Negative Pressure Wound Therapy

Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure. (Stechmiller et al., 2008) Pressure ulcers still one of the most significant health problem in our hospitals today, It affects on patients quality of life patient self-image and how long they will stay in hospital then the cost of patient treatment . Moore (2005) estimate that it costs a quarter of a million euro’s per annum to manage pressure ulcers in hospital and community settings across Ireland .which allows one to take immediate actions and prevent the ulcer if possible. To support pressure ulcer risk assessment several standardized pressure ulcer risk assessment scales have been introduced

Eligible participants for the application of Type 1 formulated collagen gel must 1) have an open pressure ulcer at least 2.0 cm in diameter that did not heal after using NPWT and 2) have no symptoms of and wound or bone infection. The three patients in the study had a wound of at least 18 months’ and had showed no signs of improvement during 4 weeks of NPWT. The patients received the standard care including the treatment of moist wound healing and debridement, prevention of additional skin breakdown, and maintenance of functional abilities. Before beginning the use of collagen gel, sharp debridement was performed with additional sharp debridement performed at

Agrawal, K., & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian Journal Of Plastic Surgery, 45(2), 244-254.

venous leg ulcers and diabetic foot ulcers. Canadian Association of Wound Care (CAWC) has published

Pressure ulcers remain an issue in nursing, as they cause financial losses to not only the patients, but also the healthcare sector. In addition, the expenses arising from extended hospital stays, an increase in readmissions, and admissions to the hospital are included as well. Over the years, preventive interventions have focused on the elimination of pressure ulcers. In such cases, the prevention strategies have concentrated on the role of nurses in preventing the occurrence of pressure ulcers. Current texts reveal strategies that can be implemented in order to effectively manage and prevent pressure ulcers in the healthcare sector. The use of a proficient wound care team is common in many skilled nursing facilities. The failure for the effective management of this ulcer demonstrates a need for the adoption of new beneficial strategies. While previous researchers have proposed investigations on the effectiveness of a wound care team in the management of a pressure ulcer patient, the gap between writings and implementation still persists. Nurses have a role in presenting a plan that will encourage effective prevention and management of

Pressure ulcer prevention (PUP) in surgical patients has become a major interest in acute care hospitals with the increased focus on patient safety and quality of care. A pressure ulcer is any area of skin or underlying tissue that has been damaged by unrelieved pressure or pressure in combination with friction and shear. Pressure ulcers are caused due to diminished blood supply which in turn leads to decreased oxygen and nutrient delivery to the affected tissues (Tschannen, Bates, Talsma, &Guo, 2012). Pressure ulcers can cause extreme discomfort and often lead to serious, life threatening infections, which substantially increase the

A pressure ulcer is a localized injury to the skin usually over bony prominence, as a result of pressure, or pressure in combination with shear. It is estimated that 5 to 10 percent of patient admitted to the hospital acquire a pressure ulcer and it result in increased suffering, morbidity and mortality. The policy titled Pressure Ulcer Prevention and Managing Skin integrity provides direction for the nurses to prevent the development of pressure ulcer. It

Pressure ulcers are a commonly seen problem among elderly hospitalized patients. Despite new findings about the causes and approaches to treatment, the incidence of these wounds is still increasing. Scott, Gibran, Engrav, Mack and Rivara (2006) revealed that during the thirteen years of their study, the incidence of pressure ulcer development has more than doubled. As our elderly population becomes greater in number, and older in age, this problem is expected to escalate. It is of great importance for the patients as well as for the

The wound care team is able to correspond with the physicians, and recommend and write order in accordance to the best treat for each individual patient’s issues with pressure ulcer. Therefore they are constantly using and teaching the nurses and physicians better ways to prevent and treat pressure ulcers.

Pressure ulcers that occur in the long term care setting are increasing in the number of incidences each year in the United States. Consequences and complications of pressure ulcer development include pain, sepsis, cellulitis, bone, and joint infections. Pressure ulcers are also associated with an increased morbidity and mortality rate, negative emotional and physical effects on patients and caregivers, and are the second leading cause of litigation in long term care facilities. The cost of treatment for pressure ulcers in the United States is estimated at 11 billion dollars annually. This has led to many programs that focus on education and intervention to prevent the development of pressure ulcers, even being addressed in public initiatives such as Healthy People 2010. Appropriate information and education for healthcare providers, patients, and families has proven to be a key factor in the prevention of pressure ulcer development. Wound management is an area of healthcare that must include a comprehensive plan for the best outcome. A care plan that includes a well-educated care team composed of various disciplines working together for holistic care of each patient has seen the best results for patients who suffer from pressure ulcers.

I showed the supernumerary nurse the proper way of preparing an NPWT using a non-touch sterile technique, started by slowly cleaning the surrounding skin prior to the application of the pressure dressing. Since it was the first time of the preceptee to perform a pressure dressing, I have provided my preceptee the principles of wound management so that it will reinforce the knowledge of the supervised nurse and skills on the management of wound using NPWT. I also provided the preceptee the protocols and the wound management chart to take note of the type of solutions to be used in managing a surgical wound. We also documented in the progress notes what we have performed, and informed the nurse in-charge on the frequency of dressing change in a week.

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

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.

Non healing ulcers represent a common problem in the plastic surgery practice. Many patients are unable to undergo definitive form of treatment immediately as they are medically unfit to undergo any procedure under general anesthesia or the wound bed is not ready for definitive cover. In such situations wound bed preparation plays a very important role.

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