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- Title
PRZYDATNOŚĆ WYBRANYCH METOD OCZYSZCZANIA RAN PRZEWLEKŁYCH U CHORYCH OBJĘTYCH OPIEKĄ HOSPICYJNĄ W WARUNKACH DOMOWYCH.
- Authors
BAZALIŃSKI, DARIUSZ; BARAŃSKA, BEATA; KACZMARSKA, DOROTA; WOŁKOWICZ, MAGDALENA; KÓZKA, MARIA
- Abstract
Introduction The fundamental treatment principle for the local management of chronic wounds is to remove necrotic tissue, minimise infection and control exudate. Most of the methods recommended by the Polish Wound Management Association can be applied in homecare. Aim The objective of the study is to present our experience with using the methods of chronic wound cleansing in patients under long-term hospice home care. Material and methods The study material comprised 15 patients with stage III and IV pressure ulcers according to the NPUAP staging. The patients were under hospice care from 2012 to 2017. The following methods of wound cleansing were used: surgical debridement, application of Lucilia sericata larvae, controlled negative pressure and autolysis. Study methods included observation and analysis of medical records with the use of IBM SPSS Statistics 20. The analysis of data was done using descriptive statistics. Results The study group comprised of 9 female patients (60.0%) and 6 male patients (40.0%).The patients were under homecare (hospice care: 40.0% of the cases, long-term care: 60.0% of the cases). Mean age was 73.67±11.68 (range: 47-92 years). Self-care evaluated according to the Barthel scale was 0-25 points. Multiple pressure ulcers were noted in 9 cases. The number of wounds affecting each patient varied from two to four in one female patient. The ulcers were mainly localised in the sacral region (42.3%; n=11), heels (27.0%; n=7), trochanter region (19.2%; n=5), thoracic spine (7.7%; n=2), sciatic tuber region (3.8%; n=1). The wounds were classified as black, yellow and red according to the RYB system. Black wounds were predominant (53.3%; n=14), followed by yellow (42.3%; n=11) and red (3.8%). Mean time of cleansing the wound of necrotic tissue was 2.53 weeks, with a maximum length of 4 weeks. Pressure ulcers healed completely in 3 cases (20.0%). In 12 patients (80.0%) the surface and depth of the wounds decreased. Conclusions Surgical debridement combined with biological therapy with L. sericata larvae significantly reduces the length of cleansing the wound of necrotic tissue. The use of negative controlled pressure is a safe method accelerating the process of cleansing the wounds with high exudate.
- Subjects
PRESSURE ulcers; APOPTOSIS; BIOTHERAPY; COMBINED modality therapy; FEMUR; HOME care services; HOSPICE care; IBM-compatible computers; LONG-term health care; MAGGOT therapy; SACRUM; SCIATIC nerve; HEALTH self-care; SPINE; WOUND care; TREATMENT effectiveness; CHRONIC wounds &; injuries; TREATMENT duration; DATA analysis software; HEEL (Anatomy); NEGATIVE-pressure wound therapy; BARTHEL Index; THERAPEUTICS
- Publication
Polish Journal of Wound Management / Leczenie Ran, 2018, Vol 15, Issue 2, p51
- ISSN
1733-4101
- Publication type
Article
- DOI
10.15374/LR2018007