Assessment And Management Of Leaky Wounds Following Prosthetic Joint Replacements

Wound management is one of the cornerstones for nursing care however, effective wound care extends far beyond the application of the wound itself. Nurses may be required to assess, plan, implement, and evaluate wound care; therefore, order to fill these roles it’s critical to have an understanding of the several different areas of wound care such as, integumentary system, classification of wounds, wound procedures, and documentation. Knowledge in each of these areas will allow nurses to make well informed decisions about wound care, and as a result play an active part in wound healing.

My practical competencies have been obtained through working with a general and orthopaedic surgeon. Whilst working with my clinical supervisor, (a consultant orthopaedic surgeon) we decided it would be beneficial to review orthopaedic wound infections. I chose to concentrate on wound infections during a Total Hip Replacement (THR). Wound infections is a massive subject so I have selected specific areas to look at, which are:

The following assignment will take the form of a case study. The subject is a 79-year-old sikh gentleman, who will be known as patient X. Patient X only speaks English as his second language. Patient X has developed a wound on his right hip after being admitted a few days previously, after suffering from a stroke. Patient X has a history of a mild stroke and has slow mobility and uses the aid of a frame to mobilise. Patient X is obese, a heavy smoker and now

The wounds that were located in the left sacrum and left hip had been present for more than 41 days and had serous exudate. The wound in the right hip had been present for more than 35 days and also had serous exudate. The provider cauterized the wound in the left sacrum after administering a local anesthetic and applied a special dressing to all 3 wounds. The plan was to follow-up “within 7 days.”

I stopped what I was doing to assess what was wrong. The patient’s abdominal dressing was soaked in fluid. I removed the dressing and noticed that in the middle of her incision site fluid was leaking and would not stop. I grabbed the gauze and applied pressure. After several soaked gauzes, I told the CNA to continue to apply slight pressure on that site and I went to get the

• These procedures are used when stable symptoms persist despite maximal medical therapy, or when unstable symptoms fail to settle.

The researchers’ goal was to achieve successful wound healing by identifying good practices before and during surgery. The study relied on evidence-based analysis to isolate the most successful practices. They saw that when wound healing was successful, an infection-free recovery from joint surgery was most likely. The authors argued that, because the chance of complications comes with the surgeries, medical practitioners must know the best practices for reducing the risk of infection after surgery (Jones, Russell, and Huo, 2015).

Chronic wounds are defined as the wounds fail to heal within a period of 3 months. Further, chronic wounds represent a significant health care problem since they affect 1 % of the western population. Common chronic wounds categories are pressure ulcers, diabetic foot ulcers, venous ulcers, and ischemic ulcers [19]. According to The National Pressure Ulcer Advisory Panel (NPUAP) “a pressure injury is localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device”. The damage could be presented as unbroken skin or wide-open ulcer and might be painful. The injury arises due to sever or continued pressure or combined shear and pressure. Soft tissue

Background. Surgical site wound closure can play a key part in the recovery of patients post-operatively. The use of closure material is usually according to the preference of the surgeon and is a frequently debated issue.

“The most common types of non-healing wounds are pressure ulcers, diabetic ulcers, ischemic ulcers and venous ulcers.” (2)

Wound healing is an intricate process, whereas the skin may heal itself after an injury. At the time of injury, the inflammatory phase begins and is noted as a significant time, because this process prepares the wound environment for recovery. Since Mr. Jones laceration is five days old, suturing the laceration may not be appropriate. The wound was not stitched and allowed to heal by primary intention (first intention), because scarring is minimized during this process and no tissue loss is noted. Mr. Jones wound will have to heal by primary intention. Cleaning the laceration daily and applying a clean dressing will invoke healing. Since Mr. Jones will be a risk for infection, the continuation of antibiotics will be beneficial. Mr. Jones

In comparison to Yao et al. (2014), the success of negative pressure wound therapy to lower extremity wound ulcer is very evident over those patient who did not have the therapy. It is agreeably that even though the patients have comorbidities it did not hinder into the healing process of the wound with the help of the machine. Although, there is a difference into the number of participant’s diseases in those conducted under non-NPWT group, I would disagree that the result can somehow inappropriate to be compared to its

Research work on acute wounds in an animal model shows that wounds heal in four phases. It is believed that chronic wounds must also go through the same basic phases. Some authors combine the first two phases.

As it was well stated by Barber et al (3) it may be difficult to determine whether to use a clean technique or a sterile technique when dealing with the different types of wound one encounters. As mentioned in the same article, it is important to consider the policies of the hospital. The the type of wound, bone exposure and an immunosuppressed state would also require sterile technique. Research has been done in order to determine which technique to use. The Agency for Healthcare Research and Quality (AHRQ) has emitted guidelines regarding that clean procedure should be used in the context of pressure ulcers. On the other hand, the Centers for Disease Control and Prevention (CDC) advise for use of sterile technique when dealing with surgical wounds. The CDC also has provided healthcare workers with guidelines up to 48 hours after wound closure and not for longer periods of time. The Wound, Ostomy and Continence Nurses Society 's fact sheet (4) has brought some definitions and recommendations with regards to clean or sterile techniques to be used in wound care. Table 3 outlines some of the reasons when clean or sterile procedures should be used.

(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.