Kana mudiwa akakuvara zvakaipisisa kana kuti achirwara zvikuru, angafanira kupedza nguva yakawanda ari pamubhedha.Nguva refu yekusaita basa, kunyangwe ichibatsira kupora, inogona kuve nedambudziko kana vakaisa dhizaini paganda rakapfava.
Maronda ekudzvinyirira, anozivikanwawo semabhedha kana maronda epamubhedha, anogona kukura kana matanho ekudzivirira akasatorwa.Maronda emibhedha anokonzerwa nekumanikidzwa kwenguva refu paganda.Kumanikidzwa kunoderedza kuyerera kweropa kunzvimbo yeganda, zvichitungamira kurufu rwesero (atrophy) uye kuparadzwa kwetishu.Maronda ekudzvinyirira anowanzoitika paganda rinofukidza nhengo dzemapfupa emuviri, senge zvitsitsinho, zvitsitsinho, matako, uye tailbone.
Avo vanotambura zvakanyanya ndeavo vane mamiriro emuviri asingavatenderi kuchinja nzvimbo.Izvi zvinosanganisira vakwegura, vanhu vakarohwa nesitiroko, vanhu vane kukuvara kwemusana, uye vanhu vakaoma mitezo kana kuti vakaremara mumuviri.Kune ava nevamwe vanhu, maronda emubhedha anogona kuitika muwiricheya uye pamubhedha.
Maronda ekumanikidza anogona kukamurwa kuita chimwe chezvinhanho zvina zvichibva pakudzika kwawo, kuomarara, uye hunhu hwemuviri.Maronda anoenderera mberi anogona kuratidza kukuvadzwa kwenyama yakadzika kunosanganisira tsandanyama nebhonzo.Kana chironda chekumanikidza chakura, chinogona kunetsa kurapa.Kunzwisisa matanho akasiyana-siyana kunogona kubatsira kuona nzira yakanakisisa yekuita.
IAmerican Pressure Ulcer Advisory Group inoisa maronda ekumanikidza kuita nhanho ina, zvichienderana nehuwandu hwekukuvadzwa kwetishu kana kudzika kweronda.Manhanho esangano anogona kukamurwa kuita:
I.
Maronda eStage I anoratidzirwa nekutsvuka pamusoro peganda rakasimba risingaite chena kana rakatsikirirwa.Ganda rinogona kunge richidziya pakubata uye rinoratidzika kusimba kana kupfava kupfuura ganda rakatenderedza.Vanhu vane ganda rakasvibira vanogona kuona kushanduka kwemavara.
Edema (tishu kuzvimba) uye induration (tishu kuomeswa) anogona kuva zviratidzo danho 1 dzvinyiriro sore.Danho rekutanga repressure ulcer rinogona kuenderera kusvika padanho rechipiri kana dzvinyiriro ikasapera.
Nekukurumidza kuongororwa uye kurapwa, yekutanga-danho rekumanikidza maronda anowanzo gadzirisa mukati memazuva matatu kusvika mana.
II.
Chironda chechipiri chinoonekwa kana ganda rakasimba rinobvaruka ravhurika, richiburitsa epidermis uye dzimwe nguva dermis.Maronda acho ari pamusoro uye anowanzoita semabrasions, kuputika mablisters, kana makomba asina kudzika paganda.Stage 2 bedsores inowanzo tsvuku uye inodziya kusvika pakubata.Panogonawo kuva nemvura yakajeka muganda rakakuvadzwa.
Kudzivirira kufambira mberi kusvika padanho rechitatu, kuedza kwese kunofanirwa kuitwa kuvhara maronda uye kuchinja nzvimbo nguva nenguva.
Nekurapwa kwakakodzera, nhanho II bedsores inogona kupora kubva pamazuva mana kusvika kumavhiki matatu.
III.
Maronda eChikamu chechitatu anoratidzwa nemaronda anowedzera mudermis uye anotanga kusanganisira subcutaneous tissue (inozivikanwawo se hypodermis).Panguva ino, gomba diki rave kuita muronda.Mafuta anogona kutanga kuoneka mumaronda akazaruka, asi kwete mumhasuru, tendon, kana mapfupa.Mune zvimwe zviitiko, pus uye kunhuwa kusingafadzi kunogona kuonekwa.
Rudzi rweronda urwu runosiya muviri uri panjodzi yekubatwa neutachiona, kusanganisira zviratidzo zvekunhuwa, urwa, kutsvuka, uye kubuda tsvina.Izvi zvinogona kutungamirira kumatambudziko akakomba, kusanganisira osteomyelitis (hosha yemapfupa) uye sepsis (inokonzerwa nehutachiona muropa).
Nekurapa kwehasha uye kunoenderana, nhanho III yekumanikidza sore inogona kugadzirisa mukati memwedzi mumwe kusvika mina, zvichienderana nehukuru hwayo nekudzika kwayo.
IV.
Nhanho IV yekumanikidza maronda inoitika kana subcutaneous tishu uye pasi pefascia zvakuvadzwa, zvichiburitsa tsandanyama nemapfupa.Urwu ndirwo rudzi rwakaipisisa rwekudzvanya uye rwakanyanya kuoma kurapa, nenjodzi huru yekutapukirwa.Kukuvadzwa kwematishu akadzika, tendon, tsinga, uye majoini anogona kuitika, kazhinji aine pus yakawanda uye kubuda.
Nhanho IV yekumanikidza maronda inoda kurapwa kwehasha kudzivirira systemic hutachiona uye zvimwe zvinogona kuuraya hupenyu.Maererano nekuongorora kwe2014 kwakabudiswa mumagazini Advances in Nursing, vanhu vakuru vane nhanho yechina yekumanikidzika maronda vanogona kuva nehuwandu hwekufa hunosvika makumi matanhatu muzana mukati megore.
Kunyangwe nekurapa kunoshanda munzvimbo yevakoti, nhanho 4 yekumanikidza maronda anogona kutora mwedzi miviri kusvika mitanhatu (kana kureba) kupora.
Kana iyo bedsore yakadzika uye yakagara mumatishu anoputika, mutarisiri wako wehutano anogona kusakwanisa kunyatsoona danho rayo.Rudzi urwu rwemaronda anoonekwa seasiri-chiratidziro uye angangoda kukanganiswa kwakawanda kuti abvise necrotic tishu isati yatanga nhanho.
Mamwe maronda emubhedha anogona kuita sedanho 1 kana 2 pakutanga kuona, asi matishu ari pasi anogona kunge akakuvara zvakanyanya.Muchiitiko ichi, chironda chacho chinogona kuverengerwa sechinhu chinofungidzirwa kuti chakadzama kukuvara kwetishu (SDTI) nhanho 1. Pakuwedzera kuongororwa, SDTI dzimwe nguva inowanikwa sedanho.III kana IV kudzvinyirira maronda.
Kana mudiwa wako ari muchipatara uye asingafambi, unofanira kungwarira kuziva uye zviri nani kudzivirira maronda ekumanikidza.Nyanzvi yezvehutano kana murapi wepanyama anogona kushanda newe neboka rako rekuchengeta kuti ave nechokwadi chekuti zvinotevera zvinoteedzerwa:
Dana chiremba wako kana ukaona kurwadziwa, kutsvuka, fivha, kana chero imwe shanduko yeganda inogara kupfuura mazuva mashoma.Kukasika maronda ekumanikidza anorapwa, zviri nani.
Ergonomic dhizaini yekudzikisa kudzvanywa uye kudzivirira bedsores
- Bhattacharya S., Mishra RK Kudzvinyirira maronda: kunzwisisa kwazvino uye kurapwa kwakagadziridzwa Indian J Plast Surg.2015;48(1):4-16.Hofisi yepamba: 10-4103/0970-0358-155260
- Agrawal K, Chauhan N. Maronda ekudzvinyirira: kudzokera kune zvakakosha.Vadivelu Comedy Indian J Plast Surg.2012;45(2):244-254.Hofisi yepamba: 10-4103/0970-0358-101287
- Muka BT.Maronda emaronda: izvo varapi vanofanirwa kuziva.Perm Journal 2010;14(2):56-60.doi: 10.7812/tpp/09-117
- Kruger EA, Pires M., Ngann Y., Sterling M., Rubayi S. Kunyatsorapwa kwemaronda ekumanikidzika mumusana wekukuvara kwemusana: mafungiro ezvino uye maitiro emangwana.J. Mushonga wemuzongoza.2013;36(6):572-585.doi: 10.1179/2045772313Y.0000000093
- Edsberg LE, Black JM, Goldberg M. et al.Yakagadziridzwa National Pressure Ulcer Advisory Group pressure ulcer classification system.J Weti Incontinence Stoma Post Injury Nurse.2016;43(6):585-597.doi:10.1097/KRW.0000000000000281
- Boyko TV, Longaker MT, Yan GP Ongororo yemazuva ano kurapwa kwemubhedha.Adv Wound Care (New Rochelle).2018;7(2):57-67.doi: 10.1089/ronda.2016.0697
- Palese A, Louise S, Ilenia P, nevamwe.Ndeipi nguva yekupora kwechikamu chechipiri chekumanikidza maronda?Migumisiro yekuongorora kwechipiri.Kuchengetedza ronda kwepamusoro.2015;28(2):69-75.doi: 10.1097/01.ASW.0000459964.49436.ce
- Porreka EG, Giordano-Jablon GM Kurapa kwakanyanya (danho III uye IV) kusingaperi kudzvinyirira maronda muparaplegics uchishandisa pulsed radiofrequency energy.kuvhiyiwa kwepurasitiki.2008;8:e49.
- Andrianasolo J, Ferry T, Boucher F, et al.Kudzvinyirira ulcer-inosanganiswa nepelvic osteomyelitis: kuongororwa kwemaitiro maviri ekuvhiya (kusvibiswa, kusagadzikana kudzvinyirira kurapa, uye kuvhara kuputika) kwenguva refu yemishonga inorwisa mabhakitiriya.Zvirwere zvinotapukira zveNavy.2018;18(1):166.doi:10.1186/s12879-018-3076-y
- Brem H, Maggie J, Nirman D, nevamwe.Mutengo wakakwira wedanho IV kumanikidza maronda.Ini ndiri Jay Surg.2010;200(4):473-477.doi: 10.1016/j.amjsrg.2009.12.021
- Gedamu H, Hailu M, Amano A. Kuwandisa uye comorbidities yedzvinyiriro maronda pakati pevarwere paFelegehivot Specialist Hospital muBahir Dar, Ethiopia.Kufambira mberi muukoti.2014;2014. doi: 10.1155/2014/767358
- Sunarti S. Kubudirira kurapwa kwezvisina-taged pressure maronda ane maronda epamusoro ekupfeka.Indonesian medical magazine.2015;47(3):251-252.
Nguva yekutumira: Kubvumbi-28-2023