Pressure Ulcer Therapy

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Pressure Ulcer Therapy
Pressure Ulcer Therapy
Video: Pressure Ulcer Therapy
Video: Dressing a Pressure Injury With Basic Wound Care Supplies by Susan Hamilton for OPENPediatrics 2023, February
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Pressure ulcers: therapy

The main aim of pressure ulcer therapy is to prevent the chronic wound from spreading and to allow the skin defect to heal. A first step in the treatment of pressure ulcers is therefore to provide pressure relief by changing position (repositioning). The treatment of a pressure ulcer that has already occurred includes both local and causal therapeutic measures, ie measures directed against the triggering factors.

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  • How are the costs going to be covered?

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How is the local treatment carried out?

In order to allow a pressure ulcer to heal, the following measures are required directly in the area of ​​the pressure ulcer:

  • Necrosis removal (debridement): Dead tissue (necrosis) hinders wound healing and promotes the development of inflammation. Large necroses are removed surgically, while smaller necroses are either physically, bio-surgically (maggot therapy) or enzymatically.
  • Control of infection: The infected wound can be treated directly with an antiseptic or with rinsing with 0.9 percent saline solution or Ringer's solution. In addition, affected areas must be adequately supplied with oxygen.
  • Phase-appropriate wound care: A pressure sore goes through various wound healing phases, each of which requires special measures and dressing materials. The self-cleaning mechanisms of the wound are supported in the cleaning phase. In the granulation phase, new tissue formation is promoted and the newly formed tissue is protected. In the epithelialization phase, the focus is on promoting cell division and migration in a moist environment.
  • Moist wound treatment: The wound should be protected from drying out, cooling down and the penetration of germs by means of appropriate wound dressings. Furthermore, they should enable the unhindered exchange of gases and water vapor.
  • Wound conditioning: Various measures are used to exert a granulation-promoting stimulus on the wound. For example, polyurethane wound dressings are suitable for conditioning poorly healing wounds. They can absorb large amounts of wound exudate and necrotic material. In addition, they ensure a moist environment for the wound. Changing the dressing refreshes the wound and promotes wound granulation.
  • Newer therapy methods: With pulsed electrical stimulation, the wound is treated repeatedly with pulses of positive and negative polarity. In the vacuum sealing technique, the wound is lined with a polyvinyl alcohol foam with a dissipative drainage and covered with a polyurethane film. The drainage creates a negative pressure that is supposed to promote the build-up of granulation tissue.

How is the cause treated?

These include the following factors in particular:

  • Adequate treatment of the underlying disease: eg optimal drug setting for diabetes;
  • Complete pressure relief of the affected area: The pressure should be distributed over as large an area as possible, thereby restoring the blood flow to the wound and its supply of nutrients and oxygen. Various storage techniques and aids (e.g. special cushions and wedges) are available for this.
  • Improvement of the general condition: The following measures are useful over a longer period of time:

    • sufficient fluid intake (at least 1.5 liters / day),
    • balanced diet (rich in protein and vitamins), if necessary (malnutrition or malnutrition) special diet with an increased supply of energy, protein, vitamins and minerals,
    • adequate pain therapy,
    • Active and passive mobilization: in this way the patient should learn again to move independently and to be able to change his position.
    • Support with psychological and social problems.

Whom can I ask?

If you find evidence of pressure sores or an already existing pressure ulcer in yourself or someone close to you, you can contact the following offices, depending on the circumstances:

  • General Practitioner,
  • Doctor for dermatology,
  • Wound manager,
  • Nursing staff,
  • Hospital doctor.

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB).

However, you can also use a doctor of your choice (i.e. doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

When hospitalization is required

Hospitalization may sometimes be required for treatment. The hospital costs are billed for. The patient has to pay a daily contribution to the costs. Further medication treatment at home takes place by prescription by the general practitioner or specialist.

For more information, see What does a hospital stay cost?

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