OLGU RAPOR FORMU
ANTİBİYOTİK BAŞARI DEĞERLENDİRİLMESİ:
L. OPERASYON ÖZELLİKLERİ: 1.a) Debritman Yapıldı mı?
0. Hayır, 1. Evet
L.1.b) Debritman Sayısı(yapıldıysa):………. (ara debritmanlarla birlikte toplam sayı)
L.2.a)Ampütasyon Yapıldı mı? 0. Hayır, 1. Evet
L.2.b) Ampütasyon Sayısı (yapıldıysa):………..(ara ampütasyonlarla birlikte toplam sayı)
L.2.c) Nihayi Amputasyon Tipi:
1.Parmak 2.Ray (Parmak+metetarsdistali) 3.Transmetetarsal 4.Bilek altı(Syme) 5.Diz altı 6.Diz üstü
GEÇEN SÜRE-YATIŞ SÜRESİ-vs
DM ayak nedeniyle Toplam yatış süresi:…………/gün Bitiş(son) YARA/Hasta parametreleri özellikleri: Toplam Yara Süresi: ………gün
Sağ taraf yaranın En son yeri:……… Sol taraf taraf yaranın En son yeri:……… En son Yara eni:………cm
En son Yara Boyu:………cm En son Yara derinliği:………cm En son Yara Alanıcm2……….
82 Son Lökosit:…… …….
Son Nötrofil yüzdesi:…………. Son CRP:…… ………..
Son Sedim:………/saat YARA YERİ Son Fotoğrafı
83
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