Bedsore treatment: medications, antibiotics and topical treatments and therapies

Prompt action is needed in case a newly forming pressure ulcer is suspected. Excess pressure on the site must be removed. Regular repositioning, especially anti-decubitus aids, an adjustable bed and, if possible, patient mobilisation will help.

A suitable bed and bed linen are also important. A correct lifting technique is also important when positioning and handling people, otherwise there is a risk of bed sores due to friction or shearing.

Anti-decubitus aids nclude:

• foam overlays (rollers, rings)
• an anti-decubitus mattress filled with air or other materials
• air mattress with a compressor
• a pad, tarpaulin or fleece blanket that ensures breathability, moisture-absorbing
• synthetic fleece overlay
• pads, might be filled with air, gel, or granulate
• protection bar

Sufficient hygiene and cleanliness are important for skin care. The risk is mainly incontinence of urine and stool, while urine and stool have an aggressive effect on the skin and accelerate the formation of pressure ulcers. The skin must not be damp or too dry. It should be treated and massaged.

The treatment is focused on wound treatment. The healing process consists of three phases:

1. debridement phase, or exsudation, if a necrotic film is present, the film is white-gray or green-brown and has a foul smell
2. granulation phase, in which the base is deep red and the ulcer is filled with granulation tissue
3. epithelialisation phase, when a new epithelium grows from the edges of the affected site, which covers the granulation tissue

Adequate nutrition during treatment is of utmost importance, as pressure ulcers can cause protein deficiency. Thus, proteins are added, but also vitamins and minerals, with vitamin C and, most importantly, zinc.

How can we treat it?

Pharmacological treatment, i.e. in the form of antibiotics, is used when there is evidence of microbial infection of the wound with bacteria and their sensitivity to the right antibiotics. Antibiotics are generally administered.

Of course, local treatment is important. Saline flush solutions (physiological, iodine, ringer's solution, hypermanganese solution) are used to rinse the wound. Aggressive solutions are unsuitable and can harm the skin and the healing process.

Wound care must be performed carefully to achieve asepsis (a measure to eliminate wound infection). After rinsing/flushing and disinfecting, various products are applied to ensure wound healing. Examples are topical antiseptics, various dressings and films.

There are numerous methods that are specifically developed to treat pressure ulcers. The suitability and the right type and combination is best consulted with a doctor, e.g. a surgeon.

Surgical treatment (removal of necrotic tissue) is necessary in stages 3 and 4. Examples are antiseptic wound dressings, non-stick dressings, activated charcoal dressings, hydrogels, hydrocolloid, silver mesh dressings, foam dressings, films, silicone mesh dressings, and alginate dressings.

Timely and appropriate treatment is a guarantee of success in the fight against pressure ulcers. Of course, risk assessment and prevention are the best course of action. The treatment assesses the patient's general condition (Norton Scale). The right wound care (not every day, determined by an expert) and rehabilitation are very important indeed.