Yanık Hastasının Yanık Birimlerinde Tedavisi

Doç. Dr. Ayetullah Temiz1
Prof. Dr. Çetin Ali Karadağ2

1Erzurum Şehir Hastanesi, Genel Cerrahi Kliniği, Erzurum, Türkiye
2SBÜ, Şişli Hamidiye Etfal EAH, Çocuk Cerrahisi Kliniği, İstanbul, Türkiye

ÖZET

Yanık hastalarının tedavisinde primer ve sekonder değerlendirmeler kritik öneme sahiptir. Bu adımlar, hava yolunun güvenliğinin sağlanmasını, solunum fonksiyonlarının değerlendirilmesini ve dolaşımın izlenmesini içerir, bu sayede acil müdahale gerektiren durumlar belirlenir. Hava yolu açıklığının sağlanması ve solunum sıkıntı- sının önlenmesi, birincil değerlendirmenin temel hedeflerindendir. Özellikle inhalasyon yanıkları bu aşamada büyük risk taşır. Sıcak ve toksik gazların solunması, erken dönemde entübasyon ihtiyacını doğurabilecek solunum yolu hasarına yol açabilir. Bu nedenle, solunum yetmezliğini önlemek ve başarılı bir tedavi sağlamak için erken ve doğru tanı büyük önem taşır. Daha ayrıntılı bir inceleme gerektiren sekonder değerlendirmede, yanık alanı, derinliği ve etkilenen vücut yüzey alanı belirlenir. Yanığın şiddetine bağlı olarak, yanık şokunu önlemek için gerekli sıvı resüsitasyonu uygulanır. Sekonder değerlendirme sonucunda acil cerrahi müdahale gereksinimleri belirlenir. Özellikle derin ve çevresel yanıklar, kompartman sendromuna yol açabilir ve bu durum acil eskarotomi veya fasiyotomi gerektirebilir. Bu cerrahi müdahaleler, yanığın neden olduğu doku basıncını azaltarak dolaşım ve solunumu iyileştirmeyi amaçlar. Elektrik yanıkları, diğer yanıklardan farklı bir yönetim gerektirir. Elektrik yanıkları, derin doku hasarı ve organ işlev bozukluklarına yol açabilir ve yalnızca yüzeyde değil, derin dokularda da ciddi hasar bırakabilir. Elektrik akımının vücut üzerindeki etkileri, kalp ritim bozuklukları, sinir hasarı ve gözde ortaya çıkabilecek komplikasyonlar gibi çeşitli sistemlere zarar verebilir. Bu nedenle, bu tür yanıkların yönetiminde yalnızca yanık tedavisi değil, kardiyoloji, nöroloji, göz ve KBB gibi multidisipliner bir yaklaşım gereklidir. Sonuç olarak, yanık tedavisi primer ve sekonder değerlendirmelere dayalı olarak şekillen- dirilir ve her hastanın bireysel ihtiyaçlarına göre uyarlanır. Tedavi planı, yanığın boyutu, derinliği ve etkilenen sistemlere göre yapılır, böylece hastanın hayatta kalma şansı ve iyileşme süreci optimize edilir.

Anahtar Kelimeler: Yanıkta primer ve sekonder değerlendirme; İnhalasyon yanıkları; Yanık şoku; Sıvı resüsitasyonu; Eskarotomi; Fasiyotomi; Elektrik yanıkları yönetimi; Acil cerrahi girişimler

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