Khum mu chunga pressure injury chungchang hi i zir dawn teh ang. (Pressure Hliam / Khum natna) 1.1.

I chhungkuaah hian damlohna emaw, tar emaw avanga khumah inkhung tlat, dinhmun inang rei tak awm reng an awm em? Chutiang mite chuan a chang chuan vun hliam an nei tih i hmu tawh ngei ang. Hengte hi "bed sores" kan ti a. Damdawi lamah chuan hengte hi `(Pressure Injuries)` emaw `(Bedsores) tia hriat a ni. Vawiin hian hengte hi eng nge an nih tak tak te, an lo awm chhan te, an ven dan tur te, leh a lo awm leh a nih chuan eng nge tih tur tih te chipchiar takin kan sawi dawn a ni . Hei hi mi tam tak tan chuan thupui pawimawh tak a ni.

Heng bed sores te hi eng tak nge ni?

A awlsam zawngin sawi ila, bedsores chu kan vun hmun khata rei tak pressure a awm a, chu hmuna vun tichhe thei hliam a ni. Ngaihtuah teh, mi pakhat chu darkar khat emaw, ni tam tak emaw khumah a awm a, a nih loh leh wheelchair-a a dinhmun inangah rei tak a ṭhut chuan, vun hian taksa rihna tlakna hmuna ruhte chu a hmet tlat a ni. He pressure hi kan hnawih chuan thisen kalna a tlahniam a ni. Thisen a kal tha lo a nih chuan vun cell te chu an thi tan a , chutih lai chuan heng hliam te hi a lo awm thin.

Heng bedsores te hi hming dang pawh a awm bawk. I doctor chuan heng hmingte hi a hmang thei ang:

• `(Decubitus hliam)`
• `(Pressure natna)`
• `(Pressure ulcer awm thei)`
• `(Pressure hliam)`

Eng hming pawha vuah mah la, dinhmun inang tihna a ni.

Heng khum natna hi engtiang chiahin nge a awm? Tuin nge dawng tam ber?

Hei hi a takah chuan i ngaihtuah aiin a tam zawk. He hlauhawmna hi a bik takin mahni chauha kal kual harsa, khumah inkhung, wheelchair hmang thinte tan a sang hle. Kan pi leh pute zinga pakhat chu natna avanga khumah a muhil a nih chuan, emaw, mi pakhatin accident avanga ``Paralysis`` ang chi natna a neih a, khumah a inkhung tlat a nih chuan heng hliamte hi a vei tam zawk tih han ngaihtuah teh.

Tin, damdawi lam harsatna thenkhat nei te pawh an hlauhawm zawk bawk. Entir nan:

• `(Diabetes)` vei tan
• Vun sensitivity tlahniam te tan
• Ei leh in lama harsatna nei te tan (Malnutrition) .
• Vun vawt tak tak nei emaw, tui vawn tam lutuk emaw tan
• `(Dementia)` ang chi natna avanga harsatna awmte inhrilhhriattir thei lote tan
• Cancer vei thenkhat
• Naupang leh puitling, thluak lam natna nei, cerebral palsy te tan
• `(Chronic venous insufficiency)` (Veins-a thisen kal tha lo) .
• `(Thinlung tha lo)` (Thinlung tha lo) .
• `(Kidney failure)` (Kidney failure) .
• `(Peripheral artery disease)` (a taksa peng hrang hranga thisen petu thisen kalna kawng a tawi) .
• Spinal cord hliam emaw spina bifida ang chi natna te.

Heng hliamte hi taksaah khawiah nge a awm tam ber?

Dik tak chuan heng hliamte hi taksa khawi hmunah pawh a awm thei. Entirnan, oxygen mask hmangtu chuan a hnar chung lamah emaw, a beng sir lehlamah emaw, a lu hnung lamah emaw hliam a nei thei a ni. Mi pakhatin ha lem fit lo tak a vuah pawhin heng hliamte hi a hmui chhungah a lut thei bawk. Tin, mi pakhat chu intubate (breathing tube dah) emaw, mechanical ventilation (machine hmanga thawk) pek a nih chuan, a kaihhnawih pressure chuan hliam a thlen thei bawk.

Mahse, heng hliamte hi ruhte vun hnaih berna hmunah a awm tam ber . Hei hi a chhan chu chu hmunte chu vun ruh a press nasat em emna leh thisen kal a tihtlem nasat vang a ni. Chutiang hmunah chuan:

• Ankles a ni
• Hnung
• Buttocks a ni
• Elbows a ni
• Heels a ni
• Mawngbawr
• Tailbone (ruh hnuai lam) 1.1.

Bed sores awm chhante chu engte nge ni?

A chhan ber chu, ka sawi tawh ang khan , hmun khatah hun rei tak chhung pressure . Hetiang pressure avang hian vunah thisen petu thisen kalna kawng te te te chu a hrual a, thisen chu a luang lo ang mai a ni. Ngaihtuah teh, tui pipe i hrual a, nghet taka i vawn chuan tui chu a luang lo. He thisen hi a bo chuan vun chunglam ber `(Epidermis)` cell te chu an thi tan thin. Heng cell thi te hi a chhe deuh deuh chuan hliam angin an lang thin. A châng chuan , hmun khatah hun rei lo tê, darkar hnih ang chi press i nih pawhin, hliam a inṭan thei .

He pressure bakah hian thil dangin heng hliamte hi a lo piang chhuak a ni:

• Moisture: Vun hi thawmhnaw, zun, leh ek ang chi thil avanga a hnim chuan a chak lo zual a, hliam a tuar awlsam zawk.
• Traction/Shear: Khum lu chawi sang emaw, ruang wheelchair-a a awm lai emaw, taksa a tlak thlak lai emaw hian vun hi a hrual thin. He pulling hian vun hnuaia tissue te pawh a tichhe thei a, hliam a siam thei bawk.

Bed sores hi eng symptoms leh stages nge ni?

Bed sores symptoms hi mi hrang hrangah a inang lo thei. Mi thenkhat chuan heng hliam atang hian natna leh riltam an nei thei. Mahse, nerve chak lo leh hriatna tlahniam te chuan he natna hi an hre lo mai thei. Chuvangin vun hi en reng a pawimawh hle.

Doctor-te chuan heng bedsores te hi an nasat dan a zirin stage hrang hrangah an thliar hrang thin. Hei hian hliam enkawl dan tur a hriat theih nan a pui thin.

• Stage 1: Vun hi a sen emaw, a sen emaw a lang. Mahse, vun tliak leh hliam a la awm lo. Hetiang rawng inthlak danglamna hi vun dum nei tan chuan hriat a harsa deuh mai thei. Chu hmun chu khawih chuan a na deuh thei a, hmun dang aiin a lum zawk, a vawt zawk, a nem zawk emaw, a khauh zawk emaw a ni thei bawk.
• Stage 2: Hei hi vun chunglam layer lakchhuahna hmun a ni a, a hnuai lam chu pink emaw sen emaw neia hliam thuk lo tak a awm a ni. Skin peeling leh blisters te pawh i hmu thei bawk .
• Stage 3-na chu:Tunah chuan hliam chu a thuk deuh tawh. Hliam hi hypodermis, vun hnuaia thau layer thlengin a darh vek thei.
• Stage 4: Hei hi stage na ber a ni. Hliam hian vun layer pathumte chu a luhchilh vek tawh a, a hnuaia taksa ruh, ruhro leh ruh (musculoskeletal system) pawh a lang thei. Heng hliam chi hrang hrangte hi a dam theih nan hun rei tak a ngai a, harsatna a thlen tam zawk bawk.

Bed sores avanga harsatna awm thei te chu engte nge ni?

Bed sores hi vun hliam chauh a ni lo. Enkawl loh chuan nunna atana hlauhawm bacteria infection an thlen thei a ni .

Heng hliamte hian dinhmun hlauhawm tak tak, `(Cellulitis)` (vun leh a hnuaia tissue infection), `(Septicemia)` (thisen rimchhia) te a thlen thei a ni. A châng chuan, `(Sepsis)` (infection na tak, taksa pum puia darh) leh `(Amputation)` thlengin a kal thei.

Mi thenkhat chuan heng khum natna atanga chhuak sinus tract an nei thin. Heng tract te hi taksa hmun thuk zawk nena inzawm chuan harsatna te chu:

• Thisen chhunga bacteria lut (Bacteremia). Hei hian bacterial meningitis (thluak natna) emaw endocarditis (thinlung chhungril lam natna) emaw a thlen thei a ni.
• Ruh natna (Osteomyelitis) emaw, ruh natna (Septic arthritis) emaw a awm thei.
• Bacteria hrik kai te chu `(Group A streptococcus)` te hi a ni. Chungte chu hri kai tlangpui `(Cellulitis)` atanga natna hlauhawm tak `(Necrotizing fasciitis)` (sa hmin natna) an tih thlengin a awm thei.

Engtin nge khum natna hi a kai tih i hriat theih ang?

Hliam a kai chuan a natna lan chhuahna te chu i nei thei a ni:

• Khawsik leh khawsik hi a lan chhuah hmasak ber a ni fo.
• Hliam awmna hmunah natna nasa tak nei.
• Hliam atanga rimchhia lo chhuak.
• Hliam chu a sen a , khawih pawhin a lum hle .
• Hliam a hring chhuak .
• Hliam atang hian pus a chhuak .

Hetiang thil hi i hmuh chuan damdawi lam thurawn lak nghal a pawimawh hle .

Bed sores hmuhchhuah leh enkawl dan

Nangmah emaw, i enkawltu tu emaw khum natna nei nia i rinhlelh chuan Doctor i pan tur a ni. Hliam lam thiamte pawh i pan a ngai mai thei bawk. Doctor-te chuan hliam hmel chu an en ang a, khum natna a nih leh nih loh leh eng stage-ah nge a awm tih an hre ang a, a dam dan en turin hliam hi thlalak an la thei bawk.

Infection awm leh awm loh enfiah nan hetiang test hi i ti thei bawk:

• Lesion atanga tlem te chu enfiah (biopsies) atan lak.
• Thisen culture leh test te.
• `(X-rays)` emaw `(MRIs)` ang chi scan te hi a ni.

Nonsurgical hmanga enkawlna te

Stage 1 leh 2-a hliam na lo tak takte chu nangmah emaw, i enkawltu emaw (damdawi lam thurawn nen) in lamah i enkawl thei fo thin. Stage 3 leh 4-a hliam thuk tak chu damdawi lam pan a ngai a ni. Hliam nasat dan azirin, a dam theih nan kar tam tak atanga thla tam tak a daih thei .

A hnuaia enkawlnate hi a ni:

• Hliam tihfai: Hliam chu sahbawn tui emaw, saline (sterile saltwater solution) emaw hmangin silfai tur a ni.
• Damdawi hmanga hliam tuam: Medical bandage chi hrang hrang a awm a, chu chuan hliam chu a dam thuai thei a ni. Entirnan Hydrogel (tui atanga siam gel), Hydrocolloid, Alginates (tuipui atanga siam), leh foam dressing te hi a ni.

Hliam thuk, na tak takah chuan doctor chuan tissue thi chu a la chhuak ang. Hei hi ``Debridement`` an ti a. Hei hi vun thi chu hmanraw hrual ``Scalpel`` hmanga tan a ni.`` A nih loh leh, tissue thi chu tithianghlim thei hriak an hnawih thei a, an paih chhuak thei bawk. Chutianga tih a nih chuan a numb theih nan ``Local anesthetic`` inject theih a ni. A chhan chu tissue thi vel tissue hian natna a hriat avangin.

Damdawi pek dan

Hliam dinhmun leh a natna lan chhuah dan azirin a hnuaia damdawi te hi pek theih a ni.

• Antibiotics hian natna hrik a veng a, a enkawl bawk.
• Natna leh hliam tihziaawmna (Nonsteroidal anti-inflammatory drugs - NSAIDs) .
• Natna tidamtu.

Surgery hmanga enkawlna te

Stage 3 emaw 4 emaw-a hliam thuk tak, lian tak tak tan chuan operation neih a ngai mai thei. Skin graft hmangin hliam hi khar a ni thei a, a dam thuai theih bawk.

Engtin nge khum natna laka inven theih ang? Hei hi a pawimawh ber a ni!

Bed sores a lo awm hnua tuar ai chuan a lo awm hmaa ven hi a awlsam zawk hle . An chungchanga i tih theih thenkhat chu hetiang hi a ni:

• I dinhmun thlak fo rawh: Wheelchair-a i awm chuan minute 15 danah tal i dinhmun thlak rawh . Khumah i mut chuan darkar hnih danah tal i taksa chu tikehsawm rawh . Nangmah chauhin hetiang thil hi i tih harsat chuan enkawltu hnen atangin tanpuina la rawh. Hei hi a pawimawh ber a ni.
• Skin check fo thin: I taksa zawng zawng (a bik takin pressure point) ah ni khatah vawi khat tal i vun enfiah thin ang che. A rawng, a natna, a lum leh a vawt a inthlak leh awm loh enfiah thin ang che. Nangmah ngeiin i ti thei lo a nih chuan midang tih tir rawh.
• Chaw ei tha la, tui in tam rawh: I vun hrisel nan ei tur tha tak tak, a bik takin protein tamna ei tur. Nilengin tui tam tak in thin ang che.
• Vun fai leh vawt taka vawn: Vunah thawmhnaw, zun emaw, bawlhhlawh emaw a lo lut a nih chuan silfai nghal la, vawt takin dah rawh. Vun venhim nan moisture barrier cream i hmang thei bawk.
• Exercise-a inhmang: 1.1.A theih ang angin taksa exercise-ah tel ve rawh. Hei hian thisen kal dan a titha a ni. ``Physical therapy`` chungchangah doctor hnen atangin thurawn i la thei bawk.
• Meizial zu pumpelh: Meizial i zuk chuan bânsan tûrin ṭanpuina zawng rawh. Nicotine hian hliam damna a tikhawtlai.
• Mattress leh cushion bik hmang rawh: A bik taka siam mattress emaw foam cushion emaw, pressure tihziaawmna tura siam hmang rawh. Doughnut ang maia a laiah khur nei cushion-ah thut loh tur. Hei hian hliam chhehvel pressure a tisang thei a ni.
• Khum, thawmhnaw hnuai lam, leh thawmhnaw te silfai leh thlak fo tur: Hengte hi fai taka vawn reng a pawimawh hle.

Bed sores nei mi pakhat tan Outlook

Khum natna a dam hnuah pawh chu lai hmuna vun chu a hma angin a chak lo. Chuvangin a lo lang leh tur venna tur step zawm chhunzawm zel a pawimawh . Stage 3 emaw 4 emaw-a bedsores na tak takte chu tihdam a harsa zawk a, an kai tam zawk a, nunna atana hlauhawm harsatna an neih theihna a sang zawk bawk.

Engtikah nge doctor i hmuh ang?

Bed sores vei theihna i neih a, heng symptoms te hi i hriat chuan doctor hnenah hrilh nghal rawh:

• Vun rawng a danglam (red, pink, purple).
• Infection chhinchhiahna (khawsik, khuh, zun, rimchhia).
• I vun hmun engemaw zat i khawih hian a na emaw, a lum emaw a nih chuan.

I doctor zawh tur zawhna

• Engvangin nge he khum na hi ka neih?
• Eng enkawlna nge ka tan a tha ber?
• Surgery ka mamawh em?
• Khum natna laka inven nan eng nge ka tih theih ang?
• Complication chungchangah hian ka ngaihtuah tur em ni?

Bed sores leh ei leh in pawimawhna

Bedsores nei tam tak chu ei leh in lama harsatna nei an ni. Hei hi tar vang emaw, damdawi lam thil dang vang emaw a ni thei. Chaw tha, protein tamna ei hian khum natna a veng thei a, hliam a dam thuai thei bawk. Vitamin leh supplement te pawh a ngai mai thei. A tlem berah chuan ei leh in lama harsatna nasa tak nei te chu tube (enteral nutrition) emaw, intravenous nutrition (IV nutrition) emaw hmanga ei tur pek a ngai mai thei.

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Mite chu che thei lo, khumah mu, wheelchair-a kal, emaw, risk factor dang nei te chu khumah hliam an vei theihna a sang zawk. Chuvangin , vun enfiah fo leh dinhmun thlak danglam ang chi invenna dan zawm a pawimawh hle. (Nangmah ngeiin i tih theih loh chuan enkawltu, chhungte, hriselna enkawltu hnen atangin tanpuina la rawh.)

Bed sores hi hriat hmasak a tha ber (stage 1 leh 2). Tichuan, vun a tliak hma leh hliam a lian hmain enkawl theih a ni. Heng ang hliam hmasa te hi enkawlna hmangin a dam tha zawk. Mahse, hliam thuk zawk (stage 3 leh 4)-ah chuan natna hrik leh natna khirh tak dang a awm tam zawk. ChuvanginDamdawi inenkawlna mumal tak neih a pawimawh hle.

Hemi chungchangah hian nangmah emaw, i hmangaih tak emaw hian zawhna dang i neih chuan i doctor nen inbiakna neih hreh suh. Hrisel takin awm rawh!

` Khum natna, pressure sores, vun hliam, khum mu, che thei lo, vun enkawl, hliam dam