Pressure Ulcer: Prophylaxis and Therapy

The first prophylactic measure when there is a risk of bedsores is regular repositioning. Several times a day, the skin areas at risk must be inspected, and the patient must be repositioned correspondingly frequently. If turning the patient every two hours is not sufficient, aids such as soft mattresses can be used. It is important to take good care of the skin to keep it dry, clean and intact. Skin care with milking grease, petroleum jelly, zinc paste, etc., and also the use of substances that promote circulation, such as rubbing alcohol, tend to aggravate the skin condition.

Increased energy requirements

Adequate nutrition is also important: people at risk of pressure ulcers need about twice as much protein as healthy people, and the additional energy requirement is estimated at 30 to 90 percent. People who are already ill recover twice as fast with special supplementary food – for example, with drinking preparations available in pharmacies.

Sometimes maggots help

Even if it doesn’t sound particularly appetizing: maggots, the small larvae of the blowfly, are able to specifically remove dead tissue, because that is exactly what they feed on. Healthy cells are not touched. The head physician of the trauma surgery department at Bietigheim Hospital, private lecturer Dr. Wim Fleischmann, uses this method to treat patients with diabetic gangrene, wound infections caused by arterial occlusive disease, bacterial periosteum inflammation and ulcus cruris (open legs).

The animals work with absolute precision and secrete a specific digestive secretion that only liquefies dead tissue and is absorbed by the maggots. Suppurated, poorly healing wounds are cleaned in this way.

Painless and precise treatment

Due to another secretion secreted into the wound, the tissue starts to granulate faster – the open areas can finally close. The maggots are sterile and are applied to the wound while still tiny. To do this, the freshly cultured and sterile maggots are rinsed with a saline solution from the delivery container onto a close-meshed nylon net and applied to the wound.

A second dressing of gauze compresses absorbs wound secretions and provides the necessary oxygen supply. After three days, the dressings are opened and the larvae are removed. The painless treatment is considered very successful.