Uszkodzenia skóry można podzielić na odleżyny, rany niegojące się, rozdarcia skóry, stany zapalne związane z wilgocią, uszkodzenia spowodowane klejem medycznym oraz pęcherzowe oddzielanie się naskórka. Czym się charakteryzują poszczególne rodzaje uszkodzeń skóry i jak powstają?
Odleżyny (ang. Pressure Ulcers)
Odleżyny powstają w następstwie długotrwałego ucisku i tarcia oraz związanego z nim niedotlenienia tkanek. Najczęściej rozwijają się w okolicach kości krzyżowej, pośladków, na piętach i kostkach. Szczególnie narażeni na rozwój odleżyn są ludzie unieruchomieni w łóżku z powodu wieku lub choroby.
Rany niegojące się (ang. Non-Healing Wounds)
Rany niegojące się mogą mieć zróżnicowaną etiologię. Wśród przyczyn niegojących się ran wymienia się m.in. zespół stopy cukrzycowej, zaburzenia żylne i tętnicze, choroby nowotworowe, schorzenia układu limfatycznego oraz powikłania pooperacyjne i urazy. W przypadku współistnienia wielu czynników proces gojenia rany może być dodatkowo utrudniony.
Rozdarcia skóry (ang. Skin Tears)
Przyczyną rozdarć skóry może być naprężenie, otarcie lub tępy uraz, który prowadzi do rozdzielenia się warstw skóry. Rozdarcia skóry występują najczęściej u pacjentów w podeszłym wieku (powyżej 65. roku życia), pacjentów pediatrycznych oraz osób w terminalnej fazie choroby. Do najczęstszych lokalizacji tego typu uszkodzeń skóry należą ramiona, podudzia i ręce.
Stany zapalne skóry związane z wilgocią (ang. Moisture-Associated Dermatitis, MASD)
MASD to uszkodzenie skóry spowodowane długotrwałą ekspozycją na wilgoć. Do maceracji skóry może dojść na skutek nadmiernego sączenia z rany, ekspozycji skóry na mocz (np. u pacjentów z problemem nietrzymania moczu) oraz z powodu nadmiernej potliwości. Nadmierna wilgotność skóry prowadzi do pękania pod wpływem ucisku i sił tnących i może również stanowić przyczynę rozwoju odleżyn.
Uszkodzenia skóry spowodowane klejem medycznym (ang. Medical Adhesive-Related Skin Injury, MARSI)
Uszkodzenia skóry typu MARSI powstają w wyniku odrywania od skóry przylepców takich jak plastry do mocowania opatrunków oraz opatrunki przylepne, płytki stomijne, elektrody, gaza stosowana do zaopatrywania ran. Uszkodzenia MARSI najczęściej występują u noworodków (zwłaszcza wcześniaków), niemowląt, ludzi w podeszłym wieku oraz u osób przewlekle chorych. Do czynników ryzyka tego rodzaju uszkodzeń należą: niedożywienie i odwodnienie, terapia sterydami, radio- i chemioterapia, schorzenia autoimmunologiczne, niewydolność nerek, cukrzyca, choroby nowotworowe.
Pęcherzowe oddzielanie się naskórka (łac.Epidermolysis Bullosa, EB)
Pęcherzowe oddzielanie się naskórka to uwarunkowana genetycznie choroba skóry, w przebiegu której wskutek urazów mechanicznych dochodzi do powstawania surowiczych i krwotocznych pęcherzy, ubytków naskórka oraz nadżerek. Pękanie zmian pęcherzowych prowadzi do powstawania rozległych trudno gojących się ran. Wyróżnia się kilka typów choroby: prosty (simplex), łączący (junctional) oraz dystroficzny. Każdy typ charakteryzuje się odmiennym przebiegiem klinicznym.
Źródła: http://ebpolska.pl/, https://www.chorobyrzadkie.com/, https://www.healthline.com/, https://www.woundsource.com/
Przeczytaj także: Choroba Rittera – jakie są jej przyczyny i jak ją leczyć?
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