Ukulala
Amanxeba acindezelekile, izilonda, noma izintsha ezenzeka ngokucindezela isikhathi eside kwezicubu ezithambile kuya kuma-protuberance we-bony; Amabhuloho ajwayelekile okubunjwa ngamabhedi ayi-sacrum, iziqhwa nezithende. Ukucindezela kuvimbela ukujikeleza kwe-capillary esikhumbeni nasezikhungweni ezingezansi, ezingagcina ziholela ekufeni okukhulu kwesisindo kanye nokubhujiswa kwezicubu. Inqubo yokwehlukaniswa kwezicubu iqala ngokungenakuqonda futhi kancane kancane iqhubeka. Kungathatha izinsuku ezimbalwa ngaphambi kokuba umonakalo wokulimala kwezicubu ubonakale. Ukujula kwe-decubitus kungahluka kusuka kumamitha kuya kumamitha amaningana kuze kufike ekubhujisweni kwemisipha namathambo. Izifo ezilonda ulcerative zakhiwa, njengendlela, kulabo asebekhulile nababuthakathaka abangakwazi ukunyakaza ngemva kokuhlinzwa, kanye neziguli ezibhekene nomzimba ezibhekene nanoma yiluphi uhlobo lwesifo senhliziyo noma isifo senhliziyo. Ababhedlele abakwazi ukuphendula kahle ukwelashwa, ngakho umsebenzi oyinhloko ukuwuvimbela. Iziguli ezisengozini yokubunjwa kwemibhede kufanele zibheke kumatilasi okhethekile onika ingcindezi encane ezindaweni eziyinkinga; zonke izinhlobo zemithwalo zisiza ukushintsha isimo sesiguli embhedeni. Lesi sithombe sikhombisa i-decubitus esigxwini esiphansi sesiguli, sigcwele izixuku ezishisayo (ezifile). Ukulwa nenqubo yokwehlukaniswa nokuvuselelwa kokuphulukisa, ama-antibiotics futhi, mhlawumbe, ukusetshenziswa kwezibungu ezikhethekile zokuhlinzeka kuyodingeka. Izilonda zamaphethelo aphansi, nakuba zifana nokulala, zineendlela ezihluke ngokuphelele zokuthuthukiswa. Cishe amaphesenti angu-80 awo avela emonakalweni yamapayipi e-valvular wesimiso esibucayi segundane elingaphansi, okuyinto ehlukumeza kakhulu ukuphuma kwamanzi okuphuma emathisini futhi ekugcineni kungabangela isilonda (trophic ulcers).
Ukwelapha
Indlela eyinhloko yokwelashwa kwe-trophic ukusetshenziswa kokucindezelwa kwangaphandle kwemiphetho engezansi ngosizo lwezingubo ezihlanganisiwe noma ilineni lokucindezela. Lezi zinyathelo zenza ukubuyisa kwegazi kube nenhliziyo enhliziyweni, kuvimbele ukuqoqwa kohlobo oluthile emkhathini nasesikhathini.
Ischemic isifo
Ngamaphesenti amancane weziguli, ischemia yezicubu ezingezansi ezingezansi ziholela ekuqotheni, okubangelwa ukungafihli (ukuvinjelwa) kwemithwalo yegazi. Uma ukusakazwa kwegazi kulezi zitsha kunciphisa izinga elithile elibucayi, izicubu azitholi okwanele okwanele kanye nezakhi futhi zife. Ezimweni ezinzima, uma ukuvuselelwa kwegazi ngokuhlinzwa kungenzeki, isiguli sisongelwa ngokulahlekelwa yingxenye noma isilwane sonke. Amanxeba azo zonke izinhlobo anezici ezithile ezivamile: enhliziyweni yokuphulukisa kwabo kukhona izindlela ezifanayo zeselula; noma yisiphi isilonda esengozini yokutheleleka. Amanxeba okuhlinzwa kanye nezinye izinhlobo zamanxeba ajwayelekile ngokuvamile avaliwe ngokukhwabanisa - inqubo ihlanganisa ukuletha imiphetho yelonda ndawonye futhi ukuxhuma nabo ngezinto eziphathekayo. Naphezu kokuthi amanxeba amaningi okushisa kanye nezilonda zingavalwa ngokuhlinzekwa ngokusetshenziswa kwezibhamu zesikhumba, ezimweni eziningi, ukuphulukiswa kwezifo ezingezansi ezingxenyeni ezingezansi kanye nezilonda zomshoshaphansi zenziwa "ngezingqinamba zesibili". Isilonda sinekhanda elikhethekile, elihluma kancane kancane nge-granulation (ukuphulukisa) izicubu. Ekupheleni kwalolu hlelo, i-epithelium esanda kumiswa (isikhumba) iqala ukukhula kusukela emaphethelweni enxeba kuze kube yilapho ivala yonke indawo yezicubu ze-granulation iphinda ibuyise ubuqotho besikhumba. Amanxeba amaningi angavalwa ngokufakelwa kwesibhumba, okungukuthi, ngokudlulisela isigaba somzimba onempilo esihlwini. Ukuhlukaniswa kwamagciwane ezincelweni akulona uphawu olukhona lokuthi kukhona ukutheleleka, ngoba amanxeba alowo hlobo ahlwanyela ngokushesha ngamabhaktheriya avela kunani elikhulu lemithombo engenzeka. Imiphumela yokungcoliswa kwegciwane lesilonda kuncike ezintweni eziningi, kufaka phakathi:
• inani lamagciwane ezincane;
• ikhono lama-microbes okubangela isifo;
• ikhono lokuzivikela komzimba ukuze kunqobe ukutheleleka okungenzeka.
Ukuqhuba amanxeba
Ukwenza isilonda esithathelelekile kuhilela kokubili imisebenzi ehlelekile kanye neyendawo, kuhlanganise nokubeka ama-antibiotics (uma kuboniswe) nokugqoka usebenzisa izinto ezifanele (okungenzeka kube nezinto ezithile zokulwa namagciwane). Ukweluleka kokusetshenziswa kwezidakamizwa zama-antibiotic akungabazeki, ngoba kungabangela ukuthuthukiswa kokuphendula kwe-hypersensitivity noma kubangele ukuvela kwamagciwane okumelana nawo (ukumelana). Izinto zokugqoka zivame ukwenziwa ngendlela yokugcina izimo ezinomsoco kwilonda; lokhu kuvimbela umonakalo owengeziwe futhi kukhuthaza ukukhula kwezicubu ezintsha. Uma kungekho izinyathelo ezifanele zokulwa nokutheleleka, ukuthuthukiswa kwe-cellulite (ukutheleleka kwebhaktheriya kwezingxenyana ezingaphansi), okudala ingozi yokungena kwamagciwane ngaphakathi kwegazi (i-bacactia ne-septicemia).