Brochure Triticum - L
Transcrição
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
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