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Jak rozpoznać i ocenić ranę? Część I – owrzodzenia nowotworowe [ZDJĘCIA]

Ten tekst przeczytasz w 2 min.

Warunkiem skutecznego leczenia rany jest prawidłowe rozpoznanie etiologii oraz ocena rany, uwzględniająca stan brzegów, łożyska, tkanek okalających oraz wysięk. Pozwala to wdrożyć postępowanie najlepiej odpowiadające potrzebom pacjenta. W niniejszym cyklu prezentujemy kryteria rozpoznania różnych typów ran wraz ze zdjęciami.

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 ran nowotworowych.

 

Przypadki kliniczne – owrzodzenia nowotworowe

Przypadek nr 1 - Owrzodzenie nowotworowe skroni

Okalające tkanki: Niezmienione
Brzegi rany: Nieregularne
Łożysko: Suche, pokryte czarną martwicą
Skala kolorowa: Rana zielono-czarna

Przypadek nr 2 - Owrzodzenie nowotworowe klatki piersiowej

Okalające tkanki: Niezmienione
Brzegi rany: Wywinięte
Łożysko: Tkanki znacznie przerastające powierzchnię skóry, krwawiące, z tkanka martwiczą, tkanki zszyte szwami
Skala kolorowa: Rana zielono-żółta

Przypadek nr 3 - Rana nowotworowa przedramienia

Okalające tkanki: Niezmienione
Brzegi rany: Wywinięte
Łożysko: Rozpulchniona, krwawiąca ziarnina znacznie przerastająca powłoki skórne
Skala kolorowa: Rana zielono-żółta

Przypadek nr 4 - Rana nowotworowa przedniej części goleni

Okalające tkanki: Niezmienione
Brzegi rany: Wywinięte
Łożysko: Rozpulchniona, krwawiąca ziarnina znacznie przerastająca powłoki skórne
Skala kolorowa: Rana zielono-czerwona

Przypadek nr 5 - Rana nowotworowa goleni

Okalające tkanki: Niezmienione
Brzegi rany: Wałowate
Łożysko: Obecność surowiczego wysięku
Skala kolorowa: Rana zielono-żółta

Przypadek nr 6 - Przerzut nowotworu do gruczołu piersiowego

Okalające tkanki: Twarde, przebarwione, pokryte twardymi guzami do wysokości barku
Brzegi rany: Nieregularne, płaskie
Łożysko: Z małą ilością wysięku, pokryte martwicą żółtą
Skala kolorowa: Rana zielono-czarna

Przypadek nr 7 - Mięsak goleni

Okalające tkanki: Z blizną, lekko zaczerwienione i obrzęknięte
Brzegi rany: Odwarstwione od dna, pokryte martwicą żółtą
Łożysko: Z głębokimi kieszeniami wokół kończyny, pokryte martwicą żółtą suchą, u góry widoczna odsłonięta kość piszczelowa, z małym wysiękiem
Skala kolorowa: Rana zielono-czarna

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

Pobierz poradnik w formie PDF:

843 thoughts on “Jak rozpoznać i ocenić ranę? Część I – owrzodzenia nowotworowe [ZDJĘCIA]

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