Aim: This paper considers the effectiveness of different methods of closure materials after surgery looking primarily at complications such as infection rates and dehiscence of wounds. Secondary outcomes measured include cosmetic scar evaluation, patient satisfaction, and cost, ease of use and speed of application.
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.
I have significantly developed my skill in wound care assessment and dressing, in developing this skill I now recognize the importance of documenting each dressing. Morison (2001) supports this in saying that by detailing pressure ulcer assessment it provides a basis for deciding the effectiveness of the current treatment.
A full assessment of the wound should be carried out prior to selection of dressings. Any allergies should also be noted. The wound should be traced, photographed and measured providing data for comparison throughout the treatment. Consent should be gained prior to photographing the wound and the patient should not be identifiable from the photograph (Benbow 2004). All information should be documented in patients’ records, using the wound assessment tool. The pressure sore was identified as grade two
Pressure ulcers are a serious health care problem and it is crucial to assess how patients acquire pressure areas after admission to the perioperative environment (Walton-Geer, 2009). In the operating room factors related to positioning, anaesthesia and the durations of surgeries along with individual patient related factors can all contribute to pressure ulcer development. This essay aims to review current standards of recommended practice regarding pressure ulcer prevention efforts for the surgical patient.
Pelvic organ prolapsed repair surgery is either performed through the vagina or the abdomen. The repair is reinforced with stitches or surgical mesh which is supposed to support the pelvic organs. The problem is that the mesh puts women at a greater risk of complications than other options that are available. There is no greater benefit
Pressure ulcers, also known as pressure sores, bedsores, and decubitus ulcers, result from pressure or shear friction and pressure that cause skin and underlying tissue to breakdown (Pamaiahgari, 2014, p.1). This is commonly seen over bony prominences such as the sacrum or the heel. Pressure ulcers prove to be an issue for the patient and require the determination of best practice to prevent the pressure ulcer and the complications that can accompany it. Pressure ulcers can be infected, increase in size, odor, and drainage, have necrotic tissue, be indurated, warm, and painful (Lewis et. al, 2014, p.184). Furthermore, untreated pressure ulcers can lead to more serious conditions such as cellulitis, chronic infection, sepsis, and possibly death (Lewis et. al, 2014, p.184). Recurrence of pressure ulcers
Throughout the procedure, I was able to interact with the patient and communicate effectively with him, discussing his pertinent health history as well as his experience in dealing with his chronic wound. Such communication and patient interactions bring an abundance of positive feelings to any clinical situation. I also felt positively about the decision of the nurse and healthcare provider in the use of barrier cream to prevent further maceration of the peri-wound skin,
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
The surveys were conducted between 1989 and 2005 predominantly in the US and showed an increase of 4.4% in number of nosocomial pressure ulcer prevalence rated with increase 6.3% in overall pressure ulcer prevalence rates. Nosocomial pressure ulcer prevalence rates were highest in long-term acute care facilities with anatomical location of greatest number of pressure ulcers being sacrum, hells and buttocks. The surveys also revealed that majority of Stage IV pressure ulcers were related to patients with dark skin: N=447,930 (total number of patients in survey), n1=1024 (dark skinned patients), n2 = 164 (dark skinned patients with Stage IV pressure ulcers). The incidence rates of pressure ulcers averaged at 5.4% which correlated with contributing factors of Braden Scores less than 18, serum albumin levels less than 3, fecal/urine incontinence, fragile skin and
For many hundreds of years, pressure sores have been recognized clinically. Throughout this time different pedagogies have been explicated to prevent patients from developing pressure sores (R. J. G. Halfens & M. Eggink 1995). What is more, less is known about the effectiveness of these methods. On account of this observation the author opted to recapitulate the fundamental care of preventing pressure sores among high risk individuals in a nursing home setting.