Vloga medicinske sestre pri kirurškem zdravljenju razjed zaradi pritiska : pregled literature

Maksin, Nataša (author), Pajnič, Manca (mentor)

Uvod: Kljub obsežni tehnološko napredni opremi, številnim pripomočkom za preventivo in letom raziskav, razjeda zaradi pritiska (RZP) ostaja velik izziv za obvladovanje in zdravstveni problem, ki slabša kakovost življenja pacientov, povečuje stroške ter močno obremenjuje zdravstveni sistem. Kirurško zdravljenje RZP je ena izmed možnosti v oskrbi teh razjed. Različne tehnike rekonstrukcije defektov z režnji so tako poleg uporabe sodobnih oblog ter drugih načinov pospeševanja celjenja, kot je na primer metoda uporabe negativnega podtlaka, pogosta metoda izbire. Spremljanje izgleda režnja, izcedka, bolečine ter splošnega stanja pacienta so najpomembnejše naloge medicinske sestre. Namen: Namen diplomskega dela je predstaviti kirurško oskrbo rane pri pacientih z RZP ter raziskati vzroke, ki preprečujejo dober rezultat kirurškega zdravljenja RZP. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom strokovne in znanstvene literature. Obdobje pregleda literature je potekalo od februarja 2016 do novembra 2016 s pomočjo podatkovnih baz CINAHL, Medline (Pubmed in Wiley Online Library. Literatura je iskana tudi s pomočjo bibliografske baze podatkov slovenskih knjižnic COBBIB.SI. Pri iskanju literature smo se odločili za uporabo ključnih besed in besednih zvez v slovenščini: razjeda zaradi pritiska, kirurško zdravljenje razjed, oskrba rane in zdravstvena nega. V angleškem jeziku pa: surgical treatment AND pressure ulcer, nursing care AND pressure ulcer. Razprava: Zaradi kontinuirane zdravstvene nege pri kirurškem zdravljenju RZP je medicinska sestra za nego rane dolžna spremljati potek celjenja rane in ob ugotovljeni nepravilnosti poročati kirurgu. Visoka stopnja zapletov in s tem povezani stroški kažejo, da je potrebno oceniti kakšen bo najprimernejši način zdravljenja RZP. Za lažje spremljanje napredka ali poslabšanja razjed obstajajo ocenjevalne metode, ki pripomorejo k ocenitvi ran. Sklep: Rane z odloženim celjenjem, kamor spadajo tudi RZP, predstavljajo svojevrsten izziv tako zdravstvu, kot proizvajalcem sodobnih oblog. Strategijo zdravljenja je potrebno nenehno prilagajati glede na oceno stanja RZP ter ostale spremljajoče zunanje ter notranje dejavnike. Z natančnim sprotnim dokumentiranjem lahko celostno in kontinuirano vsi skupaj kakovostno obravnavamo posameznika z RZP in pripomoremo k zdravljenju razjede.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, kirurška oskrba rane, rekonstrukcija z režnji, odloženo celjenje, zapleti rekonstrukcije
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [N. Maksin]
• Year: 2017
• Number of pages: 28 str.
• PID: 20.500.12556/RUL-88886
• COBISS.SI-ID: 5231211
• Publication date in RUL: 26.01.2017

MAKSIN, Nataša, 2017, Vloga medicinske sestre pri kirurškem zdravljenju razjed zaradi pritiska : pregled literature [online]. Bachelor’s thesis. Ljubljana : [N. Maksin. [Accessed 2 April 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=88886

Secondary language

• Language: English
• Title: The role of a nurse in the surgical treatment of pressure ulcer : literature review

Abstract

Introduction: Despite the extension of technologically advanced equipment, a number of utility for the prevention and years of research, pressure ulcer (PU) remains a major challenge. It is also a big health problem that reduces the quality of patients' lives, increases costs and represents a heavy burden on the health system. Surgical treatment of PU is one of the possibilities in the supply of these ulcers. Different techniques of reconstruction of defects with the lobes as well as the use of modern wraps and other ways to promote healing, such as the method of application of downforce are frequent methods of choice. The most important tasks of a nurse are monitoring the patients, discharging them, enabling pain release and taking care of the general condition of the patient. Purpose: The purpose of this thesis is to present a surgical wound care in patients with PU and to explore the causes that prevent the good result of the surgical treatment of PU. Methods: We used the descriptive method as well as the scientific literature. The overview was conducted from February 2016 to November 2016 using the database CINAHL, Medline (PubMed) and the Wiley Online Library. Literature was searched with the help of bibliographic databases Slovenian libraries COBBIB.SI. In search of the literature, we decided to use keywords and phrases in Slovenian: pressure ulcer, surgical treatment of ulcers, wound care and nursing. In English, however: surgical treatment AND pressure ulcer, nursing care AND pressure ulcer. Discussion: Due to the continuous care for the surgical treatment of PU the nurse is obligated to care for the wound, to follow the course of wound healing and to report about observed irregularities to the surgeon. High rate of complications and associated costs show that it is necessary to assess what will be the best way to treat PU. In order to facilitate monitoring of the progress or deterioration of the ulcer, there are assessment methods that help to evaluate healing. Conclusion: The wounds with delayed healing, which include PU, represent a unique challenge for both health care and the manufacturer of modern wrappings. Treatment strategy must be continuously adapted to assess the state of PU and other accompanying external and internal factors. With precise ongoing documentation we can integrate and continue a quality treatment for the individuals with PU and contribute to the treatment of ulcers.

• Keywords: diploma theses, nursing care, surgical wound care, flap reconstruction, delayed healing, reconstruction complications