Jesteśmy już po trzecim dniu wirtualnej konferencji IV Forum Leczenia Ran Before. Tematem przewodnim tego dnia była rola żywienia w procesie gojenia ran oraz opieka nad raną zakażoną. Na uczestników czekał również blok warsztatów praktycznych, który poprowadzili eksperci w zakresie leczenia ran.
Rola żywienia w procesie gojenia ran
Uczestnicy mieli okazję wysłuchać wykładów ekspertów w zakresie roli żywienia w procesie leczenia ran. Wśród nich głos zabrali m.in. dr n. med. Grzegorz Krasowski, który w swoich wykładach podkreślił tezę „bez żywienia nie ma leczenia”, a także opowiedział o żywieniu dojelitowym i pozajelitowym w warunkach domowych.
Jak podkreślił, żywienie jest niestety doceniane w kilku dziedzinach, a jego potrzeby i możliwości wykorzystania można przełożyć na wszystkie dziedziny medycyny. „Każda choroba, niezależnie od przyczyny choroby, na którą pacjent choruje może być porównana do stanu wojny, którą toczy organizm”.
– Aby poradzić sobie z tego rodzaju wojną, musimy sobie zdać sprawę z faktu, że wojna niesie za sobą straty, zniszczenia i uszkodzenia. I tak samo właśnie jest w czasie trwania choroby. Dlatego, aby poradzić sobie z tą wojną, musimy przygotować dokładny plan, a następnie atakować wszystkimi posiadanymi przez nas siłami.
Dr Krasowski zwrócił również uwagę, iż w procesie leczenia pacjenta musimy zwracać uwagę na stan odżywienia pacjenta, ponieważ niedożywienie jest chorobą i należy je leczyć.
Jak powinno wyglądać przygotowanie do procesu leczenia ran?
Trzeci dzień konferencji swoim wystąpieniem uświetnił również prof. dr hab. n. med. Tomasz Banasiewicz. Ekspert podczas swojego wykładu skupił się na istocie przygotowania w gojeniu ran. Jak podkreślił podczas swojego wystąpienia prof. Banasiewicz, monitorowanie stanu klinicznego pacjenta jest kluczowe, a obniżenie poziomu białka w organizmie wiąże się z całym szeregiem poważnych powikłań. „Poprawa pojedynczych parametrów nie jest kluczem do sukcesu”.
– Musimy nastawić się, aby cały czas traktować pacjenta z raną czy chorobą chirurgiczną, jako pacjenta, który będzie wymagał dobrego stanu odżywiania.
Ekspert zaznaczył również, jak ważna jest profilaktyka w przypadku ran pooperacyjnych. „Fundamentem zabiegu operacyjnego jest prehabilitacja, czyli odpowiednie przygotowanie pacjenta. Przygotowanie do leczenia jest kluczowe. Zarówno przygotowanie pacjenta, ale również zespołu, który powinien brać udział w programach treningowych, takich jak właśnie szkolenia, konferencje, które służą aktualizacji danych” – dodał.
– My musimy się spotykać. Czeka nas wysyp trudnych ran (red. w związku z pandemią), a więc leczmy je efektywnie oraz róbmy wszystko, żeby do nich nie dopuścić. Tłumaczmy, edukujmy, postępujmy odpowiednio z raną i stosujmy jako jeden z elementów profilaktyki dobrze rozumiane żywienie.
Jak rozpoznać niedożywienie u pacjenta z raną przewlekłą?
Swoją wiedzą w zakresie roli rozpoznania niedożywienia i powikłań po leczeniu żywieniowych podzieliła się pielęgniarka, mgr Zuzanna Konrady. Jak powiedziała podczas wykładu specjalistka, leczenie żywieniowe odgrywa bardzo istotną rolę, ale musi ono być poprzedzone oceną stanu odżywienia oraz zapotrzebowania na składniki odżywcze.
– Niedożywienie ma wpływ na osłabienie czynności mięśni, spadek odporności, pojawiające się odleżyny, jak również wzrost występujących powikłań, wydłużenie się hospitalizacji i wzrost kosztów leczenia.
Specjalistka przytoczyła słowa Sokratesa: „Człowiek nie żyje żeby jadł, ale je żeby żyć. Każdy gram, łyk ma znaczenie”. Jak dodała, szczególnie dla pacjenta, który jest obciążony klinicznie, często nie chce jeść, u którego występują zaburzenia związane z przełykaniem czy przyswajanie.
– Interwencja żywieniowa musi składać się z oceny stanu odżywienia, rodzaju zaburzeń, wskazań leczenia, określenia drogi interwencyjnej, przygotowania programu żywieniowego, prawidłowej podaży składników, a przede wszystkim monitorowania przebiegu leczenia, a także jego wyników.
Jak leczyć ranę zakażoną?
Podczas trzeciego dnia konferencji IV FLR Before eksperci zwrócili również uwagę na problematykę leczenia rany zakażonej oraz istotę odpowiednio dobranej terapii. W swoim wystąpieniu prof. dr hab. n. med. Marzenna Bartoszewicz zwróciła uwagę, iż produkty stosowane w leczeniu ran przewlekłych muszą być sterylne.
Uczestnicy tego dnia mogli wysłuchać również wykład dr. hab. n. med. Adama Junki. Natomiast swoją wiedzą w zakresie zakażenia w przebiegu zespołu stopy cukrzycowej podzieliła się dr n.med. Bożena Mospan.
Warsztaty praktyczne podczas IV FLR Before
Na uczestników konferencji czekali również eksperci, którzy poprowadzili warsztaty praktyczne. Podczas warsztatów swoją praktyczną wiedzą podzielił się m.in. dr. n. med. Grzegorz Krasowski, który opowiedział o „Siedmiu grzechach głównych w leczeniu ran” oraz lek. Michał Olszewski, który wyjaśnił jak ważne jest dobranie odpowiedniego opatrunku oraz kompresjoterapii w leczeniu owrzodzeń żylnych. Odbyły się również warsztaty, podczas których Anna Daudzward podkreśliła istotę najnowszych wytycznych w postępowaniu z raną, natomiast Agnieszka Klepacka wyjaśniła, jak powinno wyglądać prawidłowe oczyszczanie i zaopatrzenie rany głębokiej.
Uczestnicy wzięli udział również w warsztatach prowadzonych przez dr. n. med. Wojciecha Wilczyńskiego, który opowiedział o strategii T.I.M.E. oraz dr. n. farm. Przemysława Dalkowskiego i Sebastiana Chmielowskiego, którzy wskazali jak powinno wyglądać praktyczne postępowanie z raną zakażoną. Po każdym z bloków warsztatowych uczestnicy mieli możliwość zadawania pytań i doprecyzowania niejasnych kwestii.
Już dziś zapraszamy na kolejną dawkę profesjonalnej wiedzy o leczeniu ran!
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