Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
Örnek Görseller Eşliğinde Basınç Yarası Evrelendirme ve Koruyucu Bakım Davranışları: Geleneksel Derleme
Pressure Injury Staging and Preventive Care Behaviors with Sample Photographs: Traditional Compilation
Zeynep KAPTANa , Sevil PAMUK CEBECİb
aEskişehir Osmangazi Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Bölümü, Hemşirelik Esasları AD, Eskişehir, Türkiye
bEskişehir Osmangazi Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Hemşirelik Esasları AD, Eskişehir, Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(3):930-42
doi: 10.5336/nurses.2024-101414
Article Language: TR
Full Text
ÖZET
Basınç yarası, deri ve deri altındaki dokularda basınç, friksiyon, yırtılma ve benzeri etkenlerin yol açtığı lokal doku zedelenmesidir. Günümüzde, bilim ve teknolojideki ilerlemelere rağmen basınç yaraları hâlâ önemli bir sorun olarak karşımıza çıkmaktadır. Özellikle yoğun bakımlarda, palyatif bakım merkezlerinde yaşam sonu bakım alan hastalar ile immobil hastalarda basınç yarası örneklerine daha sık rastlanmaktadır. Basınç yarası sıklıkla sakrum, koksiks, iskiyal tuberositler, büyük trokanter, dirsekler, diz kapağı çevresi, topuklar, skapulalar, krista iliyaka, lateral ve mediyal bölgelerde meydana gelmektedir. Özellikle kemik çıkıntılarının bulunduğu alanlarda gelişebilen basınç yaraları; hasta sırt üstü pozisyonda ise sakrum, koksiks, oksipital, skapula ve topuklarda, sürekli lateral pozisyonda yatan hastalarda ise omuz başları, trokanter, diz kapağı çevresi ve ayak bileklerinde, oturur pozisyonda ise gluteal bölümde ve skapulada daha sık görülmektedir. ABD'de en yaygın kabul gören sınıflandırma sistemi Amerikan Ulusal Basınç Yaralanması Danışma Paneli sistemine göre basınç yaraları ''Evre 1, Evre 2, Evre 3, Evre 4, Evrelendirilemeyen Evre, Şüpheli Derin Doku Hasarı, Tıbbi Cihazlarla İlişkili Basınç Yaralanması, Mukozal Membran Basınç Yaralanması'' olarak sınıflandırılmıştır. Kullanılan bu sınıflandırma sistemi, basınç yaralarının ciddiyetini ve tedavi seçeneklerini değerlendirmede klinik uygulamada önemli bir rol oynamaktadır. Basınç yarası önlenebilir bir durum olmasına rağmen önlenemediği ve oluşması durumunda; hastaların hastanede yatış süreleri uzamakta, morbidite ve mortalite oranları yükselmekte, bakım veren profesyonellerin iş yükü ve bakımının maliyeti artmakta, ikincil enfeksiyon riski gelişebilmekte ve komplikasyonlardan kaynaklanan ölümler de artmaya yol açabilmektedir. Bu nedenlerle özellikle hastalara 24 saat bakım veren hemşirelerin ve diğer sağlık profesyonellerinin basınç yarası hakkında bilgi ve bilinç farkındalığının artırılmasına ihtiyaç vardır. Makale basınç yarasını tanıma, evrelendirme hakkında görseller eşliğinde bilgi vermek ve basınç yarasından koruyucu bakım davranışlarına değinmek amacıyla yazılmıştır.

Anahtar Kelimeler: Basınç yarası; yara evrelendirme; sınıflama; koruyucu bakım; hemşirelik
ABSTRACT
Pressure injury is a local tissue damage occurring in the skin and underlying tissues due to factors such as pressure, friction, shear, and similar influences. Despite advancements in science and technology, pressure injurys continue to pose a significant problem. Instances of pressure injurys are more frequently encountered, especially in intensive care units, palliative care centers, and in patients receiving end-of-life care, as well as in immobilized patients. Pressure injury often occur in the sacrum, coccyx, ischial tuberosities, greater trochanters, elbows, heels, scapulae, cristae, lateral and medial regions. Pressure injury, which can develop especially in areas where bone protrusions are present; It is more common in the sacrum, coccyx, occipital, scapula and heels if the patient is in the supine position, in the shoulder heads, thorachanter, kneecap area and ankles in patients who always lie in the lateral position, and in the gluteal part and scapula in the sitting position. According to the National Pressure Injury Advisory Panel system, the most widely accepted classification system in the USA, pressure injury are classified as Stage 1, Stage 2, Stage 3, Stage 4, Unstageable Pressure Injury, Suspected Deep Tissue Injury, Medical Device-Related Pressure Injury, Mucous Membrane Pressure Injury''. This classification system used plays an important role in clinical practice in assessing the severity of pressure injury and treatment options. While pressure injury are a preventable condition, their occurrence leads to prolonged hospital stays, increased morbidity and mortality rates, heightened workload and care costs for healthcare professionals, potential development of secondary infections, and a rise in deaths attributed to complications. Therefore, there is a need to enhance the knowledge and awareness of pressure injury, particularly among nurses providing 24-hour care and other healthcare professionals. This article aims to provide information, accompanied by visuals, about recognizing and staging pressure injury, and discusses preventive care behaviors related to pressure injury.

Keywords: Pressure injury; wound staging; classification; preventive care; nursing
REFERENCES:
  1. Kıraner E, Terzi B, Ekinci AU, Tunalı B. Yoğun bakım ünitemizdeki basınç yarası insidansı ve risk faktörlerinin belirlenmesi [Characteristics of patients with pressure wound in the intensive care unit]. Yoğun Bakım Hemşireliği Dergisi. 2016;20(2):78-83. [Link] 
  2. Ersoy EO, Öcal S, Öz A, Yılmaz P, Arsava B, Topeli A. Yoğun bakım hastalarında bası yarası gelişiminde rol oynayabilecek risk faktörlerinin değerlendirmesi [Evaluation of risk factors for decubitus ulcers in intensive care unit patients]. Yoğun Bakım Dergisi. 2013;4:9-12. [Crossref] 
  3. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel, ed. Yara Ostomi İnkontinans Hemşireleri Derneği, çeviri. Basınç Ülserlerini Önleme: Hızlı Başvuru Kılavuzu. Ankara: 2010. [Link] 
  4. NPIAP (National Pressure Injury Advisory Panel). Pressure Prevention. Available from: [Link] 
  5. National Pressure Injury Advisory Panel [Internet]. [Cited: May 29, 2024]. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Available from: [Link] 
  6. Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546. [Crossref]  [PubMed] 
  7. Padula WV, Black JM, Davidson PM, Kang SY, Pronovost PJ. Adverse effects of the medicare PSI-90 hospital penalty system on revenue-neutral hospital-acquired conditions. J Patient Saf. 2020;16(2):e97-e102. [Crossref]  [PubMed] 
  8. Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care. 2009;18(4):154-61. [Crossref]  [PubMed] 
  9. Vanderwee K, Clark M, Dealey C, Gunningberg L, Defloor T. Pressure ulcer prevalence in Europe: a pilot study. J Eval Clin Pract. 2007;13(2):227-35. [Crossref]  [PubMed] 
  10. Baykara ZG, Karadag A, Bulut H, Duluklu B, Karabulut H, Aktas D, et al. Pressure injury prevalence and risk factors: a national multicenter analytical study. J Wound Ostomy Continence Nurs. 2023;50(4):289-95. [Crossref]  [PubMed] 
  11. Burston S, Chaboyer W, Gillespie B. Nurse-sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues. J Clin Nurs. 2014;23(13-14):1785-95. [Crossref]  [PubMed] 
  12. Ferris A, Price A, Harding K. Pressure ulcers in patients receiving palliative care: a systematic review. Palliat Med. 2019;33(7):770-82. Erratum in: Palliat Med. 2020;34(7):969. [Crossref]  [PubMed] 
  13. Karadağ A. Basınç ülserleri: değerlendirme, önleme ve tedavi [Pressure ulcers: assessment, prevention and treatment]. Cumhuriyet Üniv Hemşire YO Derg. 2003;7(2):41-8. [Link] 
  14. Al Mutairi KB, Hendrie D. Global incidence and prevalence of pressure injuries in public hospitals: a systematic review. Wound Med. 2018;22:23-31. [Crossref] 
  15. Çavuşoğlu A, Yeni K, İncekara H, Acun A, Polat Dünya C, Tülek Z. Bir yoğun bakım ünitesinde basınç yarası prevalansı: retrospektif bir çalışma [Pressure ulcer prevalence in an intensive care unit: a retrospective study]. Journal of Academic Research in Nursing (JAREN). 2020;6(2):203-9. [Crossref] 
  16. Brem H, Lyder C. Protocol for the successful treatment of pressure ulcers. Am J Surg. 2004;188(1A Suppl):9-17. [Crossref]  [PubMed] 
  17. İnan GD. Çukurova Üniversitesi Balcalı Hastanesi'nde yatan hastalarda basınç ülseri prevelansı [Yüksek lisans tezi]. Adana: Çukurova Üniversitesi; 2009. Erişim linki: [Link] 
  18. Ünver S, Yıldırım M, Akyolcu N, Kanan N. Basınç yaralarına ilişkin kavram analizi [Concept analysis of pressure sores]. Florance Nightengale Hemşirelik Dergisi. 2014;22(3):168-71. [Crossref] 
  19. Kökçü Doğu Ö. Yoğun bakım hemşirelerinin bası yarası, bakımı ve bakım ürünleri kullanımına ilişkin bilgi ve uygulamalarının değerlendirilmesi [Evaluation of intensive care nurses' knowledge and practices regarding pressure sore care and use of care products]. Journal Human of Rhythm. 2015;1(3):95-100. [Link] 
  20. Yara Bakım Derneği. [Erişim Tarihi: 10.12.2023]. [Link] 
  21. Orhan B. Basınç yaralarını önleme klavuzu: kanıta dayalı uygulamalar [Practice for preventing pressure ulcers: evidence based practices]. Arşiv Kaynak Tarama Dergisi. 2017;26(4):427-40. [Crossref] 
  22. Bergstrom N, Braden BJ, Laguzza A, Holman V. The Braden Scale for predicting pressure sore risk. Nurs Res. 1987;36(4):205-10. [Crossref]  [PubMed] 
  23. Oğuz S, Olgun N. Braden Ölçeği ile hastaların risklerinin belirlenmesi ve planlı hemşirelik bakımının bası yaralarının önlenmesindeki etkinliğinin saptanması [Predicting the determining the pressure sore risk with Braden Scale and determining the effectiveness of predetermined nursing care prevention of pressure sore]. Hemşirelik Forum. 1998;1(3):131-5. [Link] 
  24. Norton D, McLaren R, Exton-Smith AN. An Investigation of Geriatric Nursing Problems in Hospital. 1st ed. London: Churchill Livingstone; 1962.
  25. Norton D. Calculating the risk: reflections on the Norton Scale. Decubitus. 1989;2(3):24-31. Erratum in: Decubitus 1989;2(4):10. [PubMed] 
  26. Avşar P. Hemşirelerin Braden ve Waterlow basınç ülseri risk değerlendirme ölçeklerine ilişkin görüşleri [Yüksek lisans tezi]. Ankara: Gazi Üniversitesi; 2012. Erişim linki: [Link] 
  27. Waterlow J. Pressure sores: a risk assessment card. Nurs Times. 1985;81(48):49-55. [PubMed] 
  28. Avşar P, Karadağ A. Waterlow Basınç Ülseri Risk Değerlendirme Ölçeği'nin Türkçeye Uyarlanması, geçerlik-güvenirlik çalışması [Turkish adaptation and validity reliability study of the Waterlow Pressure Ulcer Risk Assessment Scale]. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2016;3(3):1-15. [Link] 
  29. Karadağ A, Gül Ş. Basınç ülserinin önlenmesi. Baktıroğlu S, Aktaş Ş, editörler. Kronik Yarada Güncel Yaklaşımlar. 1. Baskı. İstanbul: İstanbul Üniversitesi İstanbul Tıp Fakültesi Yayınları; 2013. p.186-208.
  30. Cereda E, Klersy C, Serioli M, Crespi A, D'Andrea F; OligoElement Sore Trial Study Group. A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: a randomized trial. Ann Intern Med. 2015;162(3):167-74. Erratum in: Ann Intern Med. 2015;163(12):964. [Crossref]  [PubMed] 
  31. Iizaka S, Kaitani T, Nakagami G, Sugama J, Sanada H. Clinical validity of the estimated energy requirement and the average protein requirement for nutritional status change and wound healing in older patients with pressure ulcers: a multicenter prospective cohort study. Geriatr Gerontol Int. 2015;15(11):1201-9. [Crossref]  [PubMed] 
  32. Kula Şahin S. Basınç yarası ve malnütrisyon [Pressure sore and malnutrition]. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi. 2020;8(3):923-45. [Crossref] 
  33. Molnar JA, Vlad LG, Gumus T. Nutrition and chronic wounds: improving clinical outcomes. Plast Reconstr Surg. 2016;138(3 Suppl):71S-81S. [Crossref]  [PubMed] 
  34. Manzano F, Colmenero M, Pérez-Pérez AM, Roldán D, Jiménez-Quintana Mdel M, Mañas MR, et al. Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses. Intensive Care Med. 2014;40(11):1679-87. [Crossref]  [PubMed] 
  35. Beeckman D, Campbell J, Campbell K, Chimentão D, Coyer F, Domansky R, et al. Proceedings of the Global IAD Expert Panel. Incontinence associated dermatitis: moving prevention forward. Wounds International. 2015:1-21. [Link] 
  36. Jocelyn Chew HS, Thiara E, Lopez V, Shorey S. Turning frequency in adult bedridden patients to prevent hospital-acquired pressure ulcer: a scoping review. Int Wound J. 2018;15(2):225-36. [Crossref]  [PubMed]  [PMC] 
  37. Bours GJ, Halfens RJ, Abu-Saad HH, Grol RT. Prevalence, prevention, and treatment of pressure ulcers: descriptive study in 89 institutions in the Netherlands. Res Nurs Health. 2002;25(2):99-110. [Crossref]  [PubMed] 
  38. Weller CD, Team V, Sussman G. First-line ınteractive wound dressing update: a comprehensive review of the evidence. Front Pharmacol. 2020;11:155. [Crossref]  [PubMed]  [PMC] 

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