A Comprehensive Guide to Local Treatment of Pressure Ulcers: Physical Therapy and Drug Selection

Prognosis: Obstructive sleep apnea syndrome has a high incidence rate, can lead to loss of working capacity, increases the risk of accidents, and in severe cases, can even cause death. Reports indicate a 5-year survival rate of 94% and a 10-year survival rate of 72%, closely related to the number of apneas per night (RDI). For those with an RDI > 20, the 10-year mortality rate is 37%, while for those with an RDI < 20, it is 4%. The series of pathological changes and worsening complications caused by hypoxia in obstructive sleep apnea syndrome, such as heart failure, respiratory failure, and arrhythmias, may be the main cause of death in patients with obstructive sleep apnea syndrome.

Pressure ulcers are a pathological process caused by continuous pressure on local soft tissues, altered hemodynamics, leading to tissue and cell ischemia and hypoxia, nutritional and metabolic disorders, resulting in degeneration and necrosis. Currently, it is considered more appropriate to refer to pressure ulcers as pressure sores.

Treatment of pressure ulcers is divided into systemic treatment and local treatment.

Systemic Treatment: The main systemic treatments for pressure ulcers caused by obesity currently involve diet, exercise, psychological care, and behavioral therapy. Drug therapy is primarily used to prevent infection.

(I) Dietary Therapy
In addition to controlling diet and reducing the weight of obese patients, dietary therapy for pressure ulcers requires nutritional supplementation.

1. Protein Supplementation
Good nutrition is crucial for wound healing. A balanced diet is best for pressure ulcer patients, but protein intake needs to be increased to correct negative nitrogen balance. Studies have shown that large pressure ulcers requiring drainage can consume up to 30g of protein daily. If the patient has severe malnutrition and lacks the protein and energy needed for wound healing and tissue repair, pressure ulcers cannot be effectively treated.

2. Vitamin and Zinc Supplementation
Supplementing with Vitamin C promotes collagen healing, and collagen is an important protein in connective tissue and skin. Zinc participates in the formation of many important enzymes and is highly concentrated in healing tissues. Furthermore, Vitamin A also contributes to collagen synthesis.

(II) Drug treatment Drug treatment mainly controls infection. Although systemic infection is not common in patients with pressure ulcers, it is a common cause of death. Patients with sepsis must be given strong antibiotics and the wound must be adequately drained or debrided.