Above all, under the supervision of a doctor or nurse.
Bedsores should be treated topically, i.e. the wound should be secured with appropriate dressings.

Another important element of treatment is appropriate patient care, which includes:

• changing the position – the patient should not lie on the bedsore
• placing the patient on an anti-bedsore mattress
• protecting the affected areas with special discs and anti-bedsore supports
• adequate nutrition and hydration of the patient
• monitoring of concomitant diseases

The topical treatment of bedsores involves the use of dressings specifically designed for this purpose, so-called specialised or modern dressings that create a moist healing environment in the wound.

BLACK WOUNDS

Wounds with black necrosis require: 

• maintenance of a moist environment
• removal of necrotic tissue to initiate the healing process

The healing process will not occur under thick layers of necrotic tissue, and in order to trigger the healing process, the necrosis must first be removed. We have two basic choices for removing necrosis from the wound bed: 

• Surgical debridement – this involves mechanical removal of necrotic tissue to expose healthy skin structures in order to initiate the wound healing process.
• The use of interactive dressings – this involves placing a dressing which stimulates the process of autolysis, i.e. the body’s natural wound cleansing process. In this case, the necrosis is broken down by enzymes produced by the damaged cells of the wound. The most effective dressings in this group are hydrogel dressings, including Medisorb G.

Dressings recommended for black wounds: 

• Medisorb G – hydrogel dressing

YELLOW WOUNDS

Wounds with yellow colliquative necrotic tissue require: 

• maintenance of a moist environment
• absorption of excess exudate together with residual necrotic material

Wounds with colliquative necrosis are characterised by an increased degree of secretion. The necrotic tissue remaining at the bottom of the wound is fluid. Such wounds provide an ideal environment for the growth of microorganisms, and are therefore often infected. The role of the dressing in this case is to absorb exudate and necrotic material, liquefying necrosis that is too dry and compacted, not allowing the wound to dry out, and protecting it from secondary trauma.

Appropriate dressings for yellow wounds, depending on the amount of exudate and wound depth: 

• Medisorb A – alginate dressing – heavy to medium exudate, superficial and deep wounds
• Medisorb P PLUS ADHESIVE – absorbent dressing – heavy to medium exudate, superficial wounds
• Medisorb P PLUS – absorbent dressing – heavy to medium exudate, superficial wounds
• Medisorb R MEMBRANE – resorbable dressing – heavy to medium exudate, superficial wounds
• Medisorb R POWDER – resorbable dressing – heavy to moderate exudate, wounds with furrowed bottom

RED WOUNDS
with visible granulation tissue require: 

• maintenance of a moist environment
• protection against secondary infection
• control of the exudate level

In addition to maintaining the moist environment, this type of wound also requires protection from possible mechanical trauma. This is particularly important because well-vascularised granulation tissue is susceptible to traumas that delay healing and can cause infection. Another important factor is to maintain an adequate temperature close to body temperature, so that new cells can develop at an optimal rate.

Dressings appropriate for red wounds, depending on amount of exudate and wound depth: 

• Medisorb A – alginate dressing – heavy to medium exudate, superficial and deep wounds
• Medisorb P PLUS ADHESIVE – absorbent dressing – heavy to medium exudate, superficial wounds
• Medisorb P PLUS – absorbent dressing – heavy to medium exudate, superficial wounds
• Medisorb H – hydrocolloid dressing – moderate to light exudate, superficial wounds
• Medisorb R MEMBRANE – resorbable dressing – heavy to medium exudate, superficial wounds
• Medisorb R POWDER – resorbable dressing – heavy to moderate exudate, wounds with furrowed bottom

PINK WOUNDS

Pink epithelialising wounds require: 

• maintenance of a moist environment
• protection of delicate tissues

When a wound begins to develop epidermis, it needs protection from drying out, friction and other factors that can damage the newly formed tissue.

Dressings appropriate for pink wounds, depending on the amount of exudate: 

• Medisorb H – hydrocolloid dressing – moderate to light exudate
• Medisorb F – film dressing for minor exudate

INFECTED WOUNDS                                                                                    

Wounds of varying degrees of severity, infected or at risk of infection, protection against infection, inhibition of infection development.                                                               

To initiate the healing process, it is necessary to stop the ongoing infection or prevent the wound from becoming infected. Bacterial proliferation triggers cell breakdown, which significantly delays the healing process.

Dressings appropriate for this type of wounds:    

• Medisorb SILVER – absorbent dressing with silver – heavy to medium exudate, superficial wounds
• Medisorb SILVER PAD – absorbent dressing with silver – heavy to medium exudate, superficial wounds                                      
• Medisorb P SILVER – absorbent dressing with silver – heavy to medium exudate, superficial wounds
• Medisorb R Ag – resorbable dressing with silver – heavy to medium exudate, superficial wounds      

Analysis of the phases of healing shows that wounds in various stages of healing require slightly different conditions for the process to proceed smoothly. It should be remembered that in addition to different stages of healing, wounds also differ depending on their extent, depth, presence of necrotic tissue and degree of secretion.

All of these features make it necessary to choose the appropriate type of dressing for each wound, and sometimes several dressings that will be changed during the healing process.

The table below shows factors that can slow down the process of wound healing.
 

slowing factor	why	optimal conditions	how it works under optimal conditions
dry environment		moist environment	adequate level of exudate in the wound  allows activation of natural wound cleaning process accelerates granulation  ensures quick and normal epithelialisation
necrotic tissues	wound healing is only possible after removal of dead tissue, necrosis can be a source of infection	wound debridement surgical autolytic	a cleaned wound allows the granulation phase to begin
infection	all mechanisms in the wound work to eradicate the intruder, the healing process is inhibited	fight infection	a cleaned wound allows the healing process to begin