| Abstract | Koža, grčki- dermis; latinski-cutis, pokriva cijelu površinu tijela te je samim tim najveći organ. Normalna koža morfološki se sastoji od epidermisa, dermisa i supkutisa. Primarni zadatak kože je zaštita cijelog organizma i unutarnjih organa od negativnih utjecaja okoline.
Dermatitis je upala svih slojeva kože. Znaci upale su: calor (toplina) - povećani protok krvi koji dovodi do blagog edema kože, rubor (crvenilo) - dilatirane krvne žile, eritem kože, dolor (bol) - iritacija živaca u upaljenom tkivu, što dovodi do svrbeža, peckanja i slično, a u slučaju kože rezultira grebanjem, svrbežom što pak, dovodi do daljnjeg oštećenja kože - functio laesa. Etiološki razlikujemo brojne dermatitise, no najčešći su kontaktni iritativni dermatitis, kontaktni alergijski dermatitis, atopijski dermatitis, phytophotodermatitis, perioralni dermatitis, itd.
Kontaktni dermatitis je upalno stanje kože uzrokovano direktnim kontaktom te je najčešća profesionalna bolest kože. Oštećenja kože iritativnim (toksičnim) sredstvima koja djeluju direktno na površinu kože uzrokuju nastanak nealergijskog ili iritativnog kontaktnog dermatitisa. Ukoliko je oštećenje posljedica senzibilizacije kože tvarima male molekularne mase radi se o alergijskom kontaktnom dermatitisu. Najčešće promjene pojavljuju se na rukama. Prilikom postavljanja dijagnoze koriste se anamnestički podatci, klinička slika i alergološka testiranja na standardne kontaktne alergene provođenjem epikutalnog testa.
Cilj rada bio je istražiti pojavnost kontaktnog dermatitisa kao posljedicu pranja ruku medicinskim sredstvima za pranje i dezinfekciju kod zdravstvenog osoblja u OB Dubrovnik; utvrditi koja se sredstva za pranje i dezinfekciju najčešće koriste u svakodnevnom radu, ali i procjeniti znanje ispitanika o čimbenicima rizika kao i mjerama prevencije obzirom da zdravstveni djelatnici spadaju u rizičnu skupinu zbog prirode svog posla. Istraživanje je provedeno kod zdravstvenih djelatnika u nekim službama OB Dubrovnik (kirurški odjel, jedinica intenzivnog liječenja i interni odjel).
Prema rezultatima našeg istraživanja može se zaključiti kako 54% ispitanika koristi uvijek sredstva za dezinfekciju ruku. Najrašireniji u upotrebi su proizvodi Plivasept pjenušavi i Plivasept blue. Na pitanje koriste li sredstva za njegu kože 40% ispitanika odgovorilo je da ih koriste rijetko, dok ih 6% ispitanika uopće ne koristi. Možemo zaključiti kako su zdravstveni djelatnici educirani o važnosti pranja i dezinfekcije ruku, kao i o upotrebi zaštitnih sredstava u radu s pacijentima. Iz rezultata istraživanja među ispitanim djelatnicima Opće bolnice Dubrovnik može se zaključiti kako samo mali broj zdravstvenih djelatnika ima dijagnosticirani kontaktni ili iritativni dermatitis. Ispitani djelatnici promjene na rukama koje su posljedica češćeg pranja i dezinfekcije kože ne doživljavaju kao bolest, nego kao posljedicu svoga posla. Anketirani djelatnici upotrebljavaju zaštitne rukavice u svakodnevnom radu, a jedan djelatnik prijavio je alergiju na latex i gumu. |
| Abstract (english) | Skin, Greek- dermis, Latin - cutis, covers the entire body surface and it is the largest organ. Normal skin is morphologically composed of epidermis, dermis and supcutis. The primary skin function is to protect the entire organism and internal organs from the negative effects of the environment.
Dermatitis is an inflammation of all skin layers. The symptoms are: warmth, increased blood flow leading to mild skin edema, redness- dilated blood vessels, skin erythema, pain- nerve irritation of the inflamed tissue, which leads to itch, prickle and similar, resulting in scratching, itching which leads to further skin damage and functio laesa. There are different types of dermatitis, but the most common are irritant contact dermatitis, allergic contact dermatitis, atopic dermatitis, phytophotodermatitis, perioral dermatitis, etc.
Contact dermatitis is the inflammation of the skin caused by direct contact and is the most common professional skin disease. Skin damages with irritant (toxic) agents acting directly on the skin surface causes the formation of non-allergic or irritant contact dermatitis. If the damage is caused by the skin sensitization to the substances of low molecular weight then we are talking about allergic contact dermatitis. The most common changes occur on the hands. Diagnosis is performed by using anamnestic data, clinical picture and allergy tests to standard series of allergens by performing an Epicutaneous patch testing.
The aim of this thesis was to investigate the occurrence of contact dermatitis as a consequence of hands washing with medical soaps and disinfectants that health care professionals in Dubrovnik hospital are using; to determine which washing and disinfecting agents are the most often used in their everyday work, but also to assess their knowledge and awareness of risk factors and prevention measures, as the health care professionals are in risk group due to the nature of their work. This study was made on health care staff in some of the departments of Dubrovnik General Hospital like: department of surgery, intensive care unit and internal department.According to our research results, we can conclude that 54% of the examinees are always using the hand disinfectants. The most widely used are Plivasept – the red one and the blue one. When they were asked if they are using the skin protect care products, 40% of the examinees answered that they rarely used them, while 6% responded they are not using them at all. We can conclude that health care professionals are aware and educated about the importance of hand washing and disinfecting, as well as the use of the protective equipment when working with the patients. According to the survey results, we can conclude that only the small number of health care professionals have the diagnosed irritant or contact dermatitis. The examinees answered that their hand skin changes due to often hand washing and disinfection are not related to illness, but as a result of their work. Survey employees use the protective gloves in their daily work, and one employee reported allergy to latex and rubber. |
