man had refused to allow caregivers to move him when allowed two and a half days later man has bed sores what now is best treatment man weighs 270 pounds?
15 Jan 2013
Wow, cannot believe the patient does not want to be moved. I knew a woman that had bed sores and it is very painful. It needs to be kept cleaned with sterile things and covered so infection does not get in. Also your not supposed to put anymore pressure on them. That's hard though because usually that is the reason they get it because they are sitting on them. The patient needs to be repositionned often to avoid them. I also worked in healthcare.
14 Jan 2013
It sounds like these may be pressure ulcers, which fall into four categories, 1-4, 4 obviously the worst where the tissue has become necrotic and tunneled to the bone. In the early stages, the wounds need to be kept clean. As long as there is no kidney disease present, as a clinical dietitian that is part of our wound care group, we push protein to assist with healing. Due to the weight, I'd recommend Glucerna which is the diabetic form of Ensure. If he's not eating than I'd recommend Ensure Plus or ensure clinical strength. Also we recommend ten days of 250 mg Vit C taken twice daily(again as long as kidney function is stable) and 220 mg Zinc Sulfate for ten days. These are early interventions and would want to implemented ASAP. Also arginine (an amino acid) is recommended, specifically to aid in healing. He needs to be turned every 2 hours to prevent further skin breakdown.
What setting is he in? The goal is to prevent these pressure ulcers from becoming stage 2 or beyond. If he was in a hospital or nursing facility he'd be followed by wound care. If you could give us a little more information, maybe we can provide further guidance. Why is he refusing to be turned? Are you a care giver if I may ask. I'll look forward to your response so I can try to assist you further. Right now the main thing again is to keep the wounds clean. Warmest regards and hoping some of these suggestions may help!!!
14 Jan 2013
If he will not turn, you will need to document this (if he is in a medical setting) and document that he was educated on what can happen if he doesnt turn and relieve the pressure (tissue death) You will also need to look into pressure relief devices. There are many different mattresses and special beds that are designed to reduce pressure. As far as treatment of the open areas, it depends on how deep they are. Ask a Dr for assistance or ask for a wound care specialist to see the patient.
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