Yaşlılarda Bası Yaraları ve Beslenme Tedavisi

Bası yaraları, baskı veya sıkıştırma sonucu genelde kemik çıkıntısının üzerinde bulunan deri ve/veya dokunun hasarıdır. Yaşlılar bası yarası gelişim riski bakımından en riskli gruptur. Bası yaraları; istenmeyen ağırlık kaybı, besin öğelerinin yetersiz alımı ve düşük beden kütle indeksi (<18.5 kg/m2) ile ilişkilendirilmektedir. Yaşlılarda bası yarası oluşum riskini en aza indirmek için günlük 30-35 kkal/kg enerji, 1.2-1.5 g/kg protein ve 1 mL/kkal sıvı alınması önemlidir. Arjinin ve glutamin gibi spesifik aminoasit suplemantasyonlarının bası yarasının iyileşmesini hızlandırabileceği düşünülmektedir. Yaşlılarda bası yararlarının önlenmesinde ve tedavisinde sadece diyetle alımı az olan veya besin öğesi yetersizliği olan vitamin ve mineral suplemantasyonu önerilmelidir. Bası yarası iyileşmeyen bireyin besin öğesi gereksinimleri oral olarak karşılanamıyorsa, enteral veya paranteral beslenme desteği düşünülmelidir. Ancak, tüple beslenme uygulanacağı durumlarda, riskler ve bireyde ulaşılması düşünülen hedefler iyi değerlendirilmelidir.

Anahtar Kelimeler:

yaşlı, bası yaraları, beslenme, malnütrisyon

Pressure Ulcers and Nutritional Treatment in Older Adults

Pressure ulcer is a skin or/and tissue injury usually over a bone prominence as a result of pressure or shear. Older adults are the most risky group for pressure ulcer development. Pressure ulcers are associated with undesired weight loss, inadequate nutrient intake and low body mass index (<18.5kg/m2). It is important to take daily at least 30-35 kkal/kg energy, 1.2-1.5g/kg protein and 1mL/kkal fluid to minimize the risk of pressure ulcers in older adults. Specific amino acid supplements such as arginine and glutamin are thought to accelerate healing of pressure ulcer. Vitamins and mineral supplements should only be offered to the older people who have poor dietary intake or have a nutrient deficiency for prevention and treatment of pressure ulsers. If the nutrient requirements of the individual having unhealed wound are not met orally, enteral or parenteral nutrition should be considered. However, when feeding with tube, risks and targets to be reached in the individual should be good evaluated.

Keywords:

elderly, pressure ulcers, nutrition, malnutrition,

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