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Kronik Yaralarda Risk Faktörlerinin Ortadan Kaldırılması

ALLEVIATION OF RISK FACTORS IN CHRONIC WOUNDS

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Abstract (2. Language): 
Wounds heal through a number of coordinated cellular and humoral mechanisms. When the coordination of these mechanisms is altered, the wound can not regain its anatomical and functional integrity and hence is named as a chronic wound. As the mean life expectancy and quality of life expectancy of the populations increase, physicians face increasing numbers of chronic wounds. Hypoxia and wound infection seem to be the most important risk factors for chronic wounds. It is imperative to investigate if hypoxia can be corrected by surgical means. Hyperbaric oxygen treat¬ment may be indicated if surgery is not possible. The use of topical and systemic antibiotics is the most controversial issue as far as wound infection is concerned. Age; dietary insufficiency; tobacco use; diabetes and immune compro¬mise are the other important risk factors that can cause chronic wounds. It may not be possible to relieve these risk factors completely. Nevertheless, physicians should be aware of the risk factors and should take the necessary precautions in order to heal the wound.
Abstract (Original Language): 
Yara iyileşmesi, birbiriyle ilişkili hücresel ve hümoral mekanizmalarla gerçekleşir. Bu mekanizmaların koordinasyonu bozulduğunda yara anatomik ve fonksiyonel bütünlüğünü kazanamaz ve kronik yara adını alır. Ortalama yaşam süresinin artması ve yaşam kalitesine yönelik beklentiler, hekimlerin giderek daha fazla sayıda kronik yara bakımı sorunu ile karşı karşıya kalmalarına yol açmaktadır. Kronik yaradaki en önemli risk faktörleri hipoksi ve yara enfeksiyonudur. Hipok-siyle mücadele etmek için durumun cerrahi olarak düzeltile¬bilir olup olmadığı araştırılır. Cerrahi olarak düzeltilemeyen yaralarda hiperbarik oksijen tedavisi yardımcı olabilir. Enfeksiyonla mücadelenin en tartışmalı konusu ise topikal ve siste-mik antibiyotiklerin ne zaman kullanılacağıdır. Yaş, beslenme bozukluğu, tütün kullanımı, diyabet, bağışıklık sisteminin baskılanması diğer önemli risk faktörleridir. Bu risk faktörleri¬ni tamamen ortadan kaldırmak mümkün olmayabilir, ancak hekimin risk faktörlerinin farkında olması ve mümkün olan düzeltici tedbirleri alması yaranın iyileşmesine yardımcı olur.
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