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Case №26

Diagnosis: Left lateral malleolus. Acute (recurrent) Venous Stasis + PAD. Previous Revascularization. Multi-layer Compression Therapy.

Age of Wound: Unknown

USA
  • Gender:
    Woman
  • Age:
    80 Years
  • Diagnosis:
    Pressure Injury

Dynamics of treatment with Mirragen

  • Pressure Injury, Woman 80 Years

    At The Beginning

  • Пролежень у женщины 80 лет

    After 4 Weeks

Pressure Injury

A bedsore is damage to a patient's tissue or skin that occurs due to poor circulation caused by pressure in a specific area. Initially, you may notice redness in the affected area. Due to a violation of the blood supply, the tissue in this place collapses, necrosis is formed. Various layers of skin, muscle, and bone may be affected. Areas that are particularly at risk are the sacral spine, heels, elbows, and shoulder blades.

Depending on the condition of the wound, bedsores are divided into four stages.c

  • Stage 1 — The skin is not damaged, but it has redness that does not turn white when touched.
  • Stage 2 — The tissues of the epidermis or dermis are damaged, possibly damage to both layers of the skin. The damage manifests itself clinically as a wound or blister. The surrounding skin may be reddened.
  • Stage 3 — All superficial layers of the skin, fatty tissues, up to muscles are damaged. The bedsore looks like a deep funnel.
  • Stage 4 — All structures of soft tissues, bone or articular structures are destroyed.
Anyone can develop a pressure sore, but elderly, bedridden, paralyzed, and malnourished patients are at higher risk. Individual risk of developing pressure ulcers can be determined using risk assessment tools such as the Braden scale.

The Braden scale is a rating scale consisting of 6 parameters.

  • Sensory perception (the ability to meaningfully respond to discomfort)
  • Moisture (the degree of skin hydration)
  • Activity (degree of physical activity)
  • Mobility (the ability to change and control body position)
  • Power Problems
  • Rubbers
The most important aspect of the prevention and treatment of pressure ulcers is pressure reduction. This can be achieved through frequent changes in patient position, use of anti-decubitus mattresses, or special equipment to reduce stress. Correct treatment should include thorough cleaning and treatment of wounds, removal of the avital cover from the wound, and freeing the wound environment from urine and feces. Stages 3 and 4 often require surgery.

Prevention and treatment of pressure ulcers

Before starting any manipulation, thoroughly treat your hands with an antiseptic.Pressure ulcer classification based on the international pressure ulcer classification system NPUAP - EPUAP 2011.

Stage 1

Description

  • Redness of the skin without damaging it
  • Red area of ​​skin with fever, swelling, roughness or pain

Treatment goals

  • Skin treatment
  • Restoration of capillary functions

Local wound treatment

  • Maintaining skin integrity, skin care
Stage 2, wound not infected
  • Partial damage to the upper layers of the skin (dermis or epidermis)
  • Shiny or dry small pressure sore without damage or bruising
  • Maceration possible

Treatment goals

  • Ensure the cleanliness of the wound surface for wound granulation

Local wound treatment

  • Preparation of the wound surface: treatment of the wound with an antiseptic solution or gel, for example: Septil
  • Surface and deep treatment of pressure ulcers: application of Matrix for tissue repair Mirragen
Stage 3, the wound is not infected

Description

  • All superficial layers of the skin are damaged. Visibility of adipose tissue is possible, muscles and bones are not damaged
  • Possible partial coverage of the wound edges with a scab
  • Treatment goals
  • Removal of a scab
  • Ensure the cleanliness of the wound surface for wound granulation 

Local wound treatment

  • Preparation of the wound surface: treatment of the wound with an antiseptic solution or gel (for example, Septil, Dekasan)
  • Treatment of deep pressure ulcers: application of the Mirragen Tissue Repair Matrix
  • Treatment of pressure sores on the heels: application of the Mirragen Tissue Repair Matrix
  • Treatment of pressure ulcers in the sacral spine: application of the Matrix for tissue repair Mirragen
Stage 4, wound not infected

Description

  • All structures of soft tissues, bone or articular structures are destroyed
  • Possible partial coverage of the wound edges with a scab. The bedsore looks like a deep funnel  Treatment goals
  • Removal of a scab
  • Ensuring the cleanliness of the wound surface for wound granulation

Local wound treatment

  • Preparation of the wound surface: treatment of the wound with an antiseptic solution or gel (for example, Septil, Dekasan)
  • Deep Treatment of Pressure Ulcers: Application of Mirragen Tissue Repair Matrix
  • Treatment of pressure sores on the heels: application of the Mirragen Tissue Repair Matrix
  • Treatment of pressure ulcers in the sacral spine: application of Matrix for tissue repair Mirragen
Stage 4, wound infected

Description

  • Signs and symptoms of infection: discoloration, foul odor, swelling, increased wound temperature 

Treatment goals

  • Reduce bacterial load
  • Monitor exudate and odor
  • Prevent the formation of biofilm, remove if
  • Ensure the cleanliness of the wound surface for wound granulation 

Local wound treatment

  • Preparation of the wound surface: treatment of the wound with an antiseptic solution or gel (for example, Septil, Dekasan)
  • Surface and deep treatment of pressure ulcers: application of Matrix for tissue repair Mirragen
  • Treatment of pressure sores on the heels: application of the Mirragen Tissue Repair Matrix
  • Treatment of pressure ulcers in the sacral spine: application of Matrix for tissue repair Mirragen.

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