severe, high-risk pregnancy (forcing the woman to lie still in bed), broken bones.
- When a patient is forced to remain motionless, the blood vessels undergo compression. The resulting increase in blood pressure could degenerate into obstruction of the vessels, coagulation and tissue necrosis.
- Complications: anemia, bone decalcification, dehydration, electrolyte imbalance.
It should be remembered that bedsores cannot spontaneously regress: therapeutic aids are in fact indispensable for wound healing and to reduce the risk of complications.
The damage caused by pressure sores is proportional to the period of forced immobility: the lack of care and neglect of the patient can also lead to his death. The assistance of patients suffering from pressure sores is essential.
The following are the classes of drugs most used in the therapy against pressure sores, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Therapeutic aids for pain control: bedsores are painful and very annoying, therefore a pharmacological treatment based on NSAIDs and local analgesics can be an excellent aid to give relief to the patient
- Ibuprofen (eg. Brufen, Moment, Subitene): take orally from 200 to 400 mg of active ingredient (tablets, effervescent sachets) every 4-6 hours, as needed. In some cases, the analgesic can also be taken intravenously at a dosage of 400-800 mg every 6 hours, as needed.
- Naproxen (eg Aleve, Naprosyn, Prexan, Naprius): indicatively, to reduce the pain associated with pressure sores, take 250-500 mg of naproxen or 275-550 mg of naproxen sodium orally, twice a day. For the maintenance dose, the dose can be increased up to 1500 mg of naproxen or 1650 mg of naproxen sodium, divided into two doses, over a period of six months.
- Lidocaine (eg. Xylocaine, Lidofast, Luan CHIR): it is a local anesthetic, widely used in therapy to reduce pain associated with pressure sores. It is often formulated together with steroids such as hydrocostisone (eg Proctosedyl), useful for enhancing the anti-inflammatory effect. Lidocaine is also often associated with prilocaine (eg Emla).
Antibiotics and disinfectants: to be used only in case of proven bacterial infection in the context of bedsores: wet or not thoroughly cleaned wounds can in fact become an excellent breeding ground for bacteria, which can create even greater damage.
The choice of the most suitable antibiotic depends on the pathogen involved in the infection.
- Silver nanocrystals (eg. Katoxyn Spray): disinfectant substance (antiseptic). The administration of these active ingredients is indicated to discourage the formation of necrotic bodies and fibrin, as well as to create a balance of the bacterial load, thus reducing the frequency of medication wounds (bedsores, diaper rash, burns, skin maceration, etc.).
- Becaplermin (eg Regranex gel): indicated for the treatment of ulcers in the field of bedsores; it is a recombinant platelet growth factor, also and above all used for the treatment of diabetic ulcers. The drug is not allowed in Italy .
- Cadexomer iodine (eg lodosorb): healing substance indicated to speed up wound healing in the context of bedsores. The bactericidal power of the drug is enhanced by the presence of iodine. Treatment with this drug is indicated to avoid the chronicization of the sore and to reactivate the repair mechanisms of tissues damaged by pressure sores.
Muscle relaxants: They inhibit muscle spasms and promote the healing of pressure sores, which can be accentuated by involuntary muscle contractions.
- Diazepam eg. (Micropam, Ansiolin, Diazepam FN, Valium, Diazepam, Valpinax): indicatively, take 2-10 mg of the drug 3-4 times a day orally; alternatively, administer the active principle intravenously or intramuscularly at a dosage of 5-10 mg over 3-4 hours, as needed. This dosage is indicated to reduce muscle spasms in the context of pressure sores.
- Dantrolene (eg Dantrium): start therapy to counter spasms with a dose of 25 mg, to be taken once a day for 7 days; continue taking the same dose 3 times a day for 7 days. The third week, continue the therapy with 50 mg, to be taken 3 times a day for another 7 days. During the fourth week it is possible to increase the dose up to 100 mg, three times a day. Consult your doctor: dantrolene is not used as a first-line drug to reduce muscle spasms in the context of pressure sores.
- Tizanidina (eg Sirdalud, Navizan): indicatively, take 4 mg orally, once a day. If necessary, repeat the administration every 6-8 hours, up to a maximum of three doses in 24 hours. It is possible to increase the dose by 1-2 mg every 4-7 days, until the desired therapeutic response is achieved. Do not exceed 36 mg per day and 12 mg for any single dose. Always consult your doctor before taking this drug.
- Baclofen (eg Baclofen MYL, Lioresal): start taking the drug orally at a dose of 5 mg, three times a day for 3 days. Continue with 10 mg, 3 times a day for another 3 days; increase the dosage by 5 mg for another two weeks. The maintenance dose involves taking 40-80 mg of the drug per day. The active ingredient can also be taken intrathecally.
Natural remedies to treat pressure sores: In some patients, pressure sores are not a real concern because they are shallow and easy to heal. In this case, it is possible to resort to natural therapy, applying ointments, creams, oils, sprays or talcs to the skin to speed up the healing of wounds, to nourish the skin and relieve the injured part. Here are some examples:
- Corn starch and zinc oxide: their astringent, soothing and anti-itching properties are indicated for treating pressure sores, especially those that suppurate.
- Hypericum oil (Hypericum perforatum): Natural first-line drug for the treatment of mild pressure sores. The phytocomplex is mainly made up of hyperforin (natural antibiotic) and hypericin (very useful for inflammation). St. John's wort is indicated as a wound healing agent. It is recommended to cover the part treated with St. John's wort oil with a sterile gauze or bandage: the drug, in fact, could create photosensitization of the skin.
- Aloe vera (aloe vera gel): for the treatment of pressure sores, the topical application of products formulated with aloe vera is indicated for its restorative, anti-inflammatory and refreshing properties, useful for giving a pleasant sensation of relief immediately after the " application on the sore.
For further information: see the article on natural remedies for pressure sores
It is recommended to keep the wound clean, to change the bandages several times a day and to dry the wound thoroughly after cleaning and disinfecting it. Whenever a bandage is changed, the wound must be cleaned with saline (for open wounds) or with mild soap and water (for shallow wounds).
