Brochure Triticum - L

Application of honey based products in a traumatic thigh wound
Enfª Loureiro, Sonia1; Enfª Mendes, Liliana1; Enfª Mendonça, Alexandra1
1Enfermeira
no serviço de ORL/MAXFAC/CIRPLAS
no Hospital Garcia de Orta,
E.P.E. E-mail: [email protected]
Key words
Wounds, bite wound, trauma.
Introduction
Traumatic wounds are tissue injuries caused by any instrument or mechanical force acting on the skin surface, and
may or may not have damaged skin surface.
Fig.1 22/10/2015
Fig.2 26/10/2015
Fig. 3 29/10/2015
Fig. 4 02/11/2015
Debridement at surgery department
Fig. 5 03/11/2015
Debridement at surgery department
Fig. 6 04/11/2015
Post-surgical debridement and skin
grafting
Trauma are usually associated with complex and painful
wounds with tissue infections and poor healing (Alves et al.,
2014).
Traumatic wound studies reveal several features which, together, cause delay in the wound healing process.
Medical honey was applied, because the scientific evidence
reveals that, when applied in wounds of different etiologies,
the results are very favorable.
Honey’s antimicrobial (broad spectrum) and anti-inflammatory properties facilitate reducing edema by increasing
the draining wound bed fluids (Mateus cit in. Cancela et al.
2012).
We intend to highlight the importance of action of the
product in the preparation of the wound bed, which led to
reduced hospitalization time and improving the quality of
care.
Case Study
Patient: Female, 70 years;
Personal Background: Dementia; HTA; Hypercholesterolaemia;
Wound Location: Right Thigh;
Wound Source: Dog bite on October 16, 2015;
Number of days of existence of the wound before starting
treatment with honey: 7 days;
Total number of days of use of L-Mesitran: 12 days;
Frequency of treatment: daily.
Methodology
• Qualitative study
• Case Study
• Descriptive analysis resorted to the direct observation of
the wound in the different phases, i.e. before, during and
after application of the honey-based dressing material.
Chronology of the study
18/10/2015
Wound debridement at another hospital; 20.10.2015
transferred to the HGO;
21/10/2015
Made new surgical debridement at the general surgery
department.
22/10/215
Starts treatment with honey - L-Mesitran.
Discussion and conclusion
The scar evolution was favorable, corresponding
to an acceleration of angiogenesis in the wound
bed accompanied by a decrease in exudate and
inflammatory signs. These aspects are crucial because they created ideal conditions for receipt of
the skin graft. In this way, it contributed to a decrease in length of stay, reducing the risk of comorbidities for the patient and the burden on health
care. It is important to highlight the fact that the
dressing changes are completely atraumatic, thereby improving the patient’s well-being and quality of
care
References
1. Fortin MF. O processo de investigação: da concepção à
realização. Loures: Lusociência; 1999.
2. Black JM, Steven SB. Feridas complexas. In: Baranoski
S, Ayello EA. O essencial sobre o tratamento de feridas:
Princípios práticos. Loures: Lusodidacta; 2006. p.431-447.
3. Alves P, Vales L. Prevenção e Tratamento de Feridas Da
Evidência à Prática. HARTMANN Portugal: Eugénio Pinto, Isabela Vieira; 2014.
4. Mateus C. Mel. In: Cancela C, Mateus C, Dias J, Sadio P,
Santos T. Manual ELCOS – Material de penso: Guia prático. Rio Tinto: Clássica, Artes Gráficas S.A.; 2012. p.120.
5. Vilelas J. Investigação: o processo e construção do conhecimento. Lisboa: Edições Sílabo; 2009.
Day
Fig. 1
(22/10/15)
Fig. 2
(26/10/15)
Fig.3
(29/10/15)
Fig.4
(02/11/15)
Fig.5
(03/11/15)
Wound dimensions (LxHxD)
17x26x15cm
17x24x7cm
17x24x7cm
No registration*
No registration*
Type of wound
Exposure tendons
and fascia and granulation tissue
Tendon exposure
Granulation tissue
and some devitalized;
Tendon exposure;
Granulation
Granulation tissue tissue and slight
and slight devitadevitalized
lized
Granulation
tissue and little
slough
Wound
exudate
Intense sero-hematic
Moderate serohematic
Moderate serohematic
Moderate serohematic
Moderate serohematic
Odour
modorate
lightly
absent
absent
absent
Peri wound
area
Wound edges Ischemic and slightly
macerated wound,
severe edema
Necrotic wound
with marked reduction of the thigh
edema
Necrotic wound
edges and slightly
macerated without edema thigh
Necrotic wound
edges
Inflamed wound
edges
Laboratory
results for
infection
-
-
Pseudomonas
aeroginosa ; enterococcus faecium
Pseudomonas
aeroginosa ;
enterococcus
faecium
Pseudomonas
aeroginosa ;
enterococcus
faecium
Use of antibiotics
Piperacillin/ Tazobactam
Piperacillin/ Tazobactam; Vancomycin + amikacin
Vancomycin +
Meropenem
Vancomycin +
Meropenem
Vancomycin +
Meropenem
Pain assessment scale
0-10 at dressing changes
Pain assessment
scale=0
Pain assessment
scale=0
Pain assessment
scale=0
Pain assessment
scale=0
Pain assessment
scale=0
Used products
L-Mesitran
Soft & Tulle
L-Mesitran
Ointment
L-Mesitran
Ointment
L-Mesitran
Ointment
L-Mesitran
Soft & Tulle (with
secondary bandage, dressing
changes twice daily)
* Increased wound size by debridement of the edges