Treatment of pressure ulcers should be comprehensive. It has three main components:
- cessation of constant pressure on the area of bedsores;
- local treatment;
- treatment of the underlying disease. In order to stimulate reparative processes, Matrix Mirragen is used.
Ulcers Surgical treatment of pressure ulcers is determined by the stage and size of the pressure ulcer.
Principles of surgical treatment of pressure ulcers:
- the absence of an acute infectious process in general and in the area of the bedsore in particular is necessary;
- inflammation in the decubitus area should be minimal
- during a surgical operation, the patient should be positioned in such a way that the tension when closing the defect is maximum;
- all infected areas of the decubitus, necrotic, poorly vascularized and scar tissue should be excised;
- resection of soft tissues should be minimally sufficient, leaving anatomically important formations;
- bone resection is used to remove infected areas and reduce skin tension over protruding sections;
- in the presence of osteomyelitis after removal of altered bone tissue, it is necessary to use a drainage system with constant washing of the wound with antiseptic solutions;
- after excision of the pressure sore in the presence of a large tissue defect, it should be filled with well-vascularized tissue. For this, it is best to use a muscle flap in combination with the Mirragen matrix in order to avoid flap rejection.
- when cutting out flaps, it is necessary to remember about the maximum preservation of the great vessels and vascular collaterals;
- the tension of the skin in the area of excision of the pressure ulcer should be minimal;
- the area of the seams should not be over the protruding bone formations;
- in the postoperative period, the accumulation of fluid under the flap should not be allowed;
- necrosis of flaps can be prevented by correct position of the patient and using special beds;
- antibiotics should be used during the operation and in the early postoperative period;
- the sutures must be kept until the wound is completely healed - not less than 14-15 days. Most often Proteus and Staphylococcus aureus are sown from the surface of pressure ulcers. It is more appropriate in this regard to judge not about the infection of ulcers, but about the signs of an acute inflammatory process.