 Verfasst am: 03. Jun 2007 23:31 Titel: bitte ganz lieb um korrektur - ist sehr wichtig! thx |
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| hallo. ich bin neu in diesem forum und würde euch gern um eure hilfe bitten. ich muss ende der woche ein mediz./pflegerisches referat abhalten. den text habe ich bereits bis auf wenige worte übersetzt - weiß jedoch nicht welche fehler ich dabei fabriziert habe. wäre sehr lieb, wenn irgendjemand von euch mich darauf aufmerksam machen könnte. vielen lieben dank vorab!!! At first I would like to explain the definition of decubital ulcer: The decubital ulcer is a badly and slowly curative wound as a result of reduced circulation by missing pressure …. (Druckentlastung). The decubital ulcer is mostly contingent on immobile reasons. It isn`t an independent desease. The next one are the causales of decubital ulcer: Three factors are crucially for the origin of the decubital ulcer: 1. pressure (pressure load?) 2. time (pressure retention time?) 3. disposition/risk factors Until a continuing pressure exists for a longer time (more than 2 hours) by disposition of the patient, a defect/damage of the skin is the result/consequence of this. It’s never only one cause, which is responsible for decubitalgenesis. 1. pressure The blood flow of the skin capillaries is hindered, as soon the pressure on the capillaries is bigger than the middle blood pressure into them. The pressure on the skin can be ????? (kann von innen oder außen ausgeführt werden….???) from the outside or from the inside. -from the outside: e.g. folds in the sheet, crumb in the bed, catheter and probes if they lie among the person -from the inside: e.g. by the bones which lie without muscle pad and fat pad under the skin 2. time It is vital, how long put pressure on any skin districts. The nutrition of the skin cells is interrupted less than 2 hours, they can recover again. With longer persistent oxygen deficiency single cells die, it originates a necrosis. DANGER: the time up to the entry of irreversible damages can clearly lie less than 2 hours if the skin is already pre damaged. For example some factors which: - aggravate the circulation (e.g. cardiovascular diseases) - hinder the pressure relief (e.g. immobility) - injure the skin additional (e.g. incontinence) 3. disposition The skin is damaged, for example, by: =>fever – owing to sweat it comes to the dehydration of the body and to a raised oxygen consumption =>humidity – humid skin becomes soften and more susceptible =>incontinence – incontinent peoples skin is/are loaded not only by humidity, but, in addition, by the sour pH – value of the urine and perhaps by bacterial contamination with intestinal bacteria =>adiposis – adipose people usually sweat more – concomitant the weight which weigh on the skin is bigger =>shear forces – “the skew level” with wrong seat tugs on the skin =>the skin has an badly blood flow with: - anemia and cardiac insufficiency, which favour an ischemia - by IDDM (insulin – depended diabetes mellitus) the cell metabolism is impaired The pressure relief is hindered by lacking movement (immobility), confinement to bed, paralyses like hemiplegia and by therapeutic restraint (e.g. gypsum) Vulnerable body places: Threat of decubital ulcer exists, all above, at body places at which is between skin and lying underneath bones none or only less musculature. Among the rest, in addition count: - ear, shoulder joint, shoulder blade,spinal column, elbow, iliac crest, trochanter, sacral bone and coccyx, knee joint, ankle, heel |
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