Thursday, May 16, 2019

Pressure Ulcers (Bedsores)―All Things Considered

Pressure sores can develop even when you’re in confined for a short period. This includes people who must stay in bed or wheelchair because of an illness or an injury. Chronic diseases make it difficult for pressure sores to heal. These include diabetes and hardening of the arteries.

Treating pressure ulcers involves reducing pressure on the affected skin, caring for the wounds, controlling pain, preventing infection and maintaining good nutrition.[2]


Symptoms of Pressure Sores


Symptoms look different at each of the 4 stages:.[1]
  • Stage 1.
    • The area looks red. It may feel warm to the touch. It may burn, hurt, or itch. The pressure sore may look blue or purple in people who have dark skin.
  • Stage 2.
    • The area is more damaged. The sore may be open. It may look like a cut or blister. The skin around the sore may be discolored. The sore is painful.
  • Stage 3.
    • The sore will have a crater-like look. This is due to increased damage below the surface. This makes the wound deeper.
  • Stage 4.
    • This is the most serious. Skin and tissue are severely damaged. It becomes a large wound. Infection is possible. You are likely able to see muscle, bones, tendons, and joints.

Pressure Ulcers Treatment Market


The global pressure ulcers treatment market was valued at US$ 4,500.0 Mn in 2017 and is anticipated to expand at a CAGR of about 5% from 2018 to 2026 to reach US$ 7,000 Mn by 2026.[3]




Key Market Segments


In terms of treatment type, the global pressure ulcers treatment market has been segmented into[4]
  • Wound care dressings
    • Has been further classified into antimicrobial dressings, foam dressings, hydrocolloid dressings, film dressings, alginate dressings, hydrogel dressings, and other dressings.
    • Growth of the wound care dressings segment is primarily driven by usage of antimicrobial dressings in the treatment of pressure ulcers.
  • Wound care devices
    • Has been further categorized into negative pressure wound therapy (NPWT), ultrasound therapy, and others (HBOT and electromagnetic therapy).
  • Active therapies, 
    • Has been further divided into skin grafts & substitutes, growth factors, and others (hemostatic agents, sealants (collagen and fibrin sealants)).
  • Others
    • Has been further segmented into pressure relief devices, traditional wound care products, and others. 
In terms of type of wound, the global pressure ulcers treatment market has been categorized into stage 1, stage 2, stage 3, and stage 4.  Incidence of stage 2 pressure ulcer is higher than other stages; however, the treatment cost of severe stages (stage 3 and stage 4) of pressure ulcer is higher than stage 2.

The stage 2 segment held the largest market share in 2017.

Treatment team


Addressing the many aspects of wound care usually requires a multidisciplinary approach. Members of your care team might include:
  • A primary care physician who oversees the treatment plan
  • A physician or nurse specializing in wound care
  • Nurses or medical assistants who provide both care and education for managing wounds
  • A social worker who helps you or your family access resources and who addresses emotional concerns related to long-term recovery
  • A physical therapist who helps with improving mobility
  • An occupational therapist who helps to ensure appropriate seating surfaces
  • A dietitian who monitors your nutritional needs and recommends a good diet
  • A doctor who specializes in conditions of the skin (dermatologist)
  • A neurosurgeon, orthopedic surgeon or plastic surgeon

Reducing pressure


The first step in treating a bedsore is reducing the pressure and friction that caused it. Strategies include:
  • Repositioning. 
    • If you have a pressure sore, turn and change your position often. How often you reposition depends on your condition and the quality of the surface you are on. Generally if you use a wheelchair, try shifting your weight every 15 minutes or so and change positions every hour. If you're in a bed, change positions every two hours.
  • Using support surfaces
    • Use a mattress, bed and special cushions that help you sit or lie in a way that protects vulnerable skin.

Cleaning and dressing wounds


Care for pressure ulcers depends on how deep the wound is. Generally, cleaning and dressing a wound includes the following:
  • Cleaning
    • If the affected skin is not broken, wash it with a gentle cleanser and pat dry. Clean open sores with water or a saltwater (saline) solution each time the dressing is changed.
  • Putting on a bandage
    • A bandage speeds healing by keeping the wound moist. This creates a barrier against infection and keeps the surrounding skin dry. Bandage choices include films, gauzes, gels, foams and treated coverings. You may need a combination of dressings.

Removing damaged tissue


To heal properly, wounds need to be free of damaged, dead or infected tissue. Removing this tissue (debridement) is accomplished with a number of methods, such as gently flushing the wound with water or cutting out damaged tissue.

Other interventions


Other interventions include:
  • Drugs to control pain. 
    • Nonsteroidal anti-inflammatory drugs — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — might reduce pain. These can be very helpful before or after repositioning and wound care. Topical pain medications also can be helpful during wound care.
  • Drugs to fight infection
    • Infected pressure sores that aren't responding to other interventions can be treated with topical or oral antibiotics.
  • A healthy diet. 
    • Good nutrition promotes wound healing.
  • Negative pressure therapy. 
    • This method, which is also called vacuum-assisted closure (VAC), uses a device to clean a wound with suction.

Surgery


A large pressure sore that fails to heal might require surgery. One method of surgical repair is to use a pad of your muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).

References

  1. Pressure Scores
  2. Bedsores (pressure ulcers)―Mayo Clinics
  3. Global Pressure Ulcers Treatment Market
  4. Pressure Ulcers Treatment Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2018 - 2026
  5. Antimicrobial dressings - Wounds International (PDF)
  6. Diabetic Foot Ulcers and Pressure Ulcers Market is Projected to be WorthUS$4.9 bn by the End of 2024

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