wound management using ‘time’
DESCRIPTION
Wound management using ‘TIME’. Jeannie Randles RN Grad cert wound care PG Cert & PG Dip Primary Health. Manage whole patient not just hole in patient. overview. Patient outcomes Wound outcomes Cleansing Products On going assessment documentation. What the patient wants!!. - PowerPoint PPT PresentationTRANSCRIPT
WOUND MANAGEMENT USING ‘TIME’
Jeannie Randles RNGrad cert wound care
PG Cert & PG Dip Primary Health
Manage whole patient not just hole in patient
overview
Patient outcomes Wound outcomes Cleansing Products On going
assessment documentation
What the patient wants!!
Work in partnership Expectations General health Palliative wound
care Curative wound
care
Set your goals!
To heal palliative To treat infection To reduce exudates To protect Remove Escher To create wound
healing environment
To control odour To control pain
TIME
Devitalised tissue Slough Escher Dry/wet Granulation Epithelial islands Bacterial burden
TIME
TIME
Moisture balance Too wet?
(macerated) Too dry?
(desiccated) Moist healing
required?
TIME
What is happening at the margins
Rolled Epethelialising Granulating Punched out undermining
cleansing
Consider why cleansing is required
How to cleanse i.e. aseptic or clean
Products used to cleanse
Temperature of cleansing fluid
Environment patient is in
products
Think about goal Debriding Protection Pressure Pressure relief Moisture control Bacterial control
foams
Example above is allevyn non adhesive
Variety of dressings available for use with low to heavily exudating wounds
Available with antimicrobial additives
Check absorption of dressing
Antimicrobials
Inadine Iodosorb AG dressings Honey Polyhexamethylene
biguanide
films
Used to protect Waterproof Avoid multiple
layers Used to secure
primary dressings Monitor for
folliculitis Damaged skin easy
to monitor
Hydrofibre
Vertical wicking Moderate to heavy
exudating wounds Protects periwound Available added to
waterproof backings
Available as antimicrobial
Alginate
Seaweed dressing Haemostatic Available in sheets
or ropes Available with
antimicrobial addition
Moderate to heavy exudating wounds
Horizontal wicking properties
Hydrocolloid
Occlusive dressing creating bacterial and viral barrier
Maintains moisture preventing desiccation
Patient can shower Pain reduction due
to moist environment
Secondary dressings
Comfort Absorption Compression Cosmetic
appearance Compliance Hygiene
Adjunctive treatments
Compression Pressure relief Medication Psychological
support Education Financial support
Case study
73 year old female Congestive heart
failure COPD Diabetic Venous
hypertension Ulcer present 6
weeks Now necrotic
Case study
63 year old male Dementia Smoker 10/day Dietary intake poor #patella after fall Developed
pressure ulcer to heal whilst in hospital
34 year old female Depression Lichen planus
(inflammatory condition)
Oedema to lower limb
conclusion
Think about goal of care
Tissue Infection or
inflammation Moisture control Edges or
epithelialisation Document
Further reading
Hard-to-heal wounds: a holistic approach (May 2008)
Topical negative pressure in wound management (May 2007)
Management of wound infection (spring 2006)
Identifying criteria for wound infection (fall 2005)
Focus Document: Lymphoedema bandaging in practice (fall 2005)
Wound bed preparation in practice (spring 2004)
Understanding compression therapy (spring 2003)
Pain at wound dressing changes (spring 2002)
Sites to check out
ewma.org/english/position-documents.html
www.awma.com.au www.worldwidewounds.com www.woundsinternational.com Wound care education resources Also remember courses at CPIT include
wound assessment and management courses!
www.wounds-uk.com/pdf/content_9364.pdf