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Retention of urine

Retention of urine may be due to renal and extrarenal causes. In renal insufficiency ostentatious treatment of the underlying disease and its complications, the appointment of diuretics. In cases where the cause of urinary retention is extrarenal complications necessary measures to eliminate them (nephrostomy, ureterostomiya, tsystostomiya) and organization with care.

Treatment bedsores

Decubitus - a necrotic skin ulcers and soft tissue that develop as a result of ischemia, which is a result of external pressure and friction. Compression of soft tissues, mainly in the field bony protrusions leads to ischemia and necrotic changes of already after 1-2 hours. Especially rapidly developing these changes in fixed patients during deep circulatory disorders and trophic tissue. Risk factors are: old age, exhaustion, weakness, hypoalbuminemia, vitamin deficiency, dehydration, anemia, hypotension, neurological disorders, fainting and coma, maceration of the skin, etc. The main causes of pressure ulcers: external pressure, injury, skin friction surfaces, folds linen, infection, skin contamination. Most pressure ulcers are formed in the following locations: sacrum, greater trochanter of the femur, thoracic spine, sciatic pohorbok, heel, shoulder, outer ankle, neck, ear. In the development of bedsores vydyalyayut 4 stages:

     at 1 (initial) stage is marked redness and swelling of the skin induration, blisters appearing or hemorrhage, but no visible damage to the epidermis;

     Stage 2 is characterized by damage to the epidermis and superficial ulcer formation;

     at 3 stages of necrosis extends to the entire thickness of the skin to form deep ulcers, performed necrotic masses;

     Phase 4 means spreading necrosis on hlybsheroztashovani tissue and bone.

Treatment of pressure ulcers made ​​taking into account the stage of disease development. Basic principles of treatment of pressure ulcers:

     removal of external pressure and prevent further spread of necrosis;

     protection of the surrounding skin and wounds from infection;

     general and local use of drugs that improve blood circulation and trophic tissue;

     removal of necrotic tissue (surgical nekrektomiya, autolitychna enzimatychna or reorganization);

     keeping the wound moist sredovyscha and temperature, stimulation of reparative processes anesthesia.

In 1 and 2 stages of treatment aimed at protecting the skin from infection and improve trophic tissue to prevent the development of necrotic processes or minimize them.

In stages 3 and 4 focuses on cleaning the wound of necrotic tissue, preventing infection, keeping moist environment in the wound, stimulating reparative processes.

For the treatment of pressure ulcers are different external agents: ointment based antibiotic (bacitracin, haramitsyn, klimitsyn, Dalacin - c, Imex, linkomitsynova ointment sintomitsinovoy emulsion baneotsyn, drapolen, dermazin) ointment with anti-inflammatory and improving regeneration effect (liniment Vishnevsky, vinilin , Levomekol, levosyn, dioksyzol, trofodermin, vulnuzan, methyluracil, propotseum, panthenol) ointment of proteolytic (iruksol, fibrolan, profezim, viprosal) and analgesic effect (fastin, Menovazin, alhezal).

Bandages used to treat bedsores, must meet the following requirements: protect the wound from contamination and infection, help maintain moisture and temperature in the wound, absorb excess fluid, to ensure maximum activity of the patient. Patching and can perform special functions, depending on need: with bleeding bandages are used with a solution of adrenaline or hemostatic sponge, deodorizing effect providing bandages sorbents, activated carbon (in the form of the upper dry layer) gel metronidosol; analgesic effect can be achieved by applying bandages to 0.1% mixture of morphine gel or ointment, etc. To prevent sticking to the wound dressing applied ointment (levomikol, levosyn, dioksyzol and so on.), hydrogels, hidropolimery.

Particular attention should be paid to personal hygiene and patient adherence to rules of asepsis. Despite the severity of the patient is necessary to organize regular washing of the body with warm water 1-2 times a day and thoroughly podmyvaniya after each defecation and urination, with subsequent treatment of skin creams and ointments. Given that patients are particularly vulnerable to infection, required strict compliance with all aseptic procedures and protecting patients from unwanted contact with carriers of infection by caring, relatives or visitors.

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