PRESSURE SORE EDUCATION

SN: Your father has developed pressure sores, which we have to take care of.

FM: But how can this have happened? I was recently in a visit.

SN: You have to know that this can appear suddenly, I mean only in a couple of hours.

FM: Ok. But what’s the reason behind that?

SN: Well, first of all, we have to bear in mind that a bed sore is of ischemic origin. To put it simply, it’s called pressure ulceration that is mostly caused by tissular hypoxia, when soft tissues are deprived of oxygen. And this can happen to anyone who’s bed or chair ridden.

FM: And how bad it is? Can you tell me more about this?

SN: The doctor and the multi-disciplinary team will determine the type and severity of this skin ulcers. So, the treatment depends on how deep the sore is, it’s aspect, color, topography, the presence of infection, edema, erythema, that is redness of the skin, suppuration, that is pus production, and odor.

FM: I don’t really get it!

SN: It’s that in the presence of some of these factors, a bacteriological swab is done in order to adapt a treatment.

FM: This is exactly what I need to know!

SN: The good news is that it is holistic and multi-professional.

FM: Sorry?

SN: I mean global, with teams from different medical specialties, taking into account the risks that the patient might incur and their condition.

FM: Umm… and what does this imply?

SN: Well, in the absence of counter-indications, we first reposition your father in order to reduce the pressure on the sore. And for this, we’d use transfer boards so as to reduce skin frictions and shearings. This could be in bed or in chair, or from bed to chair. We use chair positioning to favor your father’s rehabilitation and facilitate food intake and respiration.

FM: But you said global care. Is that all?

SN: Oh no. Still an occupational therapist would assess him and propose mobilization sessions, that’s to walk and to do some meaningful daily activities that are important for an improved quality of life. There would also be a dietitian to adapt menus and maybe give nutritional supplements because of the risk of undernutrition due to prolonged immobilization. And of course, water intake is of much importance.

FM: Would there be any proper medical care?

SN: Of course, like with any kind of wounds, all the more in the case of pressure sores. We first proceed by cleaning the wound with a physiological serum, then we use an adapted antiseptic if need be. Also, mechanical removal of any dead or necrotic tissues is done so as to encourage healing. But the doctor may prescribe autolytic removal, that is dressings which would help natural dead tissue elimination thanks to the presence of enzymes and in order to keep the wound wet. And if need be, surgical removal is done. Ok?

FM: Yes. Now I understand what you mean by holistic care.