Bed Sore Ka Ilaj: Ghar Ki Dressing Kab Tak Chalegi Aur Operation Kab Zaroori Hai

Written by Dr. Ashutosh Shah, MBBS, MS, MCh (Plastic Surgery), DNB. A senior plastic and reconstructive surgeon practising in Surat for over 22 years.

Published: 3 October 2026

Written by Dr. Ashutosh A Shah, M.B.B.S., M.S., M.Ch., D.N.B., Board Certified Plastic Surgeon. Reg. no. [REG NO]. 22+ years in plastic and reconstructive surgery.

Medically reviewed by Dr. Ashutosh A Shah · Published 3 October 2026 · Last reviewed 3 October 2026

Bed sore ka ilaj uske stage par nirbhar karta hai. Stage 1 aur 2 mein har 2 ghante karvat, air mattress aur saaf dressing se ghar par bharna sambhav hai. Stage 3 ya 4 mein, jahan haddi dikhe, badbu aaye ya bukhar ho, Dr. Ashutosh Shah jaise surgeon se debridement aur flap operation ki zaroorat padti hai.

Ghar par bistar par pade marij ki dekhbhaal karne waale parivaar ka sabse mushkil sawaal yahi hota hai: ye ghav apne aap bhar jaayega, ya ab doctor ke paas jaana zaroori hai?

Bed sore ka stage ghar par kaise pehchanein?

Stage ka matlab hai gehrai: tvacha kitni gayi hai aur neeche kya dikh raha hai. Ghar ki dressing ka faisla isi par tika hai. Neeche di gayi table NPIAP ke staging par aadharit hai, jo International Guideline ke Fourth Edition (2026) mein bhi wahi hai.

Stage	Skin par kya dikhega	Ghar par kya karein	Doctor ko kab dikhayein
Stage 1	Tvacha saabut, lekin laal nishaan dabane par safed nahi hota: "non-blanchable erythema of intact skin".	Pressure hatayein, karvat ka interval badhayein, tvacha saaf aur sookhi rakhein.	Agar 2 se 3 din mein laali kam na ho.
Stage 2	Upri parat gayi hai, chhila gulabi ghav ya paani wala chhala: "partial-thickness skin loss with exposed dermis".	Nurse ki batayi saaf dressing, pressure poori tarah hatana, khane mein protein.	Pehli baar dikhayein, phir review par rakhein.
Stage 3	Poori tvacha gayi aur ghav ke andar charbi dikh rahi hai: "full-thickness skin loss".	Ghar par akele manage karne ki koshish na karein.	Turant. Yahan se surgical assessment ka mamla hai.
Stage 4	Tvacha ke saath gehre tissue bhi gaye: muscle, tendon ya haddi dikh ya mehsoos ho sakti hai.	Sirf doctor ki nigraani mein. Ghar ki dressing kaafi nahi.	Turant, admission ki sambhavna maan kar.
Unstageable	Ghav slough ya kaali papdi (eschar) se dhaka, gehrai dikhti hi nahi: "obscured full-thickness skin and tissue loss".	Papdi khud na hatayein, na kaatein.	Turant. Papdi hatne tak stage pata nahi chalega.
Deep tissue injury	Gehra laal, maroon ya baingani rang jo dabane par safed nahi hota: "persistent non-blanchable deep red, maroon or purple discoloration".	Pressure turant hatayein. Upar se chhota, neeche bada.	Turant, chahe tvacha phati na ho.

Stage 3, stage 4, unstageable aur deep tissue injury: in chaaron mein ghar ki dressing akeli kaafi nahi hoti. Pressure ulcer treatment ki poori jaankari alag page par hai.

Kaunse gharelu upay madad karte hain aur kaunse nuksaan?

Madad wo cheezein karti hain jo pressure hatati hain, na ki wo jo ghav par lagai jaati hain. Yahi sabse badi galatfehmi hai.

Jo sach mein kaam karta hai:

Karvat badalna. NHS saaf likhta hai: "Changing position and moving regularly is important to help relieve pressure on the ulcers and help stop new ones forming."
Pressure redistribution mattress. Guideline ka interval hi iske saath juda hai.
Tvacha saaf aur sookhi rakhna, khaas kar peshab ya latrine ke baad.
Protein aur paani. Naya tissue protein se banta hai.

Jo nuksaan karta hai:

Ghav par haldi, ghee, tel, toothpaste ya raakh lagana. Inse ghav bharta nahi, aur neeche ka infection chhup jaata hai.
Kaali papdi ya slough khud kaatna ya kheenchna. Yeh kaam operation theatre ka hai.
Ghav khula chhod dena is umeed mein ki sookh jaayega.
Bina salah antibiotic cream bar bar lagana.
Rubber ring ya "donut" cushion. Yeh pressure hatata nahi, ring ke kinare par le jaata hai.

Kab dressing kaafi nahi hai aur hospital jaana chahiye? Bed sore treatment in Jamnagar kab shuru karein

NHS ke mutabik in lakshanon mein turant madad leni chahiye: "hot, swollen or red skin", "pus coming out of the ulcer", "a high temperature", aur "severe pain or pain that's getting worse".

Iske alawa, surgical assessment ka waqt aa gaya hai jab:

Ghav mein charbi, muscle ya haddi dikh rahi ho.
Badbu aa rahi ho.
Ghav kaali papdi se dhaka ho.
2 hafte ki theek dressing aur pressure relief ke baad bhi sudhaar na dikhe.
Ghav chaudai ki jagah gehrai mein badh raha ho, ya andar jeb (undermining) ban rahi ho.

In our practice, Dr. Ashutosh Shah ghar ki dressing wahan rok dete hain jahan ghav ki gehrai charbi tak pahunch jaati hai ya ghav ka base saaf nahi ho pa raha hai, kyunki uske baad dressing badalne se sirf waqt nikalta hai. Jo marij late aate hain, unmein zyada dawa ki zaroorat nahi hoti, zyada operation ki hoti hai.

Flap operation mein kya hota hai aur kitne din bharti rehna padta hai?

NHS seedhe shabdon mein kehta hai: "If the pressure ulcer is severe or other treatments have not worked, you may need to have surgery to clean and close the ulcer." Operation do kaam karta hai.

Debridement. Mara hua tissue, slough aur papdi hataana, kabhi ek baar mein aur kabhi kai stages mein, jab tak base saaf na ho. Debridement surgery kya hai iska alag page hai.
Flap se band karna. Paas ki jeevit tvacha, charbi aur kabhi muscle ko apni blood supply ke saath ghav par laaya jaata hai, taaki haddi par gadda bhar jaaye. Sirf seene se ya graft se aisa gadda nahi bharta. Bedsore flap surgery ki jaankari mein poora tareeka hai.

Bharti ke dinon ka koi fix number is page par nahi diya jaa sakta, aur jo page deta hai wo andaaza laga raha hai. Yeh depend karta hai: stage aur size, debridement ek baar mein hua ya kai baar, flap ka prakar, haddi mein infection, sugar aur poshan, aur operation ke baad us jagah par kitne din pressure nahi padna chahiye. Bahar gaon se aane waale marij planning iske hisaab se karein.

Operation ke baad bed sore dobara na ho, uske liye kya karein?

Jis wajah se pehla ghav bana, wo wajah operation se nahi badalti. Isliye baad ki dekhbhaal hi tay karti hai ki flap tika rahega ya nahi.

Repositioning ke baare mein guideline ki asli baat yeh hai, aur yeh ek number se zyada madad karti hai:

Primary recommendation (R4): "It is good practice to reposition all individuals with or at risk of pressure injuries using an individualized regimen." Matlab interval marij ke hisaab se tay hota hai.
Interval (R7): "We suggest that either repositioning at two hourly or three hourly intervals could be implemented for most individuals at risk of pressure injuries, if they are also on an appropriate pressure redistribution full body support surface." Dhyan dijiye: 2 ya 3 ghante, aur sirf tab jab theek mattress ho. Guideline isko khud "very low certainty of evidence" kehti hai.
Kis cheez se interval tay hota hai (R5): "level of activity and mobility, ability to independently reposition, skin and tissue tolerance, clinical condition, comfort, sleep patterns, goals of care, and the support surface in use".

To apne marij ka interval apni nurse ya doctor se likhwa kar lein. Woh number is page par nahi, marij ki file mein hona chahiye.

Caregiver daily checklist

Karvat ka time: likha hua schedule, deewar par, raat ki shift bhi shaamil.
Dressing: jaisa nurse ne bataya waisa hi, haath dhokar, aur jo nikla uska rang aur badbu notice karna.
Khana: har khane mein protein (doodh, dahi, dal, anda, paneer) aur din bhar paani.
Peshab aur latrine ki safai: turant saaf karna aur tvacha sukha kar hi kapda dalna, kyunki geeli tvacha sabse jaldi tootti hai.
Roz poora shareer dekhna: kamar, kulha, edi, takhna, kaan, kandha. Nayi laali jo dabane par safed na ho, usi din batayein.

Agla kadam

Agar ghav mein charbi, muscle ya haddi dikh rahi hai, badbu aa rahi hai, ya 2 hafte ki theek dressing ke baad bhi sudhaar nahi hai, to agla dressing nahi, assessment chahiye. Jo ghav ab 15 din ka hai, usme flap se bharne ki gunjaish usse zyada hai jo 6 mahine ka ho chuka hai.

Yeh page jaankari ke liye hai aur examination ka vikalp nahi hai. Stage, dressing aur karvat ka interval marij ko dekhne ke baad hi tay hote hain, aur is page par koi price, koi dawa, koi bharti ke dinon ka number aur koi fix karvat interval jaan boojh kar nahi diya gaya. Guideline ka 2 se 3 ghante ka interval bhi sirf theek pressure redistribution mattress ke saath suggest kiya gaya hai, aur guideline khud use "very low certainty of evidence" kehti hai. Papdi, slough ya mara hua tissue khud hataane ki koshish kabhi na karein. Apne marij ke baare mein Dr. Ashutosh A Shah ya apne doctor se salah lein.

FAQs

Kya bed sore par haldi ya ghee lagana sahi hai?

Nahi. Haldi, ghee, tel ya toothpaste se bed sore bharta nahi hai, aur inse ghav par aisi parat ban jaati hai jisse neeche ka infection chhup jaata hai. Ghav par kuch bhi lagane se zyada zaroori hai us jagah se pressure hataana aur nurse ki batayi hui saaf dressing karna.

Air mattress hone par bhi karvat badalni zaroori hai?

Haan, zaroori hai. International Guideline ka Good Practice Statement is baare mein saaf hai: "No support surface can entirely replace repositioning." Mattress pressure baantta hai, poori tarah hataata nahi. Mattress aane ke baad karvat band kar dena ek aam galti hai jiska nateeja naya ghav hota hai.

Bed sore mein badbu kyun aati hai?

Aam taur par badbu ka matlab hota hai ki ghav mein mara hua tissue hai, ya bacteria badh gaye hain, ya dono. Badbu khud mein ek referral ka signal hai, dressing badalne ka nahi. NHS pus nikalna aur bukhar ko turant madad lene wale lakshanon mein ginta hai, isliye badbu ke saath in dono mein se kuch bhi ho to intezaar na karein.

Kya 80 saal ke marij ka operation ho sakta hai?

Umar akeli faisla nahi karti. Dekha yeh jaata hai: dil aur fephdon ki haalat, sugar aur poshan, khoon ki kami, marij kitna hil sakta hai, ghar par dekhbhaal kaisi hogi, aur operation ke baad us jagah par pressure rok paana mumkin hai ya nahi. Kuch 80 saal ke marijon ka flap safal hota hai aur kuch 60 saal ke marijon mein pehle dusri cheezein theek karni padti hain. Bed sore treatment in Jamnagar ke liye yeh faisla examination ke baad hi hota hai.

Bed sore operation ka kharcha kis cheez par depend karta hai?

Is page par koi price nahi di jaa rahi, kyunki ghav dekhe bina di gayi keemat galat hi hogi. Kharcha in par depend karta hai: stage aur size, debridement ek baar mein hoga ya kai baar, flap ka prakar, haddi mein infection hai ya nahi, bharti ke din, anaesthesia, aur dusri bimariyon ka ilaj. Assessment ke baad likha hua estimate maangein.

Diabetes waale marij mein bed sore jaldi kyun badhta hai?

NHS ki risk list mein diabetes ka naam nahi hai, lekin usme do cheezein hain jo lambe samay ke diabetes mein aam hain: "have poor circulation or fragile skin" aur "have problems feeling sensation or pain". Kam khoon ka bahav bharne ki raftaar ghataata hai, aur sunn tvacha par marij ko dard ka wo signal nahi milta jo karvat badalne par majboor karta hai. Yahi do cheezein milkar ghav ko tez karti hain.

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About the Author

Dr. Ashutosh Shah, MBBS, MS, MCh (Plastic Surgery), DNB, is the Director of Elegance Clinic, Surat, with over 22 years of experience across cosmetic and reconstructive surgery.