Ali Osman YILDIRIM, Yalçın BAYRAM, Yusuf Emrah EYİ, Murat EROĞLU, Salim ÖZENÇ, Salim Kemal TUNCER

Acil Serviste Yara Bakım Ürünleri ve Kullanımı

Akut travmatik yara bakımı acil tıp pratiğinin en sık karşılaşılan girişimidir. Canlı dokunun anatomik ve fonksiyonel devamlılığının bozulması, yara olarak adlandırılmaktadır. Yara bakım ürünleri, temel olarak yaranın iyileşmesini sağlamanın yanında, yaranın çevresel etkenlerden korunması, enfeksiyon olasılığının ve ağrının azaltılması, hastaların yaşam kalitesinin arttırılmasında da etkilidir. Yara bakımında bütün yaralara uygun bir yara bakım ürünü olmadığından, değişik özellikteki yaralara uygulanabilmesi için farklı özelliklere sahip birçok yara bakım ürünü bulunmaktadır. Yaranın temiz ve nemli tutulması için yaranın doğru değerlendirilmesi gerekmekte, yaranın gereksinimi belirlenerek doğru yara bakım ürünü tercih edilmelidir. İdeal yara bakım ürünü yarayı travmalardan korumalı, kan ve eksudanın fazlasını emmeli, bakterilere karşı bariyer olmalı, yaraya yapışmamalı ve tiftiklenmemelidir. Yaranın vücudun neresinde olduğuna, boyutuna, üzerindeki eksuda miktarına, enfeksiyon varlığına ve ağrılı olup olmamasına göre uygun yara bakım ürünü tercih edilmelidir. Bu çalışmada acil serviste kullanılan yara bakım ürünleri ve kullanım yerleri hakkında literatür gözden geçirilerek kısa bilgiler verilmiştir.

The Usage of Wound Care Products in Emergency Department

Acute traumatic wound care is the most frequently encountered medical intervention in practice of emergency medicine. Wound is described as impairment of the anatomical or functional integrity of the living tissues. In addition to providing wound healing, basic wound care products are also effective in protection of the wound from environmental factors, reduction of the infection rate and the pain and enhancing the quality of life of patients. Many wound care products are available for wound in different properties because of unique wound care product suitable for all types of wound is not exist. Wound has to be evaluated correctly and then apropriate wound care product has to be choosen to keep the wound clean and moist. Ideal wound care products must protect the wound from trauma, absorb excess wound fluid or blood, serve a barrier against bacteria, and not adhere to the wound. Wound care products are preferred according to wound localization and dimention, amount of exudate and presencense of infection and pain. In this study literature is reviewed regarding wound care product used in emergency department and their indications. Also brief informations are given about wound care products.

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1. Piacquadio D. Synthetic surgical dressings. In: Wheeland R.G (ed). Cutaneous Surgery. Philadelphia. WB Saunders, 1994, p. 122-136.
2. Bolton LL, Rijswijk LV, Shaffer FA. Quality wound care equals cost-effective wound care. Nursing Management. 1996; 27(7): 30-37.
3. Vincent F. Advanced threatment for non-healing chronic wounds. J. EWMA. 2004; 4(2): 11-13.
4. Seaver L, Chen SC. What are wound care outcomes. Wounds. 2004; 16(5): 150-156.
5. Stewart J. Next generation product for wound management. J Wound Care. 2002; 11(9): 355- 341.
6. Beitz JM, Rijswijk LV. Using Wound Care Algorithms: A Content Validation Study. J. WOCN. 1999; 26(5): 238-249.
7. Gottrup F, Sci DM. A specializwd wound-healing center concept: importance of a multidisciplinary department structure and surgical treatment fascilities in the treatment of chronic wounds. The American Journal of Surgery. 2004; 187: 28- 43.
8. Morganof D. Setting p wound dressing guidelines: avoiding the pitfalls. Tissue viability. 1998; 8(3): 5-8.
9. Helfman T, Ovington L, Falanga V. Occlusive dressings and wound healing. Clin Dermatol 1994; 12: 121-127.
10. Carver N, Leigh IM. Synthetic dressings. Int J Dermatol. 1992; 31: 10.
11. Katz S, McGinley K, Leyden JJ. Semipermeable occlusive dressings. Effects on growth of pathogenic bacteria and reepithelialization of superficial wounds. Arch Dermatol. 1986; 122: 58.
12. Lionelli GT, Lawrence WT. Wound dressings. Surg Clin North Am. 2003; 83: 617.
13. Worley CA. So what do I put on this wound? making sense of the wound dressing puzzle: Part III. Dermatol Nurs. 2005; 17(4): 299-300.
14. Helfman T, Ovington L, Falanga V. Occlusive dressings and wound healing. Clin Dermatol 1994; 12: 121-127.
15. Erel A, Gürer MA: Bacak ülserlerinde tedavi düzenlenmesi. Türkderm. 1994; 28(4): 187-190.
16. O'hea BJ, Ho MN, Petrec JA. External compression dressing versus standard dressing after axillary lymphadenectomy. American Journal of Surgery. 1999; 177: 450-453.
17. Piacquadio D, Nelson DB. Alginates. A "new" dressing alternative. J Dermatol Surg Oncol. 1992; 18: 992.
18. Farley DR. Wound care. Current Surgery. 2001; 58(2): 145.
19. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997; 38: 563.
20. Bucalo B, Eaglstein WH, Falanga V. Inhibition of cell proliferation by chronic wound fluid. Wound Rep Regen. 1993; 1: 181.
21. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg. 1997; 38: 553.
22. Tredget EE, Shankowsky HA, Groeneveld A, Burrell R. A matched-pair, randomized study evaluating the efficacy and safety of Acticoat silver-coated dressing for the treatment of burn wounds. J Burn Care Rehabil. 1998; 9: 531.
23. In HQ, Langford R, Burrell RE. Comparative evaluation of the antimicrobial activity of ACTICOAT antimicrobial barrier dressing. J Burn Care Rehabil. 1999; 20: 195.
24. Innes ME, Umraw N, Fish JS, et al: The use of silver coated dressings on donor site wounds: a prospective, controlled matched pair study. Burns. 2001; 27: 621.
25. Trent JF, Kirsner RS: Tissue engineered skin: Apligraf, a bilayered living skin equivalent. Int J Clin Pract. 1998; 52: 408.
26. Kirsner RS: The use of Apligraf in acute wounds. J Dermatol. 1998; 25: 805.
27. Schonfeld WH, Villa KF, Fastenau JM, et al: An economic assessment of Apligraf (Graftskin) for the treatment of hardto-heal venous leg ulcers. Wound Repair Regen. 2000; 8: 251.
28. Edmonds M, Foster AV, McColgan M: "Dermagraft": a new treatment for diabetic foot ulcers. Diabet Med. 1997; 14: 1010.
29. Edmonds M, Bates M, Doxford M, et al: New treatments in ulcer healing and wound infection. Diab/Metab Res Rev. 2000; 16(Suppl): S51.
30. Gentzkow GD, Iwasaki SD, Hershon KS, et al: Use of Dermagraft, a cultured human dermis, to treat diabetic foot ulcers. Diabetes Care. 1996; 19: 350.
31. Eaglstein WH: Dermagraft treatment of diabetic ulcers. J Dermatol. 1998; 25: 803.
32. Marston WA, Hanft J, Norwood P, Pollak R. The efficacy and safety of Dermagraft in improving the healing of chronic diabetic foot ulcers: results of a prospective randomized trial. Diabetes Care. 2003; 26: 1701.
33. Ersoz N, Ozerhan IH, Zor F. Wound Care in Primary Health Care. TAF Preventive Medicine Bulletin. 2008; 7(1): 71-74.