Management of the traumatic wounds in tropics

Uvod: Poškodbene rane nastanejo nenadno, nepričakovano. So poškodbe, ki jih povzročajo zunanji dejavniki in jih delimo na odprte in zaprte. Zaradi prisotnosti mikroorganizmov je preprečevanje okužb eden od ciljev pri oskrbi poškodbenih ran. V diplomskem delu je kronološko predstavljena oskrba poškodbenih ran v tropih, kjer sem pod okriljem Sekcije za tropsko in potovalno medicino preživel 3 mesece v Keniji. Ker se vse več študentov Zdravstvene fakultete odloča za sodelovanje pri odpravah, so iz lastnih izkušenj predstavljeni štirje primeri oskrbe poškodbenih ran od njihovega nastanka do konca obravnave. Namen: Namen diplomskega dela je bil predstaviti obravnavo poškodbenih ran v tropih, natančneje v Keniji. Predstavljena je Sekcija za tropsko in potovalno medicino Medicinske fakultete v Ljubljani in slovenska ambulanta v Keniji, ki deluje v njenem sklopu. Kronološko je predstavljena oskrba poškodbenih ran, ki smo jih zdravili v ambulanti. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s pregledom domače in tuje literature. Pri iskanju smo uporabili časovni okvir od leta 2006 do 2018. Iskanje literature je potekalo preko spletnega portala digitalne knjižnice Univerze v Ljubljani preko mednarodnih spletnih baz CINAHL in Medline in s pomočjo vzajemne kataloške baze podatkov COBISS.SI. V drugem delu diplomskega dela pa bo na podlagi lastnih izkušenj in slikovnih virov predstavljena oskrba akutnih ran v slovenski ambulanti v Keniji. Rezultati: V Keniji je veliko ran, ki jih povzročijo domače živali, pogosti so piki insektov, nastajajo pa tudi različne poškodbe pri delu, doma in v prometu. Za oskrbo ran morajo pacienti sami priskrbeti material in poravnati stroške za zdravljenje, zato si rano velikokrat oskrbijo sami z neprekuhano vodo, kar še samo poslabša celjenje rane. Člani humanitarno-medicinske odprave smo za čiščenje in pokrivanje ran uporabljali sodobne materiale. Rezultati sodobnih oblog so bili pri celjenju rane hitro vidni. Razprava in zaključek: Obravnava rane v Sloveniji in Keniji je v osnovi podobna, vendar obstajajo velike razlike glede tega, s kakšnimi materiali oskrbujejo rane, saj v Keniji pogosto primanjkuje že osnovnih sredstev ali pa si teh ne morejo privoščiti. Sodobni materiali so se izkazali za zelo učinkovite, žal pa so za večino prebivalstva predragi.Introduction: Traumatic wounds occur suddenly, unexpectedly. If injuries are caused by external factors the wounds that occur are divided into open and closed. Due to the presence of microorganisms, prevention of infections is one of the goals in the treatment of traumatic wounds. In the thesis, a chronological presentation of the treatment of traumatic wounds in the tropics, where I spent 3 months in Kenya under the patronage of the Section for Tropical and Travel Medicine, is presented. As more and more students of the Faculty of Medicine decide to participate in the expeditions, four examples from own experience of the supply of traumatic wounds from their origin to the end of treatment, are presented. Purpose: The purpose of the thesis is to present the treatment of traumatic wounds in the tropics, more precisely in Kenya. We would like to present the Tropical and Travel Medicine Section of the Faculty of Medicine in Ljubljana and the Slovene Medical Clinic in Kenya, which works in its unit. We want to chronologically present the treatment of the damaged wounds that were treated in the clinic. Methods: In the thesis we used a descriptive method of work with a review of Slovene and foreign literature. During the search, we used the time frame from 2006 to 2018. The search for literature was carried out through the web portal of the digital library of the University of Ljubljana, using the COBISS.SI reciprocal database, and the international online databases CINAHL and Medline. In the second part of the diploma work the treatment of acute wounds in the Slovenian clinic in Kenya will be presented on basis of own experience and image sources. Results: In Kenya, many wounds are caused by domestic animals, common are insect bites and stings and various injuries occur at work, at home and in the traffic. For the care of the wounds, patients have to provide the materials and pay for treatment themselves, so they often treat themselves with unboiled water, which only worsens the healing of the wound. Members of the humanitarian medical expedition used modern materials to clean and cover wounds. The results of modern wound healing was quickly seen. Discussion and conclusion: Treatment of wounds in Slovenia and Kenya is similar, but there are great differences when it comes to what materials are used for the treatment, because Kenya often has shortage of basic assets or cannot afford them. Modern materials have proved to be very effective, but unfortunately for most of the population they are too expensive