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Pressure sores are also known as stress ulcers, mainly due to long-term pressure, friction, shear stress of the skin or subcutaneous tissue, this local damage in the elderly critically ill or long-term bedridden patients are more common. Studies have found that the patient's body malnutrition, humid environment and other factors and the appearance of pressure sores are closely related, while the elderly patients with decreased body function, skin tissue function degradation, so the risk of pressure sores is higher.
On the other hand, elderly patients with high risk pressure sores are prone to secondary infection, which may induce septicaemia and pose a greater threat to their lives.
The researchers used alginate dressings in elderly patients with high risk pressure sores, and found that alginate dressings can improve the cure rate and shorten the treatment time, which is worth popularizing.
Information & amp; methods
1.1 General Information From May 2016 to June 2017, a total of 52 patients with high risk pressure sores in a hospital were divided into control group (26 cases) and Observation Group (26 cases) according to the principle of simple randomized grouping of computers, of which 16 cases in the control group and 10 cases in women; age between 65~88, average (73.7±4.4) years old : 12 cases of sacral tail, 9 cases of hip, 5 cases of ankle, 20 cases of phase II pressure sores, 6 cases of phase III pressure sores. In the observation group, 22 cases were women, 14 cases were female, age was between 64 ~88 years old, average (73.9±4.3) years, pressure sores occurred: 13 cases of sacral tail, 8 cases of hip, 5 cases of ankle; 21 cases of phase II pressure sores, 5 cases of phase III pressure sores. Inclusion criteria: Patients are a pressure ulcer; informed consent to the study. Exclusion criteria: senile dementia patients; mentally abnormal persons. There was no statistical difference in baseline data between the two groups (p> 0.05), and there was comparability.
1.2 Methods The patient is treated with debridement, the necrotic tissue and secretions of the sores are completely removed, and the fresh sores are exposed.
If the patient has a large area of sores, or more tissue of festering necrosis, there should be many debridement, if the patient has signs of infection on the surface of the disease, the necrosis tissue or local secretion of bacterial culture plus drug sensitivity, if the edge of the sores surface coil or fibrosis, should be tissue resection, to help the epithelial tissue crawling. The control group underwent routine dressing change, after debridement, the burn moist cream was applied to the sores, and then the dressing was covered.
According to the dressing absorption situation, seepage situation determines the frequency of change, the early daily replacement of 1 ~3 times, the latter can be 1 ~3 days to replace 1 times. The observation group used Alginate Dressing treatment, after debridement to use alginate dressing on the sores surface, if the patient's sores are deep, the appropriate amount of alginate is filled at the center of sores, and outside the water colloidal dressing.
The frequency of the change according to the absorption expansion of the dressing, seepage seepage, the outer dressing is contaminated or self-loosening, such as the decision, the early should be replaced 1 times a day, the latter can be 3 ~7d replacement 1 times.
1.3 Evaluation indicators Clinical efficacy and ulcer surface healing scores were used as the evaluation indexes in this study.
Effective criteria: Patients with pressure sores ulcer surface healing, and the growth of new fresh meat bud tissue; Valid standard: The patient's sores surface is obviously dry, reduced, rosy, and grow part of the granulation tissue; Invalid standard: No change in the patient's sore surface. The wound surface healing score is evaluated by the push scale, which includes the surface area, tissue shape, exudate amount and so on, the score is 0~17, the lower the score, the more ideal the patient's pressure ulcer surface healing situation.
1.4 Statistical analysis
The statistical analysis of SPSS 22.0 processing data, the process of measurement data by T test, counting data by the card side test, if p < 0.05, then suggest that the data comparison is statistically significant.
Discuss The study found that the elderly had less activity, a lack of elasticity and relaxation of the skin, thinning and shrinking subcutaneous fat, so the skin was prone to damage and was a high risk group for pressure sores. The reasons for the formation of severe pressure sores are very complex, and their fundamental intervention is to strengthen the basic care at the same time.
In the course of treatment, we should pay attention to preventing the development of pressure sores and actively promote the healing of sores. In this study, alginate dressings were used in 36 elderly patients with high risk pressure ulcer in the observation group, and the total effective rate of the observation group was 96.15%, which was significantly higher than that of the control group. 73.08%,x²=5.318,p = 0.021; The healing scores of sores were significantly lower than those in the control group after 7 days and 14 days of treatment in the Observation group, and p < 0.05. Alginate dressings are extracted from seaweed, and this soft, non-woven fiber contains sodium carboxymethyl cellulose as well as natural alginate calcium fibers, which can provide a wet environment for the sores, dissolve the necrotic tissue, accelerate the differentiation and proliferation of tissue cells, create a hypoxic state for the sore surface environment, and stimulate the newborn capillaries. In turn, the growth of granulation tissue is promoted. On the other hand, alginate dressings can also avoid exposure to peripheral nerve, avoid inflammatory substances and dehydration stimulation, so can play an ideal analgesic effect. Relevant research reports that the alginate dressing in the calcium alginate fiber composition once in contact with the wound, can be with the patient's body sodium ions ion exchange, and insoluble water calcium alginate will gradually be converted to water soluble sodium alginate, and then make the inside of the fiber into a large amount of water, and form Hydrogel, isolated sores and the outside world, Effectively prevents bacterial intrusion, while also reducing the chance of infection. Through this study, we found that alginate dressing has good elasticity and soft texture, so it can reduce the damage and friction to the sore surface, so it is more helpful to the healing of the sore surface.
The gel formed can effectively prevent the dehydration of the ulcer surface, is conducive to the regulation of physiological secretion, so that the patient's pressure sores surface to form a membrane protective structure, so it can reduce the number of bleeding, seepage and drug change, more convenient, patients are more willing to accept. To sum up, in the treatment process of elderly patients with high risk pressure sores, alginate dressing can improve the cure rate and shorten the treatment time, which is worth popularizing.
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