Wound care (Pressure Ulcer) Descriptions During community placement, my mentor and I visited M (patient), a 75years old lady, who was presented with a Pressure Ulcer, on the heel of her right leg. On arrival, my mentor asked me to manage M’s wound. However, I have observed and participate in carrying out this skill (wound care) with my mentor on several occasions. I explained the procedure to M and gained her consent to carry out the procedure. The preparation and application of aseptic technique was quite challenging in M’s home, however I washed my hands, worn apron and gloves, and adopt aseptic technique. When I remove the old dressings and assessed the wound, I observed that M’s wound was slightly exudates, odour, sloughs and dry skin (flakes) around the wound. When M asked me, how the wound was, I was not confident to answer her question, but rather turn to my mentor, who then answered her. I displayed the sterile pack on a flat surface and I dipped the gauze into a warm normal saline and gently cleaned the wound; I cleaned the slough and remove the dead tissues, under my mentor’s supervision and I also applied intrasite gel unto the wound bed, and put an antimicrobial heel dressing and securing it with a two way stretch bandages (tubifast). Feelings I was nervous, when my mentor asked me to carry out this procedure and thus, became very careful not to cause more pain to M. Being an invasive procedure, I was worried not to infect the wound when it was exposed, and when I could not answer her question, I felt uncomfortable. Evaluation Being an invasive procedure, I adopt aseptic techniques; Hart (2007) state’s that, employing aseptic technique helps to create an environment (asepsis) free from living pathogenic micro-organisms. Aziz (2009) conceded that, it helps prevent wound from contaminations and other susceptible site, by organism that could cause infection (HCAIs). I gently remove the slough and dead tissues, and applied an intrasite gel unto the wound bed, and then I put an antimicrobial heel dressing on the wound. Fletch (2007) suggests that, the removal of necrotic tissue and thick slough from wound bed, helps to promote healing by creating moist balance and controls bio burden to ensures optimal healing environment. Barrett (2009) concurs that, the management of wound required dressing that can maintain a moist environment, absorbs exudates as well as remain in situ over number of days.
Andhoga J, Macharia AG, Maikuma IR, Wanyonyi ZS, Ayumba BR, Kakai R (2002) Aerobic pathogenic bacteria in post-operative wounds at Moi Teaching and Referral Hospital. East Afr Med J.79:640-644.
Evaluation of the wound related to the nutritional aspect. The best coverage to be used is then chosen.
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
Pressure ulcers development occurs in every hospital and it remains a major worldwide health problem for many years. However, pressure ulcers have received minimal attention when we talk about it as a patient safety issue. It is a patient safety issue as it can lead to serious damage such as life-threatening infections and pain (Richardson & Barrow, 2015). On a med/surg unit, individuals may experience long or short hospital stays depending on the situation. For the short stays, the focus of care is often on regaining activities of daily living (Registered Nurses’ Association of Ontario, 2011). Therefore, assessment and education regarding pressure ulcers is often minimal or non-existent (RNAO, 2011). Every client who is at risk needs to be assessed and educated regarding pressure ulcers and the subsequent skin breakdown (Cooper, 2013). During the hospital stay, clients may have limited movement and pressure ulcers can extend into the muscle, tendon, and bone (RNAO, 2011). In many cases, clients do not notice the formation of an ulcer and as it may be in areas that are out of sight such as the coccyx. Often,
Wounds is a broad term that includes many other types. It is very important to know the proper and scientific method to care for wounds as well as knowing the types of them. Moreover, nurses must familiar with each type of wound, risk factors, prevention, and treatment. However, wounds may have a different range in skin breaks such as trauma, injury, cut, incision, and laceration. Skin prevention is the first step of preventing any break to occur in the skin. The various types of wounds, method of treatment and healing are mainly depending on their conditions. This assignment will include chronic wounds, which are diabetic ulcer, venous ulcer, and pressure ulcers.
clean up the wound site. Bacteria, dirt and damaged cells, as well as other types of debris,
Fig1. This is a picture of a leg with full blown necrotizing fasciitis, just prior to surgery. Note the discoloration. The skin feels crepitant and the area is extremely tender. A larger picture with detail is available by clicking this thumbnail print.
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
A medical assistant’s cooperation and presence during a surgical procedure is essential in order to provide satisfactory patient care. Although the role of the medical assistant may not shine though as strongly as the physician’s, their subtle presence provide organization in the form of administrative and clinical tasks to facilitate the physician’s demanding profession. During a surgical procedure, such as an incision and drainage of an abscess, the medical assistant is the patient’s first point of contact. The medical assistant’s role in any surgical procedure will begin as the patient schedules an appointment with the providing health care provider.
This was also apparent when the soldiers were hospitalized and treated with previously used, contaminated gauze. In 1862, gangrene began to appear after unsanitary processes and procedures created the perfect environment for gangrene, or presently termed necrotizing fasciitis. Gangrene quickly spread through the battlefield and hospitals resulting in sepsis, high fever, sterility, unbearably stinking boils, and ultimately death for many soldiers. It wasn’t until 1865, that researchers Jones and Woodward realized that isolating patients with gangrene utilizing medical supplies one time and then discarding them significantly reduced the diagnosis and spread of Gangrene
(A)Wound healing is a biological process occurring in the human body. In this lecture we had discussed about both acute and chronic wounds. An acute wound is an injury to the skin that occurs suddenly rather than over time. It heals at a predictable and expected rate according to the normal wound healing process. The chronic wounds do not heal in an orderly set of stages and in a predictable amount of time the way most wounds do.
Carlton suffered an acute tissue injury on his foot after stepping on a sharp edge shell, which disrupted the layers of the skin. Immediately after an injury occurs, an inflammatory response begins, which serves to control and eliminate altered tissue/cells, microorganism, and antigens. This takes place in two phases. 1) The vascular phase, in which small vessels(arterioles, venules) at the site of injury undergo changes. Beginning, with
In providing quality patient outcomes, current evidence based research has to be an important part of this process. With every new research proposal, a solid foundation has to be the basis for that specific research. The following paper is a literature analysis of current studies that support the use of negative pressure wound therapy (NPWT) in healing diabetic foot ulcers in adults. This paper will also discuss what search methods were used, strengths and weaknesses of each study, and the validity and relevancy of the research on the issue of non-healing diabetic foot ulcers in healthcare today.
There is a risk for every procedure. Some complications that could happen includes infections, poor healing of the wound, bleeding, and even a reaction to the anesthesia that is used
When a wound is determined as non-healable, as described by Sibbald et al (1), it should not be treated with a moist treatment and should be kept dry in order to reduce the risk of infection that would compromise the limb. It is also important to consider the patient 's preferences and try to control his pain, his discomfort in activities of daily living and the odour that their wound may produce. In this case, special attention must be given to infection prevention and control. Some charcoal dressing would be interesting in the care of our non-healable wounds at St. Mary 's Hospital.