BY HARRIET HIGBEE, Graduate Illinois Training School for Nurses.
_From the American Journal of Nursing._
The prevention and treatment of bed-sores have been and are frequently
discussed in medical books and journals. But as it is a subject that
often taxes the nurse’s ingenuity to the extreme, it can not be dwelt
upon too frequently. Many preventive measures are familiar to us, as
the soap and water bath for cleanliness, followed by rubbing with
alcohol and dusting with boric-acid powder, or boric-acid powder and
bismuth subnitrate in equal parts for dryness. _The relief of pressure
is most important._ Make use of air-cushions, cotton-pads, pillows,
water-bed and _frequent change of position_ where that is possible.
In addition to these, there are a few measures not generally used
which after a thorough test have proved satisfactory. One is a simple
inexpensive contrivance used to relieve pressure of heel, elbow, and
ear. It is a pig’s bladder filled two-thirds full of either warm or
cold water, as the case requires, tied securely, and placed under a
cotton ring. The weight of the head or elbow rests on the ring and
the tender point rests on the soft fluctuating mass. If the skin is
inactive, as in paralysis, or there is frequent or constant moisture
from perspiration or involuntary evacuations of urine or feces, the
alcohol and boric acid, etc., are of very little value. They do not
prevent the absorption of the moisture by the skin and its subsequent
softness or excoriation, which is commonly followed by infection. In
such cases the back should be washed with soap and water every six or
eight hours, or after every involuntary evacuation, and thoroughly
rubbed with a small amount of oil-substance, as camphorated oil or a
mixture like the following:
Mutton tallow, ℥j;
Olive oil, f℥j;
Carbolic acid, 95 per cent., ♏︎j.
Render out mutton tallow on the back part of the stove; do not brown
it. Strain through a piece of muslin; add the olive oil and carbolic
acid; set dish into cold water and beat its contents until set.
This will make an ointment the consistence of vaseline, and it will
keep indefinitely. If the skin needs a great deal of stimulation,
camphorated oil or, better still, castor oil may be substituted for the
olive oil in the above recipe.
When the skin becomes excoriated the part should be cleansed as
mentioned before, not with soap and water, but with boric-acid
solution, normal salt solution, or sterile water; then gently painted
with oxide of zinc ointment made into liquid form by the addition of
olive oil, castor oil, and balsam of Peru in equal parts, or castor
oil alone, and covered with a clean cloth fastened on with a binder.
Gentle massage may be used around the excoriated surface with excellent
results.
_The_ =treatment of bed-sores= _is usually directed by the physician_;
but if it is left to the nurse, she will find the following method
helpful. If there is necrotic tissue or suppuration present, she may
irrigate the cavity once daily with peroxid of hydrogen, one glass
syringeful, followed by normal salt solution, boric-acid solution, or
sterile water. Then apply a hot boric-acid dressing, one inch thick,
every four hours until wound is clean. If the stimulation of the
tissues is needed, fill the cavity with a sterile dressing saturated
with balsam of Peru and castor oil, equal parts bovinine, castor
oil, or camphorated oil alone. When the depression is filled with
granulation tissue, it can be treated as an excoriation.