4 Decubitus Ulcer, Causes, Symptoms and How to Prevent

Decubitus ulcers, causes, symptoms and ways to prevent. What is Decubitus Ulcer ? Decubitus ulcer is a condition of local tissue damage caused by ischemia in the skin due to excessive external pressure. Generally occurs in patients with chronic diseases who lie long. Decubitus ulcers are often referred to as ischemic ulcers, pressure ulcers, afternoon pressure, afternoon beds. Decubitus is also at high risk for people who cannot feel pain, because pain is a sign that normally encourages a person to move.

4 Decubitus Ulcer, Causes, Symptoms and How to Prevent
Decubitus Ulcer
Nerve damage for example due to injury, stroke, diabetes and coma. Diabetes mellitus is a chronic disease caused by reduced pancreatic insulin production, both derived and acquired, or by the ineffectiveness of insulin production. This deficiency increases the concentration of glucose in the bloodstream, which can harm the body's system, especially blood vessels and nerves, causing a decrease in the ability to feel pain so that it is one of the risks of decubitus.

Decubitus Ulcer, Causes, Symptoms and How to Prevent

Damage to the integrity of the skin can come from injury due to trauma and surgery, but it can also be caused by long periods of skin stress which can cause irritation and will develop into pressure sores or decubitus. The incidence of decubitus in America is still quite high and needs attention from health professionals. The results showed that the incidence of decubitus varied, but it was generally reported that 5-11% occurred in the care setting, 15-25% in long-term care and 7-12% in the home care setting.

This problem has become a serious problem in both developed and developing countries, because it has resulted in increased maintenance costs and slowed rehabilitation programs for sufferers. The quality of nursing services provided in the hospital can be said to be not good and the prevention of decubitus has not been a high priority in the service of nursing actions. This makes prevention of decubitus the main thing because handling of decubitus requires a lot of time and money.

Preventive measures can be carried out by massaging the patient's skin, maintaining general conditions and hygiene of the patient, or by taking special measures such as reducing excessive external pressure in certain areas by changing body position every 2 hours in bed for 24 hours. Prevention of decubitus can also be done by increasing family knowledge about how to prevent the occurrence of decubitus.

 One factor to prevent decubitus is knowledge. A person's knowledge is closely related to the behavior that will be taken, because with this knowledge has a reason to determine a choice. Lack of knowledge about the illness will result in uncontrolled disease development process, including early detection of complications of the disease.

High-risk decubitus occurs in patients who are unable to feel pain and patients who experience nerve damage as in patients with diabetes mellitus, so families need to know how to prevent the occurrence of decubitus so that family tasks can be fulfilled. The following are the stages of decubitus including:

The first stage
Erythema is not pale on intact skin, enlarged skin lesions, colorless, warm or hard skin can also be an indicator.

Second Stage
Partial loss of skin thickness includes the epidermis and / or dermis, superficial ulcers and clinically visible abrasions or superficial holes.

Third Stage
The loss of the entire thickness of the skin includes damaged or necrotic subcutaneous tissues which may widen down, but not exceed the depth with or without damaging the surrounding tissue.

Fourth Stage
The loss of all skin thickness with extensive deformation, tissue damage or muscle damage, or supporting structures such as tendons, joints, and others.

Risk Factors for Decubitus Ulcers

Various risk factors can cause decubitus injuries including:

Sensory input interference
People who experience changes in sensory perception of pain and pressure are at high risk for impaired skin integrity.

Impaired motor function
People who are unable to change their position independently are at high risk of developing sores. The client can feel pressure but is unable to change the position independently to eliminate the pressure.

Change in level of awareness
People who are confused, disorientated, or experience a change in level of consciousness are unable to protect themselves from decubitus, people confused or disorientated may feel pressure but are unable to understand how to relieve that pressure. Coma people cannot feel pressure and are unable to change to a better position.

Casts, traction and other equipment
People who use casts are at high risk for decubitus because of the mechanical external friction force from the surface of the cast that rubs against the skin. The second mechanical force is pressure that is cast on the skin if the cast is too tight or if the extremity is swollen.

Impaired skin integrity that occurs in decubitus is a major result of pressure. But there are additional factors that can increase the risk of further decubitus in patients. These include friction and friction, moisture, poor nutrition, anemia, infection, fever, peripheral circulation disorders, obesity, kakeksia and age.

Signs and Symptoms of Decubitus Ulcer

Decubitus often occurs in parts of the body that do not have thick fat tissue and often experience contact with a bed or wheelchair. In people who cannot get out of bed, decubitus ulcers usually occur on the shoulders, elbows. Behind the back of the knees, ankles. spine and around the coccyx. Decubitus symptoms generally have almost the same characteristics, although the severity is different. Symptoms commonly found in patients with decubitus ulcer are as follows:

Swollen.
The skin becomes softer or harder than the surrounding tissue.

Unusual color changes and skin texture.

A liquid like pus appears.

Infection in the decubitus area appears.

Open wounds on the skin.

Changes in skin temperature compared to normal parts around it, can feel cooler or warmer.

Causes of Decubitus Ulcers

The main cause of decubitus ulcers is pressure on parts of the body for a long time, thus disrupting the flow of blood that carries nutrients and oxygen. Without nutrients and oxygen, the skin tissue will be damaged and die. Long-term disruption of blood flow to the skin also causes the absence of white blood cells needed to fight infection. When the ulcer has formed on the skin, bacteria can infect and damage skin tissue. Decubitus can appear due to the following:

Pressure on the skin due to unconscious muscle movements such as muscle spasms.
Body pressure by hard surfaces, such as beds or wheelchairs.
Moist skin conditions can damage the outer skin layer.

How to Prevent Decubitus Ulcers

In how to prevent decubitus ulcers that can be done by:

Maintain nutrition and diet.
To accelerate the healing process of decubitus ulcers, it is recommended to consume foods that are rich in protein, vitamins and minerals. If the sufferer experiences loss of appetite due to previous health conditions, the following tips can be taken to maintain nutritional intake:

Perform regular skin checks.
If someone is at risk of suffering from decubitus ulcers, it is necessary to check the skin regularly to observe changes. This routine check is important, especially for people with diabetes and nerve damage that causes body parts to be insensitive to pain.

Change your body position regularly.
This method is the most effective way to prevent the appearance of decubitus ulcers. If decubitus has appeared, changing the body position regularly can reduce body pressure in that part, and provide better healing opportunities on the part of the body. For wheelchair users, it is recommended to change the body position once every 15-30 minutes. In patients who are difficult to move from bed, it is advisable to change the position of the body every 1-2 hours.

Thus reviews of decubitus ulcers, causes, symptoms and ways to prevent. In this paper, the aim is to make the reader more familiar with the Dekubitus Ulcer, and thank you for reading.

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