Bed Sores

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CONSTITUTIONAL MEDICINE
- Ancient wisdom in the modern world



 

Finding a good herbalist

Most of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

Protection

The first rule of medicine is primum non nocere - which means 'firstly, do no harm'. In the case of a bed sore the first thing to do is to try to protect the body against whatever caused the issue in the first place, whether that be some kind of pressure, inflammation, infection or general lack of circulation.

Each person will have different needs in this regard depending on where the wound is located and how much mobility they do or don't have so everyone involved needs to put their heads together to think about how to ease that pressure as much possible and give the wound time to heal.

Such matters as careful positioning and the creative use of pillows and cushions will need to be considered and then just generally bring an open, problem-solving mindset to the vital issue of protection against further harm.

Movement

Movement is essential to both the treatment and prevention of bed sores. Again, how much movement and what kind of movement is going to depend on a host of factors and you just have to work with whatever you've got.

The main thing that everyone needs to understand is that a lack of blood circulation is as much of the root cause of the bed sore as any amount of pressure or immobility. The person needs movement (and/or massage) to get their circulation going or the problem won't get better and may get worse.

Again, get into a creative, problem-solving mindset as to how to best improve movement e.g. a set of clearly defined and achievable exercises or setting up some kind of automated alert to happen at regular intervals to ensure a change of position etc.

Massage

All the old medical text books highlighted massage as an essential and primary treatment for bed sores but these days this kind of hands-on therapy has fallen by the wayside as such things take time and the 'bean-counters' have taken over the administration of the hospitals.

Of course, you don't massage the bed sore itself but you can and should massage the tissues around it and be aware that any kind of massage anywhere in the body is highly stimulating to blood circulation.

The less a person is able to move themselves the more important massage becomes to get the circulation going. Any kind of technique that moves the muscles and the blood will help but it may help to know that movements that work towards the heart will be especially useful.

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Herbal Healing

With ensuring the blood is circulating through movement and/or massage, and being careful to protect against doing further harm, we should now be able to see a rapid improvement in the bed sore through the use of some safe and very effective treatments as outlined below.

The first suggestion here is a simple honey poultice as this should be immediately accessible to anyone who needs help right away and it really is very good. The honey poultice just by itself will be enough for bed sores that have not gotten too deep or large but note that there are more complex herbal treatments discussed further below that can be used for more severe conditions.

Simple Care: Honey Poultice

Honey is an ancient technique for wound healing with excellent modern research to support its traditional use. You could look online at some of the pioneering New Zealand Professor Peter Molan's work on honey and wounds to delve further into this research if interested.

The key proven point to know is that honey will speed healing in the wound whilst killing or preventing the infections that can be the hardest part of bed sores to get on top of.

Any kind of honey will work so you must not worry if your options are limited in this regard, that said, if you can get it, then the most effective form that has been identified by the research for wound healing is from Manuka honey and this is now widely available commercially, though be sure to get a well certified product.

Stage 1: Clean the wound

First clean the wound using saline solution. You can easily make this at home by adding a half tsp of salt to a cup of freshly boiled water, if you have any concerns about how clean your water might be then boil it on a stove top for a few minutes first.

You can wet a cloth with the saline solution and gently clean in and around the wound or, especially if it is quite raw and sore, you might be best to simply spray the saline solution on to the sore and the surrounding skin and then just let it naturally dry over a few minutes while you are preparing the honey bandage.

Stage 2: Dress the wound

Take a gauze bandage or other kind of clean, breathable material that is cut just a little larger than the sore and apply a liberal amount of honey to one side of it. Don't be shy to use plenty of honey, e.g. you can easily go to half a cm thick. Apply the honey directly to the wound and then fix it in place using a cotton bandage or other kind of material that will keep it attached.

Ideally you want to keep the skin around the wound quite dry but the wound itself should be kept moist whilst it is in its early stages of healing. Leave the bandage on for 24 hours and then repeat the process of first cleaning with saline and then re-applying a fresh honey poultice.

You should see rapid and significant improvements with this treatment and you can be 100% sure that the honey will not feed any infection or otherwise interfere with healing. The reason this is an ancient technique is not because it made things worse but simply because it works!

Keep looking for, and hopefully you will soon see, the development of the first stages of a heathy scab. Once there is this lattice-work of tissues, this scaffolding, this thin self-healing bandage of a healthy scab that is now covering the sore, then it is best to let the wound be open to the air, to let it dry and let the body continue to heal itself without all the risks that keeping things hot, damp and covered can lead to.

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Advanced Care: Salves &/or Poultices

No one should underestimate how much a honey poultice may be able to help and perhaps that is the best place to start for most bed sores however, for a deeper or more chronic wound, you may need a more comprehensive strategy to turn things around as now discussed

Stage 1: Clean the wound

Again, use a base of a saline solution to spray on to the wound and surrounding skin but this time, if you can obtain them, add a small amount of any one or any combination of the tinctures or extracts of Myrrh, Calendula, Golden Seal or Echinacea. These are all potent, antimicrobial, immune stimulating and healing herbs. I would be confident to use any one of them or any kind of combination of two or more, see what is available to you, preferably by contacting a herbalist in your area.

Approximately 10% of one or more of these extracts to 90% of the saline is a safe proportion to use, e.g. 10 mls of one or more of the herbs to 90 mls of saline solution. Such a mixture could be used over a period of days until finished when no fear of it going off. The saline and herbs can be simply sprayed on and allowed to dry or you can wet a cloth with the mixture and gently clean in and around the wound if preferred.

Stage 2: Medicate the wound.

Herbal Poultice

Herbal poultices are a ancient and effective way to get a lot of medicinal action from a herb directly to the area where it is needed. You make a poultice by using one or more herbs that have been powdered and then made into a paste with adding water.

Ideal herbs for a poultice for a bed sore include Calendula, Comfrey, Echinacea, Yarrow and Slippery Elm. If I had a choice of any of these I would personally use equal proportions of Calendula, Comfrey and Echinacea powders but, that said, I would be entirely happy to use just one of them or Yarrow or Slippery Elm if that was what was available.

Add enough water until you get a thick paste then either gently put a thick layer of the poultice directly on to the sore or place enough of it onto a bandage that you then apply directly to the wound to well and truly cover it. The herbal poultice is meant to make direct contact with the damaged tissue. Again, as with the honey, you can trust that many thousands of years of these practices have shown us beyond any possible doubt that these methods are both safe and effective.

You will need to hold the poultice in place for at least one or two hours for the active ingredients in the herbs to fully penetrate into the wound. Simply wrapping some plastic cling-wrap around the poultice for this amount of time will not make the area overly damp and is an easy way to hold things nicely in place.
However, if for any reason you prefer to use something like a cotton crepe bandage then that is perfectly ok too.
Ideally a poultice would be done on a daily basis or even twice a day if things were quite bad.

When you take the poultice off you should again clean the wound with the saline solution and allow to dry before re-dressing. Remember you need to keep the wound moist whilst it is in its early stages of healing but the surrounding areas relatively dry so ideally you now move to putting a salve directly on to the wound as described next, or use a honey poultice as described earlier.

Remember, the herbal poultice is meant to make direct contact with the damaged tissue. The speed with which herbs like Comfrey and Calendula affect healing can be nothing short of remarkable. Again, as with the honey, you can trust that many thousands of years of these practices have shown us beyond any possible doubt that these methods are both safe and effective.

Again, as soon as you see the development of the first stages of a heathy scab that is now covering the ulcer, then it is best to let the wound be open to the air, to let it dry and let the body continue to heal itself without all the risks that keeping things hot, damp and covered can lead to.


herbal poultice ready to apply

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Herbal Salves

Herbal Salves are also extremely effective for wound healing and are fairly easy to administer and leave in place for the long time periods needed to help cure a bed sore.

You should be able to obtain a commercial herbal salve that has been well made and ready to use e.g. Herb Pharm's 'Original Salve' would be very appropriate for this purpose and you should not be put off by their saying not to use it on broken skin, this is said because of the Comfrey in the ingredients but a recalcitrant bed sore is a perfect example of a condition where the remarkable benefits of Comfrey far outweigh its possible long term risk, see my article on Comfrey here for more on this subject.

If for any reason you need to or would prefer to make your own herbal Salve then there are some very good online sources for detailed instructions on the 'how-to' side of this. They are really very simple to make for example you can see several recipes on this page from Mountain Rose Herbals http://mountainroseblog.com/diy-herbal-salves/

I personally would especially go for Salves that contained Calendula and/or Comfrey root. If there was much pain in the sore, then using an infused oil of St John's wort in the salve will also give great relief.

Apply the herbal salve liberally to the wound, don't worry about it staying moist by your doing this, that is exactly what you want to achieve, you only need to think about the ulcer 'drying out' when the surface of the skin is forming a healthy scab. Apply a light bandage to keep the salve in place and then ideally clean and treat the wound every 24 hours.

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Prevention

Once you are getting the bed sore well and truly on its way to being healed then of course you are going to want to try to prevent this from happening again! If the person is aging or they are very immobile then their skin will be lacking tone and preventing bed sores can be especially difficult.

Movement and massage, however much you can, will go a long way towards prevention and I would also recommend to regularly spray the skin in any potential problem areas with a saline solution to which you have added no more than 10% of one or more of the tinctures or extracts of Agrimony, Calendula, Plantain, Yarrow, or Shepherd's purse. Each of these herbs has its own unique character and method of working but in this case they all share a quality of being toning and nourishing to the skin or tissues. You could use any one or more of such herbs to great preventative benefit!


Agrimonia eupatoria (Agrimony)

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd