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Jak rozpoznać i ocenić ranę? Część V – oparzenia [ZDJĘCIA]

Karolina1 812 komentarzy
Ten tekst przeczytasz w 3 min.

W przypadku ran oparzeniowych do oceny głębokości uszkodzeń stosuje się czterostopniową skalę. Podczas badania należy zwrócić uwagę m.in. na stan łożyska i brzegów rany. W jaki sposób prawidłowo ocenić oparzenie?

Oceny rany należy dokonać podczas pierwszej wizyty pacjenta w gabinecie. Podstawowym narzędziem, które należy wykorzystać do tego celu, jest tzw. trójkąt rany.

Więcej informacji na temat oceny rany znajdziesz tutaj

Następnie ranę należy ocenić w skali, która odpowiada etiologii rany:

W sporządzeniu charakterystyki rany pomaga kolorowa skala oceny rany.

Poniżej pokazujemy, jak zastosować te narzędzia w praktyce na przykładzie oparzeń.

 

Przypadki kliniczne – oparzenia

Przypadek nr 1 – Oparzenie czoła dziecka świecą

Okalające tkanki: niezmienione
Brzegi rany: zaczerwienione, płaskie
Łożysko: przesuszone, pokryte pęcherzami z wysiękiem surowiczym
Skala kolorowa: rana niebiesko-czarna
Diagnoza: oparzenie II A, rana ostra

Przypadek nr 2 – Oparzenie grzbietu dłoni

Okalające tkanki: niezmienione
Brzegi rany: nieregularne
Łożysko: zaczerwienione, bez uszkodzenia naskórka, obrzęknięte
Skala kolorowa: rana niebieska
Diagnoza: oparzenie II A, rana ostra

Przypadek nr 3 – Oparzenie boku (plecy, bok i brzuch) wrzątkiem

Okalające tkanki: zaczerwienione
Brzegi rany: nieregularne
Łożysko: liczne niewielkie uszkodzenia pełnej grubości skóry z widoczną tkanką podskórną i cienką warstwą martwicy żółtej, suche, bez wysięku
Skala kolorowa: rana niebiesko-zielono-czarna
Diagnoza: oparzenie II B, rana ostra

Przypadek nr 4 – Oparzenie klatki piersiowej i szyi po radioterapii

Okalające tkanki: zaczerwienione, suche, skórzaste
Brzegi rany: nieregularne, rozmyte
Łożysko: rana zamknięta, pokryte suchą czerwoną skórą
Skala kolorowa: rana niebiesko-czarna
Diagnoza: oparzenie III, rana ostra

Przypadek nr 5 – Oparzenie dłoni parą wodną

Okalające tkanki: niezmienione
Brzegi rany: nieregularne, rozmyte
Łożysko: nieuszkodzona, mocno zaczerwieniona skóra
Skala kolorowa: rana niebieska
Diagnoza: oparzenie I, rana ostra, zamknięta

Przypadek nr 6 – Oparzenie po radioterapii

Okalające tkanki: tworzące się kelogi, zgrubiałe, zaczerwienione, grudkowe
Brzegi rany: lekko wałowate, bliznowate
Łożysko: mocno czerwone, pokryte biofilmem
Skala kolorowa: rana niebiesko-zielono-czerwona
Diagnoza: oparzenie III, rana ostra

Przypadek nr 7 – Oparzenie uda wrzątkiem

Okalające tkanki: przebarwione, suche
Brzegi rany: lekko uniesione
Łożysko: różowe, pokryte biofilmem i martwicą żółtą suchą, z niewielką ilością wysięku
Skala kolorowa: rana niebiesko-czerwono-żółto-czarna
Diagnoza: oparzenie II A, rana ostra

Przypadek nr 8 – Oparzenie stopy przez rurę wydechową motocykla. Stan po odrzuceniu przeszczepu

Okalające tkanki: przebarwione, z widocznymi przeszczepami skóry
Brzegi rany: nieregularne, ostro wycięte, pokryte martwicą żółtą rozpływną
Łożysko: pokryte martwicą żółtą rozpływną, blade, z niewielkim wysiękiem
Skala kolorowa: rana niebiesko-zielono-żółto-czarna
Diagnoza: oparzenie III, rana ostra

Wszystkie przedstawione przypadki pochodzą z praktyki mgr Elżbiety Szkiler. Udostępnione za zgodą autorki.

Przeczytaj więcej:

Jak zmierzyć rozległość oparzenia?

Podział oparzeń ze względu na głębokość. Jak rozróżnić który to stopień?

Pobierz poradnik w formie PDF:

Pobierz

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