Ayaktan Hasta Takibi ve Lokal Yara Bakımı

Prof. Dr. Salih Tuncal1
Op. Dr. Rifat Kuşabbi2

1SBÜ, Ankara SUAM, Genel Cerrahi Kliniği, Ankara, Türkiye
2SBÜ, Ankara SUAM, Genel Cerrahi Kliniği, Ankara, Türkiye

ÖZET

Yanık yarasının takip ve tedavisinde öncelikle yara iyileşme sürecindeki aşamaların iyi bilinmesi ve hastaların lokal yara bakımları yapılırken dikkatli bir gözlem gerekmektedir. Yanık yarasındaki enflamasyon, enfeksiyon, nütrisyon ve resüsitasyon aşamaları dikkatle izlenmeli ve yara iyileşmesini olumsuz etkileyecek durumlar en- gellenmelidir. Olası istenmeyen durumların erken fark edilerek, gerekli önlemlerin alınması tedavideki başarıyı doğrudan etkilemektedir. Yanık yarasının değerlendirilmesi ve tedavisinin planlanması için standart bir prose- dür gerekmektedir. Yaranın şiddeti ve derinliği 48-72 saat içinde netleşmekte olup tedavi seçenekleri özellikle bu aşamadan sonra belirlenmelidir. Bu duruma karar verirken tedavi algoritmaları ve yatarak tedavi prensip- lerine bağlı kalınması önemlidir. Öncelikle hastanın intravenöz sıvı ihtiyacı olup olmaması, oral ağrı kesici ile ağrı kontrolünün sağlanıp sağlanamaması, yanık yarasına bağlı bir septik tablonun bulunup bulunmaması ve enteral beslenmenin sağlanabilmesi gibi faktörler göz önünde bulundurularak karar verilmeye çalışılmalıdır. Buna ilaveten hastaların sağlık tesisine ulaşma durumu da göz ardı edilmemelidir. Pansuman sıklığı günde iki seferden haftada bir kez arasında; yaranın durumu ve kullanılan pansuman materyallerine göre değişiklik gös- terebilmektedir. Çoğu zaman yanık hastasının ayaktan tabibi devam ederken, araya giren bir enfeksiyon veya olası bir komplike durumda ayaktan tedavi yeniden gözden geçirilmeli, yatarak tedavi dahil olmak üzere has- taya uygun yeni bir takip ve tedavi olasılığı göz ardı edilmemelidir. Yanık tedavisinin dinamik bir süreç olduğu asla unutulmamalıdır.

Anahtar Kelimeler: Yanıklar; Ayaktan takip

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