CARE OF PATIENTS WITH BURNS

Koža je jedan od najvećih tjelesnih organa i ima brojne funkcije, uključujući zaštitnu barijeru protiv ozljeda i infekciju, termoregulaciju, regulaciju gubitka tekućine, sintezu vitamina D i osjetni kontakt s okolinom. Opeklina je djelomično ili potpuno oštećenje kože uzrokovano toplinom, kemikalijama, električnom energijom, sunčevom svjetlošću ili nuklearnim zračenjem. Jedna je od najčešćih traumatskih ozljeda na svijetu. Opekline se općenito klasificiraju prema dubini, opsegu i težini ozljede. Prema dubini oštećenja kože koja je zahvaćena opeklinskom ozljedom razlikuje se: prvi, drugi, treći i četvrti stupanj opeklina. Dubina opeklina ovisi o sloju kože koji je oštećen. Za procjenu postotka površine zahvaćene opeklinom najčešće se primjenjuje Wallecovo pravilo devetke. Osim toga koristi se i Lund- Browderov postupak te palmarna površina ruke. Opekline s obzirom na težinu kliničke slike dijelimo na lakše, umjerene, teške i kritične. Zbrinjavanje opeklina temelji se na uklanjanju izvora opekline, zbrinjavanju vitalnih funkcija i dišnog puta, hlađenje opeklina hladnom vodom tijekom 20 minuta, uklanjanju odjeće i nakita, nadoknadi tekućine te monitoringa i praćenja. Liječenje opečenih bolesnika može biti lokalno i kirurški. Lokalno liječenje uključuje previjanje te primjenu obloga prilikom čega je važno spriječiti razvoj infekcije poštivanjem aseptičnih uvjeta. Kirurško liječenje temelji se na primjeni kožnih transplantata ili zamjena za kožu. Liječenje i rehabilitaciju potrebno je započeti već prvog dana kako bi konačan ishod bio što bolji. Važno je ublažiti odgovor organizma na stres, očuvati elektrolitsku ravnotežu i nadoknaditi povećane metaboličke potrebe organizma jer nekontrolirani hipermetabolizam dovodi do ogromnog gubitka mišićne mase. Zdravstvena njega opeklinskog bolesnika je opsežna i zahtjevna, a provodi se tijekom svake faze zbrinjavanja i liječenja od ozljeda opeklina.The skin is one of the body’s largest organs and has a number of functions, including a protective barrier against injury and infection, thermoregulation, regulation of fluid loss, vitamin D synthesis, and sensory contact with the environment. A burn is a partial or complete damage to the skin caused by heat, chemicals, electricity, sunlight, or nuclear radiation. It is one of the most common traumatic injuries in the world. Burns are generally classified according to the depth, extent, and severity of the injury. According to the depth of damage to the skin affected by the burn injury differs: first, second, third and fourth degree burns. The depth of the burn depends on the layer of skin that is damaged. To estimate the percentage of the area affected by the burn, the Wallec rule of nine is most commonly applied. In addition, the Lund-Browder procedure and the palmar surface of the hand are used. According to the severity of the clinical picture, burns are divided into mild, moderate, severe and critical. Burn care is based on removing the source of the burn, taking care of vital functions and the airway, cooling the burns with cold water for 20 minutes, removing clothing and jewelry, replenishing fluids, and monitoring and tracking. Treatment of burnt patients can be local and surgical. Local treatment includes dressing and application of dressings, in which case it is important to prevent the development of infection by respecting aseptic conditions. Surgical treatment is based on the application of skin grafts or skin substitutes. Treatment and rehabilitation should be started on the first day in order for the final outcome to be as good as possible. It is important to alleviate the body's response to stress, maintain electrolyte balance and compensate for the increased metabolic needs of the body because uncontrolled hypermetabolism leads to a huge loss of muscle mass. The health care of a burn patient is extensive and demanding, and is carried out during each phase of care and treatment of burn injuries