(1) Daichuangning —— A first-line clinical drug for bedsore in 2008.

Disinfection and sterilization can accelerate the shedding of necrotic tissue, promote the growth of granulation tissue and angiogenesis, and repair various ulcers and traumatic wounds. Suitable for refractory wounds such as bedsore.

(2) Iodine tincture can dehydrate tissues, promote wound drying and soften hard structures. Apply iodine to the wound twice a day.

(3) Polyantigen A can stimulate immune cells to enhance immune function and promote wound tissue repair. For patients with large wounds, we should first debride them with normal saline, then irradiate them with infrared light for 20 minutes, wet compress them with polyoxin A solution after the wounds are dry, then irradiate them with infrared light for 65,438+00 minutes, and finally cover them with sterilized purple clover oil gauze. For patients with excessive exudate, the dressing should be changed three times a day.

(4) Metronidazole has special effects on killing anaerobic bacteria, dilating blood vessels and enhancing blood circulation. After washing with this medicine, wet compress the wound and irradiate it with infrared lamp for 20 minutes, 3-4 times a day.

2. Physical therapy

① Oxygen therapy uses pure oxygen to inhibit the growth of anaerobic bacteria on wound surface, improve the oxygen supply of wound tissue and improve local tissue metabolism. After the oxygen flow dries the wound, it forms a thin scab, which is beneficial to healing. Methods: Cover the wound with plastic bag and fix it firmly. Blow oxygen into the bag through a small hole. The oxygen flow rate is 5-6L/min, each time 15 min, twice a day. After treatment, the wound can be covered or exposed with sterile gauze. For wounds with a lot of secretions, 75% alcohol can be put in the humidification bottle, so that some alcohol can be taken out when oxygen passes through the humidification bottle, which can inhibit the growth of bacteria, reduce secretions and accelerate wound healing.

② Air-cushion therapy: The low utilization rate of air-cushion bed can't fundamentally solve the problem. Moreover, the air cushion bed is inconvenient to move and use, expensive, and has poor air permeability, which easily leads to the patient's skin being wet and sticky due to sweating, the patient's back feeling uncomfortable, power consumption for a long time, and noise, which makes the patient restless and affects rest. Most air-cushion beds have no therapeutic effect on bedsores.

(3) Manual nursing: turn over the patient and massage the pressed skin regularly every 1 ~ 2 hours, which requires a high sense of responsibility of the nursing staff; Clean the patient's skin regularly. In practical nursing, it is difficult to ensure the cleanliness of the skin due to the inconvenience of patients.

Treatment of bedsores should be eradicated.

3. External application therapy of traditional Chinese medicine The burn powder made of eucalyptus leaves was made into paste with normal saline, and dexamethasone 5mg was applied to the bedsore wound twice a day.

4. Surgery For bedsores with large area and deep bone, when the above conservative treatment is not ideal, surgical treatment can be used to accelerate healing, such as surgical scraping and drainage, removal of necrotic tissue, and skin grafting to repair defects. Surgical repair is also suitable for war injury complicated with large area bedsore. Because of war injury, people lose a lot of blood, their body resistance is poor, and bedsore persists, which is easy to cause systemic infection. Surgical repair can shorten the course of bedsore, relieve pain and improve the cure rate.

[Edit this paragraph] Disease care

Turn over nursing

(1) Objective To make patients safe and comfortable and prevent complications. Suitable for patients who can't take care of themselves.

(2) Operation method

Essentials: Support the center of gravity, make use of the resultant force, find the gap without grasping or pinching: avoid collision and wipe the skin lightly, stably and laborsaving.

1. Single-person labor-saving turning method (turning on your back to the left side)

(1) The nurse stands on the patient's right side with the distance between her legs of 10- 15 cm, so as to keep her balance and keep her center of gravity unchanged. Put the patient's left and right hands on the abdomen.

(2) Move the upper body (the center of gravity of the upper body is on the shoulder and back). Lift the patient's right shoulder slightly with his right hand, put his left hand into the shoulder, and hold his neck with his palm and fingers; Move the right hand to the opposite left shoulder and back, and lift the upper body of the patient to the proximal side with joint force.

(3) Move the lower body (the center of gravity of the lower body is on the hip). Put your left hand into the patient's popliteal fossa, and your right hand on the instep, bending your knees and lower limbs; The right hand extends down the calf to the sacrococcygeal part, and the left hand moves to the opposite left hip, and the patient's lower body is lifted to the proximal side with joint force.

(4) adjust the body position. Hold your back with your left hand, hold your knees with your right hand, gently turn over the patient, lift the patient's right leg, flatten your pants, hold your knees, bend the patient's hips and knees, and put them by the bed; Lift your left leg, flatten your pants and put them on the bed. Smooth clothes, support the patient's back and legs with cushions, and take a comfortable lying position. Lie flat on your side with the nurse standing on the patient's left. The steps are the same as above, and the movements of both hands are adjusted to each other.

Single-person skill turn-over method

2. Two-person labor-saving turn-over method (supine position, lateral position) For people who are too fat to move, such as paraplegia, hemiplegia, coma and other patients, it is advisable to use two people to help turn over.

Two nurses stood on the same side of the hospital bed. One puts the patient's hand on the abdomen to support his neck, shoulders and waist, and the other supports his buttocks and popliteal fossa. At the same time, they carried the patient to the bedside, supported his shoulders, back, waist and knees respectively, and gently pushed him to the opposite side.

Double help the patient turn over.

If there is a catheter, it should be properly placed first, and the catheter should be checked after turning over to keep it unobstructed. Turn-over bed can be used for severe burns. When the cervical vertebra and skull are pulled, the head, neck and trunk must be rotated at the same level.

Psychological nursing

Patients who stay in bed for a long time will have all kinds of bad emotions, great psychological pressure and even depression and world-weariness. Family members should be considerate and understand, comfort and enlighten patients, so that they can establish confidence in overcoming diseases and cultivate stable and optimistic emotions. By listening to music, drama, watching TV, reading newspapers, chatting with patients, etc., distract patients' attention and adjust their emotions.