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Uvod: Opeklina je rana, ki nastane zaradi delovanja toplotne, kemične ali električne energije na tkiva. Globina in obsežnost opekline je odvisna od tega, čemu je bil pacient izpostavljen, koliko časa in lokacije oziroma mesta izpostavljenosti. Večino opeklin se obravnava ambulantno, večje opekline pa zahtevajo bolnišnično zdravljenje. Opeklinsko poškodbo se lahko zdravi konzervativno ali pa kirurško. Kirurško zdravljenje obsega izrez mrtvine in kritje rane s kožnimi presadki, ki so lahko tudi od mrtvega darovalca. Pri operativni obravnavi opeklin je potrebno sodelovanje celotnega kirurškega tima. Namen: Namen je predstaviti operativno obravnavo opeklin in pridobiti vpogled v delo operacijske medicinske sestre pri kirurški oskrbi opeklin. Metode dela: Diplomsko delo temelji na deskriptivni metodi. Izveden je bil pregled znanstvene in strokovne literature v slovenskem in angleškem jeziku. Literatura je bila pridobljena preko portala Digitalne knjižnice Univerze v Ljubljani. Uporabljene so bile podatkovne baze PubMed, Scopus, CINAHL in BASE s pomočjo Google učenjaka. V diplomskem delu je bilo uporabljenih 44 enot literature. Rezultati: Zgodnji izrez mrtvine in pokrivanje rane s kožnimi presadki močno zmanjša umrljivost in skrajša čas hospitalizacije. Kadavrski kožni presadki predstavljajo rešitev za paciente z obsežno opeklino. Odvzem in delo s kadavrskimi kožnimi presadki je naloga operacijskih medicinskih sester na področju plastične in rekonstrukcijske kirurgije. Razprava in zaključek: Kirurško zdravljenje opeklin je pri obsežnih opeklinah nujno potrebno. Kritje opeklinske rane s kožnimi presadki je zlati standard za zdravljenje obsežnih opeklin. Operacijska medicinska sestra mora imeti ustrezna znanja za rokovanje s kadavrskimi kožnimi presadki, kar vključuje odvzem, shranjevanje in uporabo kožnega presadka pri pacientu z opeklino. Introduction: A burn is a wound, caused by the action of heath, chemical or electrical energy on tissues. Depth and extent of the burn depends on what the patient has been exposed to, how long and the location or site of exposure. Most of the burns is treated on outpatient basis, while larger burns require hospital treatment. A burn injury can be treated conservatively or surgically. Surgical treatment involves excision of the eschar and covering the wound with skin grafts, which can also be from a dead donor. The surgical treatment of burns requires the participation of the entire surgical team. Purpose: The purpose of this thesis is to present the surgical treatment of burns and gain insight into the work of an operating room nurse in the surgical care of burns. Methods: The diploma thesis is based on a descriptive method with a systematic review of literature in English and Slovenian. The literature was obtained through the portal of Digital Library of the University in Ljubljana. Following databases were used PubMed, Scopus, CINAHL and BASE, with the help of Google Scholar. 44 units of literature were used. Results: Early excision of the eschar and covering the wound with skin grafts, greatly reduces mortality and shortens hospitalization time. Cadaveric skin grafts are a solution for patients with extensive burns. Skin grafting and work with cadaveric skin grafts is the task of plastic operating room nurses. Discussion and conclusion: Surgical treatment of burns is essential for large burns. Covering burn wound with skin grafts is the gold standard for treating extensive burns. The operating room nurse must have adequate knowledge to work with cadaveric skin grafts, which includes grafting, storage and use of skin graft on a burn patient. |
