Uma othandekayo elimele kabi noma egula kakhulu, kungase kudingeke achithe isikhathi esiningi embhedeni.Izikhathi ezinde zokungenzi lutho, nakuba zizuzisa ukululama, zingaba yinkinga uma zibeka ukucindezeleka okuqhubekayo esikhumbeni esithambile.
Izilonda zokucindezela, ezaziwa nangokuthi ama-bedsores noma izilonda zombhede, zingakhula uma izinyathelo zokuzivikela zingathathwa.Izilonda zombhede zibangelwa ukucindezela isikhathi eside esikhumbeni.Ukucindezela kunciphisa ukugeleza kwegazi endaweni yesikhumba, okuholela ekufeni kweseli (atrophy) kanye nokubhujiswa kwezicubu.Izilonda zokucindezela ngokuvamile zenzeka esikhumbeni esimboze amathambo omzimba, njengamaqakala, izithende, izinqe kanye nethambo lomsila.
Labo abahlupheka kakhulu yilabo izimo zabo zomzimba ezingabavumeli ukuthi bashintshe isikhundla.Lokhu kuhlanganisa abantu abadala, abantu abake bashaywa unhlangothi, abantu abalimele umgogodla, abakhubazekile noma abakhubazekile ngokomzimba.Kulaba nabanye abantu, izilonda zokulala zingavela kokubili esihlalweni sabakhubazekile naphezu kombhede.
Izilonda zomfutho wegazi zingahlukaniswa zibe esinye sezigaba ezine ngokusekelwe ekujuleni kwazo, ukuqina, kanye nezici zomzimba.Izilonda eziqhubekayo zingase zenzeke njengokulimala kwezicubu ezijulile okubandakanya imisipha nethambo eliveziwe. Uma isilonda sokucindezela siqala, kungaba nzima ukuselapha.Ukuqonda izigaba ezihlukahlukene kungasiza ekunqumeni inkambo engcono kakhulu yokwenza.
I-American Pressure Ulcer Advisory Group ihlukanisa izilonda zengcindezi zibe izigaba ezine, ngokusekelwe ezingeni lokulimala kwezicubu noma ukujula kwesilonda.Amazinga enhlangano angahlukaniswa abe:
I.
Izilonda ze-Stage I zibonakala ngokubabomvu ebusweni besikhumba esingaguquki esingajiki sibe mhlophe uma sicindezelwa.Isikhumba singase sifudumale lapho usithinta futhi sibonakale siqinile noma sithambile kunesikhumba esizungezile.Abantu abanesikhumba esimnyama bangase babe nokushintsha kombala okuphawulekayo.
I-edema (ukuvuvukala kwezicubu) kanye nokuqina (ukuqina kwezicubu) kungase kube izimpawu zesigaba soku-1 sobuhlungu bokucindezela.Isilonda somfutho wesigaba sokuqala singadlulela esigabeni sesibili uma ingcindezi ingadambi.
Ngokuxilonga ngokushesha nokwelashwa, izilonda zomfutho wesigaba sokuqala zivame ukuxazulula phakathi kwezinsuku ezintathu kuya kwezine.
II.
Isilonda sesiteji sesi-2 sitholakala lapho isikhumba esingashintshile sivuleka ngokuzumayo, siveze i-epidermis futhi ngezinye izikhathi isikhumba.Izilonda zikha phezulu futhi ngokuvamile zifana nemihuzuko, amabhamuza aqhumile, noma imigodi engashoni esikhumbeni.Izigaba 2 zokulala zivame ukubabomvu futhi zifudumele lapho uzithinta.Kungase futhi kube noketshezi olucacile esikhumbeni esilimele.
Ukuvimbela ukuqhubekela phambili esigabeni sesithathu, kufanele kwenziwe yonke imizamo yokuvala izilonda kanye nokushintsha indawo ehlala kuyo njalo.
Ngokwelashwa okufanele, i-bedsores yesigaba II ingaphola kusukela ezinsukwini ezine kuya emasontweni amathathu.
III.
Izilonda ze-Stage III zibonakala ngezilonda ezidlulela ku-dermis futhi ziqale ukubandakanya izicubu ezingaphansi kwesikhumba (ezaziwa nangokuthi i-hypodermis).Ngalesi sikhathi, i-crater encane yakhiwe esilondani.Amafutha angase aqale ukubonakala ezilonda ezivulekile, kodwa hhayi emisipha, imisipha, noma amathambo.Kwezinye izimo, ubomvu kanye nephunga elibi kungase kubonakale.
Lolu hlobo lwesilonda lushiya umzimba engcupheni yokungenwa izifo, okuhlanganisa nezimpawu zephunga elibi, ubomvu, ububomvu nokuphuma kombala.Lokhu kungaholela ezinkingeni ezinkulu, okuhlanganisa i-osteomyelitis (ukutheleleka kwamathambo) kanye ne-sepsis (ebangelwa ukutheleleka egazini).
Ngokwelashwa okunamandla nokungaguquguquki, isifo sokucindezela kwesigaba III singaxazulula phakathi nenyanga eyodwa kuya kwezine, kuye ngosayizi nokujula kwaso.
IV.
Izilonda ze-Stage IV ze-pressure zenzeka lapho izicubu ezingaphansi kwe-subcutaneous kanye ne-fascia engaphansi zilimala, ziveza imisipha namathambo.Lolu uhlobo olubi kakhulu lomfutho wegazi obuhlungu futhi okunzima kakhulu ukuwelapha, olunobungozi obukhulu bokutheleleka.Ukulimala kwezicubu ezijulile, imisipha, izinzwa, namalunga kungase kwenzeke, ngokuvamile kube nobomvu obuningi nokuphuma.
Izilonda ze-Stage IV zokucindezela zidinga ukwelashwa okunamandla ukuze kugwenywe ukutheleleka kwesistimu nezinye izinkinga ezingase zibeke ukuphila engozini.Ngokocwaningo luka-2014 olwanyatheliswa kumagazini i-Advances in Nursing, abantu abadala asebekhulile abanezilonda ze-pressure 4 bangaba nezinga lokufa elifika kumaphesenti angu-60 phakathi nonyaka.
Ngisho nokwelashwa okuphumelelayo endaweni yabahlengikazi, izilonda ze-pressure 4 zingathatha izinyanga ezimbili kuya kweziyisithupha (noma ngaphezulu) ukuze ziphole.
Uma i-bedsore ijulile futhi ifakwe ezicutshini ezidlulanayo, umhlinzeki wakho wokunakekelwa kwezempilo angase angakwazi ukunquma ngokunembile isigaba saso.Lolu hlobo lwesilonda lubhekwa njengento engeyona indawo futhi lungadinga ukuchithwa okubanzi ukuze kukhishwe izicubu ze-necrotic ngaphambi kokuba kusungulwe isiteji.
Ezinye izilonda zokulala zingase zibonakale ziyisiteji 1 noma sesi-2 ekuqaleni, kodwa izicubu ezingaphansi zingase zilimale kakhulu.Kulesi simo, isilonda singahlukaniswa njengesigaba sokuqala sokulimala kwezicubu ezijulile (SDTI) okusolakala ukuthi.III noma IV izilonda zokucindezela.
Uma othandekayo wakho elele esibhedlela futhi enganyakazi, udinga ukuqaphela ukubona futhi okungcono ukuvimbela izilonda zokucindezela.Uchwepheshe wezokunakekelwa kwempilo noma umelaphi womzimba angasebenza nawe kanye nethimba lakho lokunakekela ukuze aqiniseke ukuthi lezi zinyathelo zokuphepha ziyalandelwa:
Shayela udokotela wakho uma ubona ubuhlungu, ububomvu, imfiva, nanoma yiziphi ezinye izinguquko zesikhumba ezihlala ngaphezu kwezinsuku ezimbalwa.Ukushesha kwelashwa izilonda zengcindezi, kuba ngcono.
Idizayini ye-ergonomic yokunciphisa ingcindezi nokugwema ama-bedsores
- I-Bhattacharya S., i-Mishra RK Izilonda zokucindezela: ukuqonda kwamanje kanye nokwelashwa okubuyekeziwe kwe-Indian J Plast Surg.2015;48(1):4-16.Ihhovisi lasekhaya: 10-4103/0970-0358-155260
- U-Agrawal K, u-Chauhan N. Izilonda zokucindezela: buyela ezintweni eziyisisekelo.I-Indian J Plast Surg.2012;45(2):244-254.Ihhovisi lasekhaya: 10-4103/0970-0358-101287
- Vuka BT.Izilonda zokucindezela: lokho odokotela okudingeka bakwazi.I-Perm Journal 2010;14(2):56-60.doi: 10.7812/tpp/09-117
- Kruger EA, Pires M., Ngann Y., Sterling M., Rubayi S. Ukwelashwa okuphelele kwezilonda zokucindezela ekulimaleni komgogodla: imiqondo yamanje kanye nezitayela zesikhathi esizayo.J. Umuthi womgogodla.2013;36(6):572-585.doi: 10.1179/2045772313Y.0000000093
- Edsberg LE, Black JM, Goldberg M. et al.Uhlelo olubuyekeziwe lweNational Pressure Ulcer Advisory Group lokuhlukanisa izilonda zengcindezi.J Umhlengikazi We-Urinary Stoma Post Injury.2016;43(6):585-597.doi:10.1097/KRW.0000000000000281
- I-Boyko TV, i-Longaker MT, i-Yan GP Ukubuyekezwa kokwelashwa kwesimanje kwe-bedsores.I-Adv Wound Care (i-New Rochelle).2018;7(2):57-67.doi: 10.1089/inxeba.2016.0697
- Palese A, Louise S, Ilenia P, et al.Yisiphi isikhathi sokuphulukiswa kwezilonda zomfutho wesigaba II?Imiphumela yokuhlaziywa kwesibili.Ukunakekelwa kwenxeba okuthuthukisiwe.2015;28(2):69-75.doi: 10.1097/01.ASW.0000459964.49436.ce
- I-Porreka EG, i-Giordano-Jablon GM Ukwelashwa kwezilonda ezinzima (isigaba III kanye ne-IV) zengcindezi engapheli kuma-paraplegics usebenzisa amandla omsakazo we-pulsed radiofrequency.I - plastic surgery.2008;8:e49.
- Andrianasolo J, Ferry T, Boucher F, et al.I-osteomyelitis ye-pelvic ehlobene ne-ulcer: ukuhlolwa kwesu lokuhlinza lezinyathelo ezimbili (ukukhipha i-debride, ukwelashwa kwengcindezi engemihle, nokuvalwa kwe-flap) kokwelashwa kwe-antimicrobial yesikhathi eside.Izifo ezithathelwanayo zeNavy.2018;18(1):166.doi:10.1186/s12879-018-3076-y
- Brem H, Maggie J, Nirman D, et al.Izindleko eziphezulu zezilonda zomfutho wesigaba IV.NginguJay Surg.2010;200(4):473-477.doi: 10.1016/j.amjsrg.2009.12.021
- U-Gedamu H, u-Hailu M, u-Amano A. Ukuvama kanye nokuphazamiseka kwezilonda zengcindezi phakathi kweziguli ezilaliswa esibhedlela i-Felegehivot Specialist Hospital e-Bahir Dar, e-Ethiopia.Intuthuko kwezobuhlengikazi.2014;2014. doi: 10.1155/2014/767358
- I-Sunarti S. Ukwelashwa okuphumelelayo kwezilonda ze-non-staged pressure nezingubo ezithuthukisiwe zamanxeba.Ijenali yezokwelapha yase-Indonesia.2015;47(3):251-252.
Isikhathi sokuthumela: Apr-28-2023