae
Order: Zygophyllales

Synonym(s): Arizona poppy, orange caltrop, summer poppy

Common Name :Caltrop,Arizona Poppy,Arizona Caltrop, Mexican Poppy

Habitat :Kallstroemia grandiflora is native to tropical and warm temperate regions of the Americas. Desert, Upland. It grows in desert washes, along roadsides, and in sunny, open areas.

Description:
Flower Color: Golden orange, Golden yellow

Flowering Season: Summer, Fall (early). This wildflower blooms after the summer monsoon rains have begun.

Height: Sprawling to 3 feet (91 cm) long

The flowers are up to 2 1/2 inches (6 cm) wide and have 5 petals with raised, orange veins and dark red-orange at the base of the petals. In favorable areas, the blooming plants can create large-scale wildflower displays. The flowers are followed by bristly, beaked fruits that split into 10 nutlets. The leaves are green, opposite, and pinnately compound with paired, oval leaflets. The stems are hairy and sprawling.

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Categories
Ailmemts & Remedies

Cuts and Bleeding

Definition:
•Cuts, lacerations, gashes and tears (Wounds that go through the skin (dermis) to the fat or muscle tissue)
•Scrapes, abrasions, scratches and floor burns (Superficial wounds that don’t go all the way through the skin)
•Bruises (bleeding into the skin) without an overlying cut or scrape

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When Sutures (stitches) are Needed
•Any cut that is split open or gaping needs sutures.
•Cuts longer than ½ inch (12 mm) usually need sutures.
•On the face, cuts longer than ¼ inch (6 mm) usually need closure with sutures or skin glue.
•Any open wound that may need sutures should be checked and closed as soon as possible (ideally, within 6 hours). There is no cutoff, however, for treating open wounds to prevent wound infections.

Cuts Versus Scratches: Helping You Decide
•The skin (dermis) is 2 mm (about 1/8 inch) thick.
•A cut (laceration) goes through it.
•A scratch or scrape (wide scratch) doesn’t go through it.
•Cuts that gape open at rest or with movement need closure to prevent scarring.
•Scrapes and scratches never need closure, no matter how long they are.
•So this distinction is important.

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Symptoms:
Bleeding usually follows some sort of traumatic incident.

Dark red blood may ooze from small skin scrapes, or flow quickly from larger cuts. If an artery is damaged, the blood will appear brighter red and may spurt in pulses from the wound.

If there has been an accident involving glass, it may be possible to see the glass in the wound. This can be particularly painful, especially if the child tries to move the affected area.

In major accidents, broken bones occasionally stick out through a cut.

Causes:
Most children have scrapes, falls, cuts and bruises as they learn to walk, climb and understand how to manoeuvre to avoid dangers.

Even tiny amounts of blood can seem like a lot to a child, so bleeding may frighten them because they don’t understand the blood loss will stop when clotting occurs.

You hear a loud thud and then screaming from the next room. You run in to find your three-year-old sitting on the floor, holding her forehead, while blood streams down her face. You look at the cut and blood seems to be pouring out. By the time you get her to the ER, her whole shirt and the back of your car looks like it’s covered in blood, but your daughter actually appears well. You are confused, and perhaps embarrassed, when the ER nurse takes a look at the wound and says, “oh, she’ll be alright. It’s just a little cut.”

This scenario happens to many parents. It is often difficult to assess cuts, especially when they are actively bleeding. Here is the Dr. Sears guide to what to do if your child is injured with a cut or scrape, how to decide if stitches are needed, and guidelines for proper wound care for scrapes and stitches.

Treatment:
In most cases, blood loss is minor and soon stops of its own accord. Gentle pressure on the wound can help to slow blood loss. A clean, dry pad or plaster can also be applied to keep the wound clean.

For actively bleeding cuts:
*Step one is DON’T PANIC. If you stay calm, then your child may stay calm also.
*Step two is to cover the cut with whatever you can get your hands on the fastest. If you can cover the cut quickly, then your child will panic less.
*Step three is to look at the cut. Get an initial impression if it is minor or major.
*Step four is to stop the bleeding. Find a more appropriate item such as a clean towel or cloth and gently but firmly press it to the cut. Don’t keep peeking underneath every 10 seconds. Hold it in place for at least two minutes (longer if necessary).
*For cuts that involve a large bump or bruise, such as on the head, you may also want to apply some ice wrapped in the towel.
*Once the bleeding has stopped or dramatically decreased, take a closer look at the wound to assess how severe it is. Proceed to the next step below.

THERE IS BLOOD EVERYWHERE!YOU ARE  WORRIED YOUR CHILD HAS LOST TOO MUCH BLOOD!
Try to remain calm. It is virtually unheard of for any one to lose so much blood from a cut that it puts them in any danger. Cuts on the head and face bleed more than anywhere else on the body. This is because there are many more blood vessels in the skin here. Many parents worry that these cuts have caused a lot of blood loss. You can rest assured; the blood looks like a lot more than it really is.

HOW DO YOU DECIDE IF YOU SHOULD GO TO THE DOCTOR?
Simple cuts that do not require stitches do not need to be seen by your doctor.If it is obvious that your child does need stitches, do not rush in to your doctor’s office. Instead, call the office to find out what time would be best to come in. Since stitches usually take at least a half hour to do in the office, most offices would prefer to try to make some time later during the day, rather than squeezing you in immediately. Some offices may prefer to direct you to an ER or a plastic surgeon for the stitches, so calling ahead may save you a trip.

If you are not sure whether or not stitches are needed, here are some guidelines:

*Check to see if the cut is gaping open. If it is not, then gently tug on it to see if it gapes open. If it does, than it probably will need to be closed.
*Any cut that is gaping open with visible dark red muscle or yellowish fat should probably be closed, even if it is small.
*Any cut that is gaping and is larger than ½ cm (or 3/16 of an inch) should probably be closed. Get a ruler and measure it if you are not sure. Cuts smaller than this may not require closure, but if they are gaping, than it is best to have a doctor check out the cut.
Small cuts that are not gaping may not require actual stitches, but may still benefit from steri-strips (see below)
*Any cut, even a small one, that is gaping open on the face should be seen by a doctor because of the risk of a scar.

There are two main reasons to get stitches:1. To stop active bleeding. If a cut is large and continues to bleed, then closing it is obviously beneficial. Most cuts, however, will stop bleeding after a while if pressure is applied with a towel or cloth.2. For cosmetic reasons. Cuts on the face obviously will have a better cosmetic outcome if they are closed. However, for a small cut on a body part where you are not concerned about a scar, then closing it is not as important. Decide if the trauma of doing stitches will be worth it.

HOW SOON YOU NEED TO SEE A DOCTOR FOR STITCHES?
Most cuts can generally be closed as long as 24 hours after the accident. Some cuts should be closed sooner, but it is very safe to wait at least 8 hours to have a cut closed. Therefore, if the cut occurs at night, it is generally ok to wait until the next morning, as long as you can get the bleeding to stop. Very important – if you do decide to wait, wash the cut under the faucet to get out any dirt. Do not let the cut dry out. The best thing to do is to buy a bottle of sterile saline and some gauze. Wet the gauze and tape it over the cut. Change this every two hours to keep it moist. If you cannot do this, then put some antibiotic ointment on the cut and cover it with gauze or a band-aid. Repeat this every few hours to keep it moist. Stitches generally don’t require urgent care.

FOUR OPTIONS FOR CLOSING A CUT
There are four ways to close a cut. Your doctor will discuss these options with you:

1. Steri-strips. Also known as “butterfly” strips, these narrow strips are placed over the cut, with a bit of tension to keep it closed. A sticky liquid is placed on the skin to hold the strips on. These generally stay on for 2 to 5 days if kept dry and not accidentally pulled off. These are used for cuts that are small, not gaping open, not very deep and not over a joint or area of skin tension. If they stay in place for at least three days, the outcome can be just as good as stitches or even better because steri-strips avoid the “railroad track” appearance of some stitch lines. A big advantage is that they are quick and painless. A disadvantage is that they are not as strong and will not stay in place as long as stitches.

2. Stitches. These have the advantage of providing more strength and little to no risk of being pulled off too soon. An obvious disadvantage is the time and pain involved in putting them in.

3. Skin super glue. This is a skin glue that is applied by rubbing it over the cut while the cut is being held closed. It has the advantage of being quick and painless. It is a good choice for clean, straight cuts that are not gaping too much nor under tension. If you are hesitant to put your child through the trauma of stitches, but steri-strips are not enough, then this may be an option. If done well, the cosmetic outcome is the same as stitches.

4. Staples. These are often used in the scalp (within the hair). They are very fast, and close the cut almost as well as stitches.

WHO SHOULD DO THE STITCHES? A PLASTIC SURGEON, THE PEDIATRICIAN, OR AN ER DOCTOR?
No matter who does the stitches, there will be at least a slight scar. Even the best plastic surgeon in the world will leave a scar. It is, however, important to minimize the scar. Parents are naturally worried about this. Here are some suggestions on deciding where to have the stitches done.

*Plastic surgeon. The most common reason to use a plastic surgeon is for cuts on the face. An ER doctor or pediatrician could easily handle very small cuts on the face, but a plastic surgeon will be most able to minimize the scar. You can have the stitches done in the surgeon’s office or in an ER by the surgeon.
*ER doctors have the advantage over pediatricians of doing stitches more often. They often put in stitches several times a day. This allows an ER physician to become quite skilled in stitches.
*Your pediatrician. For simple cuts anywhere besides the face, your pediatrician is probably the best place to go for the stitches, unless the office is very busy that day. Remember, there will be a scar no matter who does the stitches. Your pediatrician will do an excellent job in minimizing the scar.

HOW DO YOU TAKE CARE OF THE WOUND AFTER IT IS CLOSED?
Ask your doctor for some specific guidelines on proper wound care. Here are some general guidelines to follow:

*For 24 to 48 hours, do not allow it to get wet in the bath or shower.
*After 48 hours, it is ok to get the wound wet.
*Steri-strips are an exception. Keep them dry for at least 5 days. After that, they have been on long enough and you may get them wet to encourage them to come off. Do not pull them off unless they come off easily.
*Avoid the build-up of a scab. A thick scab within the wound can increase the scar and prevent the skin from growing together well. You can prevent scab build-up by dabbing diluted peroxide (½ water mixed with ½ peroxide) to the wound and then gently removing any loose scab. Do not pick away any scab that is still firmly stuck. Wait for it to loosen up from the peroxide. Do this twice a day.
*Apply antibiotic ointment twice a day.
*Keep the wound covered for at least 48 hours. You can continue to cover it if it is convenient to do so for several more days.
WHAT CAN YOU DO FOR THE LONG-TERM TO MINIMIZE THE SCAR?
*Sun protection. Damaged skin is very susceptible to becoming permanently discolored by the sun for up to 6 months following an injury. It is very important to minimize sun exposure to the healing cut. Keep it covered with a hat or clothing as much as possible. When necessary (especially for long days at the park, beach, or swimming pool), apply a strong sunscreen or even a sun block (the white stuff that doesn’t soak in). Do not apply sunscreen until two weeks after the cut.
*Flax seed oil. This is an oil you can buy in a nutrition store. It contains all the essential fats that are necessary for skin to grow and heal itself. It is not proven that this actually helps for sure, but theoretically it will. It is very healthy to take anyway, even without a wound. Give 1 tsp each day for infants, and 2 tsp for children mixed in a smoothie. Do not apply the oil to the skin; it needs to work internally.
*Vitamin E oil. You can rub this oil onto the cut after the stitches are removed. There is not a definite proven benefit, but it may help the healing.

WHEN DO YOU GET THE  STITCHES   REMOVED?
*Face. These should be removed in 3 to 5 days. Why so soon? Because by five days the stitch thread starts to react with the skin and this can leave a mark for each stitch. If the stitches are not turning red where they enter the skin, then it is best to wait the full 5 days. If a stitch reaction is occurring sooner, then see your doctor before 5 days to consider having them removed. Your doctor may put steri-strips over the cut to provide a few more days of strength. Do not wait more than 5 days.
*Body and scalp. (within the hair) 7 to 10 days.
*Extremities. 10 to 14 days. If the stitches are done over a joint area that bends and stretches, then you should wait 14 days. If not, then 10 days is enough.
Ask the doctor who puts in the stitches when they should be removed.

HOW CAN YOU TELL WHEN IT’S GETTING INFECTED?
Over the first few days it is normal for the skin around cuts and scrapes to turn slightly red. If the redness continues to spread, your child develops a fever, or you see a foul- smelling greenish discharge from the wound, see or call your doctor. Your child may need an antibiotic by mouth. It is generally not necessary to page the doctor overnight for this. It can wait until morning.

SCRAPES (ABRASIONS)
Although scrapes are generally minor and do not warrant a trip to the doctor’s office, large scrapes can leave a permanent discoloration to the skin if not properly cared for. Here are some guidelines to follow to help you properly care for scrapes.

*Wash off the scrape as soon as possible with soap and warm water. Rinse or gently wipe away any dirt.
*See your doctor if there is any dirt or gravel stuck in the scrape that you can’t remove.
*Do not let the scrape dry out and form a scab. A thick scab may lead to permanent discoloration.
*Follow these steps twice a day until the scrape is healed:

#Wash with warm water under a faucet to rinse away debris and germs. Dab it dry
#Apply a diluted peroxide solution (½ water mixed with ½ peroxide) and let it sit for two minutes.
#Dab or wipe away any scab what has accumulated.
#Rinse away the peroxide.
#Apply an antibiotic ointment. See antibiotic ointment
#For large scrapes, instead of an antibiotic ointment, call your doctor for a prescription cream called Silvadene. It is used for burns, but also works well on large scrapes. Do not page your doctor after hours for this cream. You can use antibiotic ointment for a day until you can get the cream. This cream contains silver, so it may form a “tarnished” black color on the bandages.
#Apply a non-stick gauze pad over the cream or ointment. One brand name is called Telfa, but you can use any non-stick gauze.
#Tape or wrap gauze over this pad.
#For small scrapes, you do not need to meticulously follow all these steps. Simply use the peroxide and an antibiotic ointment, and try to prevent a scab from forming.
#Sun protection is very important. See the section above under long-term steps to minimize the scar.
#You can stop putting on the cream and dressing once the scrape has healed to a light pink color, with no more red, sore areas.
#Watch for infection according to the guidelines above.

You may click to see :
*How to Stop a Bleeding Cut…
*Home Remedy for Bleeding ….
*First Aid: Cuts, Scrapes and Stitches….

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/cuts2.shtml
http://kidshealth.org/parent/firstaid_safe/emergencies/bleeding.html
http://www.lpch.org/healthLibrary/ParentCareTopics/skininjurycutsscrapesbruises.html
http://www.askdrsears.com/html/8/t085600.asp

http://odlarmed.com/?cat=62&paged=2
http://www.formulamedical.com/Topics/Symptoms/Bleeding%20external.htm

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Categories
Ailmemts & Remedies

Bedsore

Definition:
Over one million are afflicted with this life-threatening woundevery year, destroying tissue,fat, muscle, and infecting bone.
Caused by pressure on bony prominences that blocks flow of blood through capillaries

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A pressure-induced ulceration of the skin occurring in persons confined to bed for long periods of time. Also called decubitus ulcer, pressure sore.

Bedsores, more properly known as pressure ulcers or decubitus, are lesions caused by unrelieved pressure to any part of the body, especially portions over bony or cartilaginous areas. Although completely treatable if found early, without medical attention, bedsores can become life-threatening.

Bedsores, more accurately called pressure sores or pressure ulcers, are areas of damaged skin and tissue that develop when sustained pressure — usually from a bed or wheelchair — cuts off circulation to vulnerable parts of your body, especially the skin on your buttocks, hips and heels. Without adequate blood flow, the affected tissue dies.

Although people living with paralysis are especially at risk, anyone who is bedridden, uses a wheelchair or is unable to change positions without help can develop bedsores.

Bedsores can develop quickly, progress rapidly and are often difficult to heal. Yet health experts say many of these wounds don’t have to occur. Key preventive measures can maintain the skin’s integrity and encourage healing of bedsores.

Signs and symptoms:
The definitions of the four pressure ulcer stages are revised periodically by the National Pressure Ulcer Advisory Panel (NPUAP) in the United States. Briefly, however, they are as follows:

  • Stage I. Initially, a pressure sore appears as a persistent area of red skin that may itch or hurt and feel warm and spongy or firm to the touch. In blacks, Hispanics and other people with darker skin, the mark may appear to have a blue or purple cast, or look flaky or ashen. Stage I wounds are superficial and go away shortly after the pressure is relieved.
  • Stage II. At this point, some skin loss has already occurred — either in the epidermis, the outermost layer of skin, in the dermis, the skin’s deeper layer, or in both. The wound is now an open sore that looks like a blister or an abrasion, and the surrounding tissues may show red or purple discoloration. If treated promptly, stage II sores usually heal fairly quickly.
  • Stage III. By the time a pressure ulcer reaches this stage, the damage has extended to the tissue below the skin, creating a deep, crater-like wound.
  • Stage IV. In the most serious and advanced stage, a large-scale loss of skin occurs, along with damage to muscle, bone, and even supporting structures such as tendons and joints. Stage IV wounds are extremely difficult to heal and can lead to lethal infections.
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If you use a wheelchair, you’re most likely to dvelop a pressure sore on:

  • Your tailbone or buttocks
  • Your shoulder blades and spine
  • The backs of your arms and legs where they rest against the chair

When you’re bed-bound, pressure sores can occur in any of these areas:

  • The back or sides of your head
  • The rims of your ears
  • Your shoulders or shoulder blades
  • Your hipbones, lower back or tailbone
  • The backs or sides of your knees, heels, ankles and t

*Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so the depth cannot be determined.

With higher stages, healing time is prolonged. While about 75% of Stage II ulcers heal within eight weeks, only 62% of Stage IV pressure ulcers ever heal, and only 52% heal within one year. It is important to note that pressure ulcers do not regress in stage as they heal. A pressure ulcer that is becoming shallower with healing is described in terms of its original deepest depth (e.g., healing Stage II pressure ulcer).

Etiology:
Bedsores are accepted to be caused by three different tissue forces:

Pressure, or the compression of tissues. In most cases, this compression is caused by the force of bone against a surface, as when a patient remains in a single decubitus position for a lengthy period. After an extended amount of time with decreased tissue perfusion, ischemia occurs and can lead to tissue necrosis if left untreated in an immunocompromised patient.
Shear force, or a force created when the skin of a patient stays in one place as the deep fascia and skeletal muscle slide down with gravity. This can also cause the pinching off of blood vessels which may lead to ischemia and tissue necrosis.
Friction, or a force resisting the shearing of skin. This may cause excess shedding through layers of epidermis.
Aggravating the situation may be other conditions such as excess moisture from incontinence, perspiration or exudate. Over time, this excess moisture may cause the bonds between epithelial cells to weaken thus resulting in the maceration of the epidermis. Other factors in the development of bedsores include age, nutrition, vascular disease, diabetes mellitus, and smoking, amongst others.

There are currently two major theories about the development of pressure ulcers. The first and most accepted is the deep tissue injury theory which claims that the ulcers begin at the deepest level, around the bone, and move outward until they reach the epidermis. The second, less popular theory is the top-to-bottom model which says that skin first begins to deteriorate at the surface and then proceeds inward.

Causes:
Many people shift in their chair during meetings, fiddle with the radio when driving, turn a dozen times in their sleep. Every day, without thinking, they make hundreds of subtle postural adjustments that help stave off problems arising from inactivity. But for people immobilized by paralysis, injury or illness, those problems — including bedsores — are a constant threat.

Pressure sores usually result from sustained pressure on your body. They’re especially common in areas that aren’t well padded with muscle or fat and that lie just over a bone, such as your spine, tailbone (coccyx), shoulder blades, hips, heels and elbows. Because your skin and the underlying tissues are trapped between bone and a surface such as a wheelchair or bed, blood flow is restricted. This deprives tissue of oxygen and other nutrients, and irreversible damage and tissue death can occur.

In some cases, the pressure that cuts off circulation comes from unlikely sources: the rivets and thick seams in jeans, crumbs in your bed, wrinkled clothing or sheets, a chair whose tilt is slightly off — even perspiration, which can soften skin, making it more vulnerable to injury.

Other causes of pressure sores include:

  • Friction. Frequent shifts in position are the key to preventing pressure sores. Yet the friction that occurs when you simply turn from side to side can damage your skin, making it more susceptible to pressure sores.
  • Shear. This occurs when your skin moves in one direction, and the underlying bone moves in another. Sliding down in a bed or chair or raising the head of your bed more than 30 degrees is especially likely to cause shearing, which stretches and tears cell walls and tiny blood vessels. Especially affected are areas such as your tailbone where skin is already thin and fragile.

Pathophysiology:
Pressure ulcers may be caused by inadequate blood supply and resulting reperfusion injury when blood re-enters tissue. A simple example of a mild pressure sore may be experienced by healthy individuals while sitting in the same position for extended periods of time: the dull ache experienced is indicative of impeded blood flow to affected areas. Within hours, this shortage of blood supply, called ischemia, may lead to tissue damage and cell death. The sore will initially start as a red, painful area, which eventually turns purple. Left untreated, the skin may break open and become infected. Moist skin is more sensitive to tissue ischemia and necrosis and is also more likely to get infected.

Epidemiology
Within acute care, the incidence of bedsores is 0.4% to 38%; within long-term care, 2.2% to 23.9%; and in home care, 0% to 17%. There is the same wide variation in prevalence: 10% to 18% in acute care, 2.3% to 28% in long-term care, and 0% to 29% in home care. There is a much higher rate of bedsores in intensive care units because of immunocompromised individuals, with 8% to 40% of ICU patients developing bedsores.

The risk of developing bedsores can be determined by using the Braden Scale for Predicting Pressure Ulcer Risk. This scale is divided into six risk categories:

sensory perception
moisture
activity
mobility
nutrition
friction and shear
The best possible interpretation is a score of 23 whilst the worst is a 6. If the total score is below 11, the patient is at risk for developing bedsores.

Screening and diagnosis:
Bedsores are usually unmistakable, even in the initial stages, but your doctor is likely to order blood tests to check your nutritional status and overall health. Depending on the circumstances, you may have other tests, including:

  • Urine analysis and culture. A sample of your urine may be examined for various reasons, but you’re especially likely to have this test if you have a problem with incontinence. The test also checks for kidney problems and urinary tract infections, which may be a particular concern for people with spinal cord injuries.
  • Stool culture. In cases of fecal incontinence, a sample of your stool may be sent to a laboratory for analysis.
  • Biopsy. When you have a wound that doesn’t improve, even with intensive treatment, or you have chronic pressure sores, your doctor may remove a small sample of tissue that allows for a complete bacterial evaluation. The tissue may also be checked for cancer, which is a risk in people with long-standing wounds.

Treatment:
The most important thing to keep in mind about the treatment of bedsores is that the most optimal outcomes find their roots in a multidisciplinary approach; by using a team of specialists, there is a better chance that all bases will be covered in treatment.

There are six major contributors to healing.:-

Debridement:
The removal of necrotic tissue is an absolute must in the treatment of pressure sores. Because dead tissue is an ideal area for bacteria growth, it has the ability to greatly compromise wound healing. There are at least seven ways to excise necrotic tissue.

Autolytic debridement is the use of moist dressings to promote autolysis with the body’s own enzymes. It is a slow process, but mostly painless.
Biological debridement, or maggot debridement therapy, is the use of medical maggots to feed on necrotic tissue and therefore clean the wound of excess bacteria. Although this fell out of favour for many years, in January 2004, the FDA approved maggots as a live medical device.
Chemical debridement, or enzymatic debridement, is the use of prescribed enzymes that promote the removal of necrotic tissue.
Mechanical debridement is the use of outside force to remove dead tissue. A quite painful method, this involves the packing of a wound with wet dressings that are allowed to dry and then are removed. This is also unpopular because it has the ability to remove healthy tissue in addition to dead tissue. Lastly, with Stage IV ulcers, there is the chance that overdrying of the dressings can lead to bone fractures and ligament snaps.
Sharp debridement is the removal of necrotic tissue with a scalpel or similar instrument.
Surgical debridement is the most popular method, as it allows a surgeon to quickly remove dead tissue with little pain to the patient.
Ultrasound-assisted wound therapy is the use of ultrasound waves to separate necrotic and healthy tissue.

Infection control:
Infection has one of the greatest effects on the healing of a wound. Purulent discharge provides a breeding ground for excess bacteria, a problem especially in the immunocompromised patient. Symptoms of systemic infection include fever, pain, erythema, oedema, and warmth of the area, not to mention purulent discharge. Additionally, infected wounds may have a gangrenous smell, be discoloured, and may eventually exude even more pus.

In order to eliminate this bioburden, it is imperative to apply antiseptics and antimicrobials at once. It is not recommended to use hydrogen peroxide for this task as it is difficult to balance the toxicity of the wound with this. New dressings have been developed that have cadexomer iodine and silver in them, and they are used to treat bad infections. Duoderm can be used on smaller wounds to both provide comfort and protect them from outside air and infections.

It is not recommended to use systemic antibiotics to treat infection of a bedsore, as it can lead to bacterial resistance.

Nutritional support:
Upon admission, the patient should have a consultation with a dietitian to determine the best diet to support healing, as a malnourished person does not have the ability to synthesize enough protein to repair tissue. The dietitian should conduct a nutritional assessment that includes a battery of questions and a physical examination. If malnourishment is suspected, lab tests should be run to check serum albumin and lymphocyte counts. Additionally, a bioelectric impedance analysis should be considered.

If the patient is found to be at risk for malnutrition, it is imperative to begin nutritional intervention with dietary supplements and nutrients including, but not limited to, arginine, glutamine, vitamin A, vitamin B complex, vitamin E, vitamin C, magnesium, manganese, selenium and zinc. It is very important that intake of these vitamins and minerals be overseen by a physician, as many of them can be detrimental in incorrect dosages.

How to properly care for a bedsore:
The most important care for a patient with bedsores is the relief of pressure. Once a bedsore is found, pressure should immediately be lifted from the area and the patient turned at least every two hours to avoid aggravating the wound. Nursing homes and hospitals usually set programs to avoid the development of bedsores in bedridden patients such as using a standing frame to reduce pressure and ensuring dry sheets by using catheters or impermeable dressings. For individuals with paralysis, pressure shifting on a regular basis and using a cushion featuring pressure relief components can help prevent pressure wounds.

Pressure-distributive mattresses are used to reduce high values of pressure on prominent or bony areas of the body. However, methods to evaluate the efficacy of these products have only been developed in recent years.

Educating the caregiver
In the case that the patient will be returning to home care, it is very important to educate the family about how to treat their loved one’s pressure ulcers. The cross-specialisation wound team should train the caregiver in the proper way to turn the patient, how to properly dress the wound, how to properly nourish the patient, and how to deal with crisis, among other things.

As this is a very difficult undertaking, the caregiver may feel overburdened and depressed, so it may be best to bring in a psychological consult.

Wound intervention:
Once the patient has reached the point that intervention is possible, there are many different options. For patients with Stages I and II ulcers, the wound care team should use guidelines established by the American Medical Directors Association (AMDA) for the treatment of these low-grade sores.

For those with Stage III or IV ulcers, most interventions will likely include surgery such as a tissue flap, skin graft or other closure methods. A more recent intervention is Negative Pressure Wound Therapy, which is the application of topical negative pressure to the wound. This technique, developed by scientists at Wake Forest University, uses foam placed into the wound cavity which is then covered in a film which creates an airtight seal. Once this seal is established, the technician is able to remove exudate and other infectious materials in addition to aiding the body produce granulation tissue, the best bed for the creation of new skin.

There are, unfortunately, contraindications to the use of negative pressure therapy. Most deal with the unprepared patient, one who has not gone through the previous steps toward recovery, but there are also wound characteristics that bar a patient from participating: a wound with inadequate circulation, a raw debridled wound, a wound with necrotised tissue and eschar, and a fibrotic wound.

After Negative Pressure Wound Therapy, the patient should be reevaluated every two weeks to determine future therapy.

Click to see :->You can Prevent Pressure Sores
Silver Oxide Skin Cream: Heals Ulcers & Sores Fast.
Complications:
Pressure sores can trigger other ailments, and cause patients considerable suffering and financial cost. Some complications include autonomic dysreflexia, bladder distension, osteomyelitis, pyarthroses, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation. Sores often recur because patients do not follow recommended treatment or develop seromas, hematomas, infections, or dehiscence. Paralytic patients are the most likely people to have pressure sores recur. In some cases, complications from pressure sores can be life-threatening. The most common causes of fatality stem from renal failure and amyloidosis.

Risk Factors:
If you’re immobilized by acute illness, injury or sedation — even for a brief time such as after an operation or accident — you can develop pressure sores. But people living with spinal cord injuries are at greatest risk.

Because the nerve damage from these injuries is often permanent, compression of skin and other tissues is ongoing. Exacerbating the problem are thinning or atrophied skin and decreased circulation, both of which make tissue damage more likely and healing more difficult. And because spinal cord injuries reduce or eliminate sensation, you don’t receive the body signals that tell you to shift your position or that a sore is developing.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
www.mayoclinic.com
http://en.wikipedia.org/wiki/Bed_sore

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