Early bedsore (1 and 2) requires the above preventive measures to prevent tissue necrosis. The damaged parts should be exposed, relieve the pressure and keep dry. Applying high ointment can promote local blood circulation and accelerate wound healing.
Ulcer beyond stage 3, if the compression is reduced and the wound is small, can not heal quickly.
Stage 4 bedsore ulcer requires debridement or extended surgery. When the wound is full of pus and necrotic tissue fragments, polysaccharide anhydride beads or a new generation of hydrophilic polymers can be used to accelerate the debridement process without surgery. The traditional debridement method is to remove necrotic tissue with tweezers and scissors. Some ulcers can be debrided with 1.5% hydrogen peroxide. Swirl bath can also help debridement.
Ulcer (stage 5) involving the further development of subcutaneous fat and muscle tissue needs surgical debridement and sealing. The damaged bone tissue (stage 6) needs surgical resection. For the affected joints, joint amputation is required. The granulation tissue formed after debridement provides the basis for skin grafting. Full-thickness free skin flap can be used to cover the wound surface, especially the larger bony processes (sacrum, ischium and greater trochanter), and the scar tissue can not bear the pressure and needs skin grafting. In order to promote wound healing, the patient should be placed on a bed that can change the compression position, such as using an air cushion bed.
For cellulitis, penicillin or penicillinase-resistant cephalosporins are needed. Bacterial culture of wound surface is not helpful to choose antibiotics, because many kinds of bacteria often grow on wound surface.
At present, there are many new dressings and external preparations to choose from. Any powder, gel and dressing have no good performance, because some materials have strong hydrophilicity and poor air permeability, and long-term use will increase the risk of infection such as Pseudomonas. Other preparations can cause pain, all drugs or dressings are expensive, and there is usually no effective clinical controlled trial to evaluate the quality of drugs or dressings. As far as I know, there is an article "Nursing Experience of Treating 62 Cases of Bedsore with High Plaster" (No.6, Volume 24, Forum of Traditional Chinese Medicine, 2009, 1 1), which is very authoritative. Among them, some methods and drugs for treating bedsore are mentioned, and there are cases of cure. I suggest you read this paper first and get to know it. I hope it helps you!