[Do mattresses and support systems prevent decubitus lesions?].
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One of the most frequent causes of early reintubation through the other nostril or a tracheostomy is necrosis due to pressure in the region of the nares. Based on experience in 85 long-term intubated patients, prophylaxis with Silastik foam appears to be most efficient. It is inexpensive and easy to handle and can therefore be highly recommended.
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Without relief of localized pressure, no healing is possible, and all other therapeutic measures are futile. If other factors are mistakenly blamed (incontinence, perspiration, malnutrition) attention may be diverted from the essential--relief of localized pressure and maintenance of patient mobility. Dressings should protect healing ulcers from mechanical damage and external bacterial recontamination after removal of pathogens by local disinfection. Dressings should be kept moist with Ringer's solution to create conditions that promote new granulation.
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