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Čiščenje kompleksnih ran s tekočo pitno vodo : pregled literature
Koštić, Rasima (Author), Djekić, Bernarda (Mentor) More about this mentor... This link opens in a new window, Vilar, Vanja (Co-mentor)

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Abstract
Uvod: Celjenje kompleksnih ran je odvisno od več dejavnikov. Okužba je eden izmed najpogostejših zapletov, ki upočasni ali zavre celjenje rane. Razvoj novih spoznanj o spodbujanju celjenja rane z ustrezno pripravo dna rane je spodbudilo tudi razmišljanja o najbolj ustreznem načinu čiščenja rane ter izbiri najustreznejše tekočine za čiščenje. Uporabljajo se različne raztopine, kot so voda iz pipe, prekuhana voda, destilirana voda, antiseptične raztopine in sterilna fiziološka raztopina. Namen: Namen diplomskega dela je predstaviti čiščenje kompleksnih ran s tekočo pitno vodo in ugotoviti varnost in učinkovitost njene uporabe v primerjavi s katerokoli drugo raztopino. Cilj diplomskega dela je ugotoviti ali uporaba tekoče pitne vode vpliva na proces celjenja ter pojavnost kontaminacije, kritične kolonizacije in okužbe kompleksnih ran. Metode dela:Uporabljena je bila deskriptivna metoda dela s pregledom literature v bibliografskih bazah MEDLINE, ScienceDirect, CINAHL with full text, Cochrane Library in Wiley Online Liberary iz obdobja med letoma 2006 in 2017. V prvi fazi so bili identificirani štirje sistematični pregledi literature, ki so zajeli primarne študije do vključno leta 2013. Druga faza iskanja literature predstavlja usmerjeno iskanje novejših randomiziranih kontroliranih študij. V analizo so vključene tri študije. Za namen kritične presoje izvedbe študij, kakovosti rezultatov in oceno tveganja pristranskosti študij je bilo uporabljeno orodje Critical Appraisal Programme for Randomised Controlled Trials. Rezultati: Analizirane študije so vključevale paciente starejše od osemnajst let, z akutnimi in kompleksnimi ranami. Opazovana intervencija je bila čiščenje ran s tekočo pitno vodo, primerjana intervencija pa čiščenje s fiziološko raztopino. Kot opazovana izida sta bila izpostavljena mikrobna obremenitev rane in proces celjenja rane. V vseh treh študijah ugotavljajo, da čiščenje s tekočo pitno vodo ne poveča mikrobne obremenitve ran. Proces celjenja so ugotavljali samo v dveh študijah in niso ugotovili statistično pomembnih razlik pri čiščenju z obema tekočinama. Razprava in sklep: Rezultati analize potrjujejo ugotovitve prejšnjih sistematičnih pregledov literature o varni uporabi tekoče pitne vode za čiščenje kompleksnih ran. Vendar smo ugotovili, da je število dokazov zelo majhno, zato ni možno, da bi rezultate posplošili. Glede na izpostavljene omejitve analize študij bi bilo v prihodnje potrebno izvesti togo zasnovane raziskave z v naprej določenim protokolom ter s primerno velikostjo vzorcev, ki bi vključevale samo paciente z natančno opredeljeno etiologijo kompleksnih ran, jasno opredeljenimi kriteriji izbora sodelujočih ter natančnim protokolom izvedbe čiščenja ran.

Language:Slovenian
Keywords:mikrobna obremenitev ran, celjenje ran, varnost, učinkovitost, primerjava med raztopinami
Work type:Bachelor thesis/paper (mb11)
Organization:ZF - University College of Health Studies
Year:2017
COBISS.SI-ID:5291115 Link is opened in a new window
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Downloads:334
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Secondary language

Language:English
Title:Cleansing complex wounds with tap water : literature review
Abstract:
Introduction: The healing of complex wounds depends on several factors. Infection is one of the most common complications, which slows down or prevents the healing of a wound. The development of new theories about improving the healing of wounds through appropriate wound management has led to the debate of which technique and solution is best for cleaning them. Currently different solutions are used, such as tap water, boiled water, distilled water, antiseptic solutions and sterile saline. Purpose: The purpose of this diploma paper is to present the cleaning of complex wounds with tap water and to determine whether its use is safe and effective compared to other solutions. The goal of this paper is to determine whether the use of tap water affects the healing process, leads to contamination, critical colonialization or infection of complex wounds. Methods of work: The descriptive method was used with a overview of literature in bibliographical bases MEDLINE, ScienceDirect, CINAHL with full text, Cochrane Library in Wiley Online Library between 2006 and 2017. During the first phase there were identified four systematic overviews of literature, which included primary studies up to and including 2013. The second phase consisted of a focused search for more recent randomized controlled studies. Three studies were included in the analysis. To ensure that the studies and results were judged objectively we used the Critical Appraisal Programme for Randomised Controlled Trials. Results: The analysed studies included patients older than eighteen years old with acute and complex wounds. The focus of observation was on the process of cleaning wounds with tap water, while the comparison was made with cleaning wounds with saline. The focus is on results of how much the wound was exposed to microbes and the process of the wound’s healing. All three studies conclude that cleaning with tap water does not increase the risk of wound exposure to microbes. Only two studies deal with the process of healing and they did not note any statistically significant differences between cleaning with potable water or saline. Discussion and resolution: The results of the analysis confirm the findings of previous systematic overviews of literature regarding the safe use of tap water for cleaning complex wounds. However, we have discovered that the number of evidence is quite small, which is why it is impossible to generalize the results. In lieu of the mentioned limitations of the analysis of the studies, future studies should be conducted in accordance with a rigid protocol and with appropriately large samples. These should include only patients with a thoroughly defined aetiology of complex wounds, clearly defined criteria for participants and a clearly defined protocol for cleaning the wounds.

Keywords:exposure to microbes, wound healing, safety, effectiveness, comparison of solutions

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