AMPUTASYON ENDIKASYONU OLAN İSKEMIK ÜLSERLI AYAĞIN PALYATIF BAKIM SONUCU İYILEŞMESI: OLGU SUNUMU

Palliative Care Resulting in the Recovery of an İschaemic, Ulcerated Foot With İndications for Amputation: Case Report

Ali Ramazan BENLİ,Aybala CEBECİK,Ufuk Turan Kürşat KORKMAZ,Malik ABACI,Didem SUNAY

Özet

Giriş: Palyatif bakım servisi ve evde sağlık hizmetlerinin koordineli bir şekilde çalışması hastaların takip ve tedavisinde önemli rol oynamaktadır. Bu olgu sunumu ile seçilmiş hastalarda birimler arasındaki koordinasyonun tedavideki etkisini göstermeyi amaçladık.Olgu: Evde sağlık hizmetlerinin evinde ziyaret ettiği 78 yaşında bayan hastanın sağ ayakta 2 yıl devam eden kronik yarası mevcut. Yara sağ ayak bileği laterale doğru uzanan, 4X5 cm. genişliğinde enfekte görünümlü idi. Amputasyon kararı verilmesine rağmen hastanın bu durumu reddettiği öğrenildi. Palyatif bakım servisinde 3 haftalık takip ve tedavisi sonrası yarası düzeldi. Evde sağlık hizmetlerinin kontrolünde olacak şekilde taburcu edildi

Abstract

Aim: The home healthcare services and palliative care services are co-ordinated in our hospital by the Family Medicine Department. With this case presentation, it was aimed to emphasise the importance of co-ordination of the palliative care unit with home healthcare services in the treatment and care of selected patients. Case: A 78-year old female was evaluated by the home healthcare services because of a wound in the left foot which had not recovered for 2 years and was then admitted to the palliative care unit with an infected wound 4 x 5 cm in the distal of the left ankle extending laterally. Amputation of the injured foot had been recommended to the patient but she had refused that option. At the end of the 3rd week of palliative care, the foot wound was seen to have improved and the patient was discharged with follow-ups to be made by home healthcare services. Discussion: Palliative care is a branch which aims to help patients who are not fully recovered because of a chronic disease or who require end-of-life support. In the case presented here, a 78-year old female patient was monitored by home healthcare services but routine dressing changes were not applied and further treatment was required. The patient was referred to the palliative care unit, was admitted and recovered with the appropriate treatment.