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Skala NPUAP – sprawdź, jak przeprowadzić ocenę odleżyny

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Klasyfikacji odleżyn dokonuje się w oparciu o obserwowany poziom uszkodzenia tkanek. Skala NPUAP (National Pressure Ulcer Advisory Panel) obejmuje cztery stopnie zaawansowania zmian odleżynowych z uwzględnieniem dodatkowych parametrów.

Stopień I – nieblednące zaczerwienienie

Na ograniczonej powierzchni nieuszkodzonej skóry pojawia się zaczerwienienie. Rumień nie ulega zblednięciu. W większości przypadków występuje nad wypukłością kostną. Zaczerwieniony obszar może być wrażliwy na dotyk, twardy lub miękki. Objawom niekiedy towarzyszy miejscowe ucieplenie. Zmieniony chorobowo obszar może być również chłodniejszy od tkanki sąsiadującej.

Stopień II – zmniejszona grubość

Dochodzi do częściowego ubytku grubości skóry właściwej. Przyjmuje on postać płytkiego otwartego wrzodu z czerwono-różowym łożyskiem. Nie występuje tkanka martwicza wilgotna oddzielająca się od tkanki zdrowej. Może pojawić się otwarty, pęknięty lub nienaruszony pęcherz wypełniony płynem surowiczym lub surowiczo-krwistym. Pęcherzyk przypomina błyszczący lub suchy wrzód.

Stopień III – pełna utrata grubości skóry

U pacjenta dochodzi do pełnej utraty grubości skóry. Może odsłonić się podskórna tkanka tłuszczowa, jednak kość, ścięgno i mięsień pozostają niewidoczne. Może wystąpić tkanka martwicza wilgotna – nie zasłania jednak głębokości utraconej tkanki. W obrębie rany może dojść do podminowania i tunelowania. Ścięgno i kość nie są bezpośrednio wyczuwalne palpacyjnie.

Stopień IV – pełna utrata grubości tkanki

U pacjenta dochodzi do pełnej utraty grubości tkanki z odsłonięciem kości, ścięgna lub mięśnia. Może pojawić się strup lub oddzielająca się tkanka martwicza. W wielu przypadkach dochodzi do podminowania lub tunelowania, które sięga w głąb mięśnia i/lub struktur podtrzymujących, takich jak ścięgna, powięzi, torebki stawu. Może rozwinąć się zapalenie szpiku lub kości. Odsłonięta kość lub odsłonięty mięsień są widoczne lub bezpośrednio wyczuwalne dotykiem.

OZ – odleżyna zamknięta

Występuje rana pełnej grubości skóry, która pokryta jest martwicą o nieznanej głębokości. Jeśli czarna i sucha martwica występuje na piętach, nie powinno się jej usuwać. Pełni funkcję naturalnej biologicznej ochrony.

OG – uszkodzenie tkanek głębokich

Występuje nieuszkodzona skóra koloru fioletowego lub bordowego albo wypełniona płynem przestrzeń w tkankach głębokich. Rany pokrywają się cienkim strupem. W trakcie leczenia odsłaniają się uszkodzone tkanki głębokie.

Źródło: „Algorytmy i wytyczne postępowania terapeutycznego w ranach trudno gojących się” w: „Forum Leczenia Ran”, 2020;1(3):95-116.

Przeczytaj także:

Odleżyny – jak je rozpoznać i zapobiegać we wczesnych stadiach? Wywiad z ekspertką

Biblioteka Faktów

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Forum Leczenia Ran”:

Algorytmy i wytyczne postępowania terapeutycznego w ranach trudno gojących się

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  77. Manufactured in an FDA-certified facility in the USA, EndoPump is pure, safe, and free from negative side effects. With its strict production standards and natural ingredients, EndoPump is a trusted choice for men looking to improve their sexual performance.

  78. GlucoCare is a dietary supplement designed to promote healthy blood sugar levels, manage weight, and curb unhealthy sugar absorption. It contains a natural blend of ingredients that target the root cause of unhealthy glucose levels.

  79. FitSpresso stands out as a remarkable dietary supplement designed to facilitate effective weight loss. Its unique blend incorporates a selection of natural elements including green tea extract, milk thistle, and other components with presumed weight loss benefits.

  80. SonoVive is an all-natural supplement made to address the root cause of tinnitus and other inflammatory effects on the brain and promises to reduce tinnitus, improve hearing, and provide peace of mind. SonoVive is is a scientifically verified 10-second hack that allows users to hear crystal-clear at maximum volume. The 100% natural mix recipe improves the ear-brain link with eight natural ingredients. The treatment consists of easy-to-use pills that can be added to one’s daily routine to improve hearing health, reduce tinnitus, and maintain a sharp mind and razor-sharp focus.

  81. TerraCalm is an antifungal mineral clay that may support the health of your toenails. It is for those who struggle with brittle, weak, and discoloured nails. It has a unique blend of natural ingredients that may work to nourish and strengthen your toenails.

  82. Sight Care is a daily supplement proven in clinical trials and conclusive science to improve vision by nourishing the body from within. The Sight Care formula claims to reverse issues in eyesight, and every ingredient is completely natural.

  83. Cortexi is a completely natural product that promotes healthy hearing, improves memory, and sharpens mental clarity. Cortexi hearing support formula is a combination of high-quality natural components that work together to offer you with a variety of health advantages, particularly for persons in their middle and late years. Cortex not only improves hearing but also decreases inflammation, eliminates brain fog, and gives natural memory protection.

  84. Prostadine is a dietary supplement meticulously formulated to support prostate health, enhance bladder function, and promote overall urinary system well-being. Crafted from a blend of entirely natural ingredients, Prostadine draws upon a recent groundbreaking discovery by Harvard scientists. This discovery identified toxic minerals present in hard water as a key contributor to prostate issues.

  85. Neotonics is an essential probiotic supplement that works to support the microbiome in the gut and also works as an anti-aging formula. The formula targets the cause of the aging of the skin.

  86. EyeFortin is a natural vision support formula crafted with a blend of plant-based compounds and essential minerals. It aims to enhance vision clarity, focus, and moisture balance.

  87. The Quietum Plus supplement promotes healthy ears, enables clearer hearing, and combats tinnitus by utilizing only the purest natural ingredients. Supplements are widely used for various reasons, including boosting energy, lowering blood pressure, and boosting metabolism.

  88. GlucoBerry is one of the biggest all-natural dietary and biggest scientific breakthrough formulas ever in the health industry today. This is all because of its amazing high-quality cutting-edge formula that helps treat high blood sugar levels very naturally and effectively.

  89. Endo Pump Male Enhancement is a dietary supplement designed to assist men improve their sexual performance. This natural formula contains a potent blend of herbs and nutrients that work together to improve blood flow

  90. Nervogen Pro, A Cutting-Edge Supplement Dedicated To Enhancing Nerve Health And Providing Natural Relief From Discomfort. Our Mission Is To Empower You To Lead A Life Free From The Limitations Of Nerve-Related Challenges. With A Focus On Premium Ingredients And Scientific Expertise.

  91. Kerassentials are natural skin care products with ingredients such as vitamins and plants that help support good health and prevent the appearance of aging skin. They’re also 100% natural and safe to use. The manufacturer states that the product has no negative side effects and is safe to take on a daily basis. Kerassentials is a convenient, easy-to-use formula.

  92. Gorilla Flow is a non-toxic supplement that was developed by experts to boost prostate health for men. It’s a blend of all-natural nutrients, including Pumpkin Seed Extract Stinging Nettle Extract, Gorilla Cherry and Saw Palmetto, Boron, and Lycopene.

  93. Metabo Flex is a nutritional formula that enhances metabolic flexibility by awakening the calorie-burning switch in the body. The supplement is designed to target the underlying causes of stubborn weight gain utilizing a special “miracle plant” from Cambodia that can melt fat 24/7.

  94. Cortexi is an effective hearing health support formula that has gained positive user feedback for its ability to improve hearing ability and memory. This supplement contains natural ingredients and has undergone evaluation to ensure its efficacy and safety. Manufactured in an FDA-registered and GMP-certified facility, Cortexi promotes healthy hearing, enhances mental acuity, and sharpens memory.

  95. Sight Care is a daily supplement proven in clinical trials and conclusive science to improve vision by nourishing the body from within. The Sight Care formula claims to reverse issues in eyesight, and every ingredient is completely natural.

  96. Elevate your vitality with Alpha Tonic – the natural solution to supercharge your testosterone levels. When you follow our guidance, experience improved physical performance

  97. Kudos on the article! It’s well-written and informative. I’m curious if you plan to include more images in your upcoming pieces. It could add a visually appealing element to your content.

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