Définition d'une escarre et comment la traiter

Definition of a pressure sore and how to treat it

Oct 23, 2017

This scourge of subcutaneous tissue that seems inevitable during prolonged bed rest still has no well-established treatment . The question then arises: how to treat bedsores? We will explain the mechanism of pressure ulcer formation and how to treat a pressure ulcer with the treatments in place.

What is a bedsore, definition?

A pressure sore is a skin lesion of ischemic origin, that is to say due to a lack of blood supply. It is also called wound , deep, bed or bed ulcer depending on the country. This wound that never seems to heal is the result of the prolonged pressing of a skin tissue against a surface. Depending on the evolution of the pressure ulcer, it is classified from stage 1 to stage 4 .

For example, if you are bedridden for a long time (or for people in an armchair), the permanent contact of the flesh against the bed (or the armchair) will gradually compress the blood vessels and therefore reduce the blood supply. The subcutaneous tissues will begin to create deep necrosis (or several), then gradually this hypoxia will spread and rise towards the surface of the skin. In general, a pressure sore will appear towards the bony prominences where the pressure is greatest. It manifests itself initially:

  • by a zone of persistent redness ( stage 1 ),
  • induration of the skin with the gradual appearance of blisters ( stage 2 )
  • then appears the wound with necrosis of the skin (stage 3).
From then on, it is very difficult to go back and surgery becomes almost inevitable. In the most severe cases, there is a stage 4 and 5 where the area of ​​the ulcer enlarges more and more.
Photo of a stage 1 heel pressure ulcer

Are bedsores frequent?

In France, the prevalence of pressure ulcers in hospitalized patients is estimated at 9%. Around 300,000 people in France , of all ages, suffer from bedsores - spinal injuries, hospitalization at home, having undergone surgery.

Why can't a pressure sore heal?

The first reason that explains the difficulty in treating a pressure sore is that very often the patient must remain bedridden . The ulcer is a secondary consequence and it is often not possible or possible to put the patient in another position. It is then necessary to understand the healing mechanism of a wound . Good healing of the skin is none other than the normal development of cells, whether we are talking about skin cells, muscles or others, we must allow proper cell development. If the cells multiply rapidly under the right conditions, then healing can occur . Let's see the needs of a cell to multiply without problem, to help us we will compare a cell to a baby. To grow, a baby must be nourished, a cell must be vascularized. The child needs to drink, a cell needs to be hydrated. It must breathe and the cell must be oxygenated. It does not need chemicals, same for the cell. Finally, it must be in a healthy and clean environment without aggressive factors. For a wound to heal , it is therefore necessary to allow vascularization by limiting compression, to hydrate it abundantly, to oxygenate it as much as possible, thus avoiding excessively thick dressings which do not allow air to pass through and above all to avoid an overabundance of products. medicinal chemicals that disrupt proper cell development. A last point is added to this list, it is the extra cellular matrix (ECM).

What is the extra cellular matrix ?

The extra cellular matrix, also called intercellular cement, is the support on which a cell will develop. It is essentially composed of proteins of all kinds, you have surely already heard of some of them which make up collagen or elastin which give the appearance of elasticity to our skin . Well, know that there are a multitude of other proteins in this matrix, including a particularly interesting family in our case: the metalloproteases (MMPs). MMPs are enzymes that are able to degrade the constituents of the extracellular matrix. Some dressings make it possible to regenerate the extra cellular matrix, this is the case with the liquid antiscar dressing .


In normal times, they make it possible to destroy the damaged or damaged parts to allow other actors to synthesize a new matrix. For healing to take place normally and quickly, a balance must always be maintained between the MMPs and their inhibitors, the TIMPs (for tissue inhibiting metaloproteases). When the concentrations of MMPs become higher than those of TIMPs, there is then a delayed healing or even no healing! When a pressure sore appears , a significant inflammatory phenomenon will occur which will disrupt the action of the TIMPs. The MMPs will then quickly take over and continue to degrade the MEC more and more. The cells can no longer multiply and the wound remains chronic. If other factors that we saw earlier in this article are added, such as a lack of oxygenation, poor hydration of the wound or the application of chemical antiseptic products, it is practically impossible for the wound to heal. of herself.

How to treat a pressure sore: the treatments

The treatment of bedsores must consider the healing of the wounds , but also the suffering of the patient. It is therefore multidisciplinary care that requires the involvement of all parties: caregivers, nurses, the doctor and of course the patient himself. To improve wound healing, it is important to keep it oxygenated and hydrated. We must apply dressings that will protect the wound, but still allow it to remain ventilated. This is why today new liquid dressings are developed to promote this oxygenation. If the eschar wound becomes infected, it will be necessary to use either antibiotics or local antiseptics. However, this strategy is of no interest if the diagnosis of the infection is not confirmed. In some cases for stage 4 pressure ulcers, resorting to surgery is unavoidable. It is necessary in the presence of tissue necrosis, when organs are exposed or when the bone is bare. Sometimes surgery is also necessary when the infection of the wound is too important.

Advice: everyday actions to treat pressure sores naturally

People suffering from pressure sores generally have fragile and/or dry skin, poor lymphatic drainage or poor blood circulation. Pressure sores can be very painful and can even lead to infection if not treated properly.

A few things to do on a daily basis will help prevent bedsores, or even relieve them. Find out how to treat pressure sores below:

1. Watch your diet and drink plenty of fluids.

Eating healthy and in large quantities helps prevent pressure sores. Drink at least six to eight glasses of water a day to help keep your skin hydrated.

2. Move regularly to help prevent pressure sores.

If you are immobilized, change position about every two hours to evenly distribute your body weight.

3. Use specially designed cushions or mattresses to reduce pressure on areas at risk for pressure sores.

Specially shaped foam cushions can help reduce pressure on the hips, heels and elbows.

4. Wear loose, comfortable clothing to avoid irritating your skin.

Tight clothing can put unwanted pressure on your skin and make pressure sores worse.

5. Remember to clean your skin every day with mild soap and warm water.

Then dry your skin carefully to avoid irritation.

6. Apply moisturizer every day to help prevent dryness in your skin.

Creams and lotions containing moisturizing agents like olive oil, aloe vera, or vitamin E can help prevent pressure sores.

7. Monitor your skin for possible signs of pressure sores, including redness, swelling, pain, or a feeling of warmth.

If you notice one or more of these symptoms, consult your doctor immediately. He can prescribe treatment to prevent or cure pressure sores.

How to treat bedsores with a natural treatment?

How to treat a bedsore? Corrective measures must be taken immediately after identifying a wound for prevention but also to reduce the risk of non-healing. Treatment can be in the form of conventional treatment or home treatment, depending on the patient's condition, which is equally effective in reversing the infection and healing the wound. Management involves identifying the wound at an early stage and starting treatment immediately.

How to treat a bedsore with aloe will see?

Aloe vera is a miracle plant, it has antibacterial, anti-inflammatory, soothing and healing properties. Use is simple, just apply fresh aloe vera gel to bedsores. Not only will it cure bedsores, but it will prevent their appearance. The natural cooling properties of Aloe Vera prevent itching and burning sensations. This method is one of the most effective home remedies to treat bedsores and get quick relief.

How to treat a bedsore naturally with myrrh and turmeric?

Applying a mixture of myrrh essential oil and turmeric powder is used to improve blood circulation, support the immune system, help wounds heal faster, and help the body get rid of toxins. Turmeric, on its own, is very effective in treating bedsores. Its antimicrobial properties prevent any type of infection that can be caused by wounds . It reduces pain and provides instant relief. Turmeric also heals wounds quickly.

How to treat a bedsore naturally with beetroot?

Beetroot has proven to be very effective in the natural treatment of bedsores. It prevents itching and soothes wounds. Red beet mixed with honey has increased effectiveness on bedsores. It is very soothing for areas affected by bedsores. In addition, honey maintains hydration in the area and prevents itching and redness.

How to treat a bedsore naturally with coconut oil?

Massage can improve blood circulation and, therefore, prevent the appearance of bedsores. Take olive oil or coconut oil and massage the body completely to improve blood circulation. Warm coconut oil is great for the skin and massage until completely absorbed. As a precaution, massage the entire body except wounds. This will help stimulate blood circulation and heal wounds quickly.

ANTISCAR the anti-bedsore liquid dressing

Antiscar is Naturveda's new natural treatment. It proved to be very effective in a clinical study conducted on stage 2 to 3 bedsores. This technology uses natural polymers to stimulate healing. Its mechanical action allows it to oxygenate, reduce inflammation proteins and proteins that degrade the extracellular matrix. The results appear quickly.


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