PRESSURE ULCER-ETIOLOGY AND TREATMENT METHODS

Tema ovog preglednog rada je dekubitus. U uvodu rada ukratko je objašnjena anatomija cijeljenja rane te definicija i kratka podjela samih rana. U razradi teme iznesene su osnovne činjenice o dekubitusu, opisana je anatomija kože i patofiziološki proces nastanka dekubitusa. Navedeni su i razjašnjeni čimbenici rizika koji uzrokuju nastanak dekubitusa i mjesta na kojima dekubitus nastaje. Opisani su stupnjevi dekubitusa i njihovi simptomi uz dodatke slika za lakši uvid u izgled rane. Slikovno su prikazane i ukratko opisane najčešće skale koje medicinska sestra koristi za procjenu rizika za nastanak dekubitusa. U trećem poglavlju razjašnjeni su uzroci nastanka infekcije dekubitalnog vrijeda i razlika između kolonizacije tkiva bakterijama i infekcije dubokih tkiva. Opisan je način obrane kože od bakterija, a navedene su i bakterije koje spadaju u normalnu floru kože te one koje najčešće uzrokuju infekciju dekubitusa. Četvrto poglavlje govori o terapiji dekubitusa koja je podijeljena na konzervativnu i kiruršku terapiju. Konzervativna terapija obuhvaća uklanjanje pritiska i primjenu obloga, dok kirurška terapija obuhvaća najčešće metode zbrinjavanja dekubitusa i njihove komplikacije. Nadalje je opisana prevencija nastanka dekubitusa te uloga medicinske sestre u njoj. Prevencija je podijeljena na smanjenje pritiska, njegu kože i prehranu i hidrataciju bolesnika. Nakon toga slijedi zaključak u kojem su iznesene činjenice na koje moramo obratiti pažnju pri pristupu bolesniku s dekubitusom i daljnjem napretku i edukaciji. Na kraju rada nalazi se popis literatu i popis priloga.The main theme of this review paper is pressure ulcer. The introduction of this paper describes the anatomy of wound healing, and it contains the definition and short classification of wounds. The second chapter presents the main facts about pressure ulcer, it describes the anatomy of the skin and pathophysiological processes of the occurrence of pressure ulcers. The risk factors that cause the emergence of decubitus and places where decubitus is found are also described and explained. There is a description of degrees of decubitus and their symptoms with pictures for an easier insight into the wound. There is also a brief description, with photographic examples, of charts which nurses most commonly use to evaluate the risk of developing a decubitus. The third chapter is focused on the causes of developing an infection of pressure ulcers. It describes the difference between wound colonization and infection of deep tissues and the ways that skin defends herself from bacterias. It also contains the names of bacteria that are most commonly found on the skin as a normal skin flora and the names of bacterias that are mostly causing infection. The conservative and surgical treatment of decubitus is described in chapter four. Conservative methods include reduction of pressure and application of wound dressings, and surgical therapy consists of procedures for treatment of decubitus with possible complications. The next chapter is focused on the prevention of pressure ulcers and the role of the nurse. It consists of pressure reduction, skin care and adequate diet and hydration. As a conclusion, there are facts on which we have to pay attention while approaching a patient and in further education. At the end of this review paper is a list of used references and the list of attachments