Comparison of two methods of management of clean surgical wounds. "Open" vs "closed" postoperative wound care

This report describes the use of a transforming powder dressing to treat lower leg surgical wounds occurring in two older patients. Wounds in this location are difficult and slow to heal. Both of these wounds exhibited complete granulation within two weeks of powder application and total healing in under four weeks, all while requiring no patient or nursing wound care.

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A mobile app for postoperative wound care after arthroplasty: Ease of use and perceived usefulness

International Journal of Medical Informatics ◽

10.1016/j.ijmedinf.2019.05.010 ◽

2019 ◽

Vol 129 ◽

pp. 75-80 ◽

Cited By ~ 7

Author(s):

H. Scheper ◽

R. Derogee ◽

R. Mahdad ◽

R.J.P. van der Wal ◽

R.G.H.H. Nelissen ◽

...

Keyword(s):

Wound Care ◽

Mobile App ◽

Ease Of Use ◽

Perceived Usefulness ◽

Postoperative Wound

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A study to evaluate the role of suction drains in orthopedic surgery

Health Renaissance ◽

10.3126/hren.v9i2.4980 ◽

1970 ◽

Vol 9 (2) ◽

pp. 91-94 ◽

Cited By ~ 3

Author(s):

GP Khanal ◽

R Rijal ◽

BP Shrestha ◽

NK Karn ◽

P Chaudhary

Keyword(s):

Beneficial Effect ◽

Orthopedic Surgery ◽

Postoperative Infection ◽

Wound Care ◽

Demographic Data ◽

Superficial Infection ◽

Postoperative Wound ◽

Suction Drain ◽

One Year

Background: There is controversy in routine use of suction drain in orthopedic surgeries. Devastating postoperative infection and years of treatment had forced on extra measures of postoperative wound care and use of drains. Objective: To find out the necessity of intraoperative drains in routine orthopedic surgery. Methods: Thirty patients were enrolled in the study. All of the patients were followed up on 2nd, 14th days and 3 monthly till one year of period. All the demographic data and preoperative investigations and intraoperative and postoperative parameters were recorded in standard proforma. Data were analysed using appropriate statistical method. Results: All the patients were followed up to one year period. Six patients had superficial infection on 2nd postoperative day. They were managed with antibiotics and no patient showed signs of infections on 14th postoperative day and thereafter. No patient needed postoperative reinforcement of dressing. Conclusion: Routine use of intraoperative drain in hip surgeries has beneficial effect of decreasing reinforcement of postoperative dressing. Keywords: orthopedic surgery; suction drain; BPKIHS DOI: http://dx.doi.org/10.3126/hren.v9i2.4980 Health Renaissance 2011: Vol.9 (No.2): 91-94

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Damage control hip disarticulation: two-stage operation with index creation of a large medial flap for the septic hip

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2020-000502 ◽

2020 ◽

Vol 5 (1) ◽

pp. e000502

Author(s):

Christina Colosimo ◽

Charles Fredericks ◽

James R Yon ◽

John C Kubasiak ◽

Faran Bokhari ◽

...

Keyword(s):

Lower Extremity ◽

Hospital Discharge ◽

High Mortality ◽

Wound Care ◽

Damage Control ◽

Mortality Rates ◽

Consecutive Series ◽

Postoperative Wound ◽

Hindquarter Amputation

BackgroundAlthough rarely performed, hip disarticulation (HD) is usually used for the patient with a non-viable leg who is also in extremis. HD was first used for trauma and infection; however, the technique was perfected during the age of hindquarter amputation for osteosarcomas. The operation performed by most surgeons today is still based on the oncological principles of high vessel control and ligation. When this approach has been used in the overwhelmingly infected or mangled extremity, it has resulted in high mortality rates. During the last 20 years, the concept of damage control operation has been embraced by emergency surgeons in all fields. We sought to extrapolate this concept and to apply it to the non-viable lower extremity.MethodsWe describe a new concept of damage control HD, review the technique and discuss our consecutive series of nine patients who underwent the procedure for trauma or necrotizing infection without flap dehiscence or mortality.ResultsAll patients survived to hospital discharge. At time of discharge or at follow-up, six of the nine patients were able to transfer to a wheelchair.DiscussionProper disarticulations for infection need to address these two operative and postoperative issues: damage control debridement with creation of sufficient flap size and thorough postoperative wound care.Level IV

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Gauze Packing of Open Surgical Wounds: Empirical or Evidence-Based Practice?

Annals of The Royal College of Surgeons of England ◽

10.1308/003588406x83014 ◽

2006 ◽

Vol 88 (1) ◽

pp. 33-36 ◽

Cited By ~ 19

Author(s):

F Dinah ◽

A Adhikari

Keyword(s):

Wound Dressing ◽

Long Term Care ◽

Wound Care ◽

Operating Theatre ◽

Evidence Based ◽

Term Care ◽

Community Or ◽

Secondary Intention ◽

Surgical Wounds

INTRODUCTION Most surgical wounds are closed primarily, but some are allowed to heal by secondary intention. This usually involves repeated packing and dressing of the raw wound surfaces. Although the long-term care of such wounds has devolved to the care of nurses in the community or out-patient setting, the initial wound dressing or cavity packing is done by the surgeon in the operating theatre. Many surgeons are unaware of the growth of the discipline of wound care, and still use traditional soaked gauze for dressing and packing open surgical wounds and cavities. RESULTS This review summarises the some of the modern alternatives available and the evidence – or the lack of it – for their use in both the acute and chronic setting.

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Single Stage Correction of Rectovestibular Fistula

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v1i2.19523 ◽

2014 ◽

Vol 1 (2) ◽

pp. 99-105

Author(s):

Kaniz Hasina ◽

Abdul Hanif ◽

S. M. Shafiqul Alam ◽

Shahin Reza ◽

Nazrul Islam ◽

...

Keyword(s):

Bowel Preparation ◽

Wound Care ◽

Single Stage ◽

Medical College Hospital ◽

College Hospital ◽

Postoperative Wound ◽

Medical College ◽

Multi Stage ◽

Rectovestibular Fistula ◽

Preoperative Bowel Preparation

Introduction: The aim of this study was to determine the feasibility, safety, cost effectiveness and functional outcome between single stage and multiple stage operation of anorectal malformation (ARM) with rectovestibular fistula (RVF).Materials & Methods: This interventional study was conducted on 40 female children born with ARM with RVF from July 2007 to June 2009 in the Department of Pediatric Surgery, Dhaka Medical College Hospital. Their age range was from 3 months to 7 years. Anterior sagittal anorectoplasty (ASARP) was done as definitive treatment of RVF. 20 out of 40 patients underwent single stage procedure and the rest underwent multiple stage procedure. Good preoperative bowel preparation and postoperative wound care were ensured for optimum outcome.Results: Mean operating time was 70 minutes in single stage and 80 minutes in multi stage definitive procedure. Average hospital stay was 10 days in single stage procedure where as 22-24 days in multi stage procedure. Partial perineal wound dehiscence occurred in two patients with single stage procedure and one patient with multi stage procedure. Wound infection was seen in two patients of single stage and also two patients of multi stage procedures. Fecal continence was good in all patients older than 3 years. Average number of bowel movement was 2-3 times daily in older patients and 2-4 in younger patients. Constipation developed in three patients with multiple stage procedure and in two patients with single stage procedure. Both groups were managed conservatively for all complications. In Dhaka Medical College Hospital, treatment cost is mostly free, so we could not compare this cost but the incidental expenses in single stage treatment was Tk. 10,000.00 and Tk. 30,000.00 in multistage treatment in three settings.Conclusion: Adequate preoperative bowel preparation, good surgical skill, proper analgesia and postoperative wound care remain the key factors to produce a cost effective excellent outcome of single stage correction of RVF.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19523

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Pengaruh Program Ambulasi Dini Terhadap Proses Penyembuhan Luka Pasien Post Operasi Di RSUD dr Adjidarmo Rangkasbitung

Jurnal Smart Keperawatan ◽

10.34310/jskp.v7i2.378 ◽

2020 ◽

Vol 7 (2) ◽

pp. 85

Author(s):

Rodi Widiantoro

Keyword(s):

Wound Healing ◽

Healing Process ◽

Intervention Group ◽

Sampling Technique ◽

Major Surgery ◽

Control Group ◽

Wound Healing Process ◽

Early Ambulation ◽

Postoperative Wound ◽

Surgical Wounds

Luka dan nyeri akibat dari pembedahan membuat pasien tidak mau bergerak sehingga banyak luka operasi yang mengalami gangguan proses penyembuhan luka, untuk membantu dalam proses penyembuhan luka operasi dapat dilakukan teknik ambulasi. Ambulasi dini adalah salah satu faktor yang dapat mempengaruhi penyembuhan luka pasca Operasi serta dapat mengurangi risiko komplikasi. Tujuan untuk melihat pengaruh program ambulasi dini terhadap perubahan proses penyembuhan luka pada pasien paska operasi. Rancangan penelitian quasi-eksperimental dengan jumlah sampel 99 responden, 75 responden (kelompok intervensi) dan 24 responden (kelompok control), yang diambil secara purposive sampling technique. Data dikumpulkan melalui kuesioner dan lembar observasi, kemudian dianalisis dengan uji regresi logistik ordinal. Hasil menunjukkan rata-rata usia 31 tahun (kontrol), 45 tahun (intervensi), jumlah pasien operasi pada laki-laki (58%), operasi mayor (78%), HB normal: (73,7%). Penyembuhan luka yang adekuat kelompok intervensi sebanyak 50 responden (66,7%) sedangkan pada kelompok kontrol sembuh dengan adekuat 6 responden (25%). Uji beda independen pasien ambulasi dini dengan proses penyembuhan luka post operasi nilai (p=0,000). Disimpulkan bahwa program ambulasi dini berpengaruh terhadap penyembuhan luka post operasi. Penelitian ini merekomendasikan penelitian lebih lanjut dan penggunaan latihan ini sebagai salah satu intervensi mandiri perawat dalam memberikan asuhan keperawatan pada pasien paska operasi. Kata kunci: ambulasi dini; proses penyembuhan luka; operasiINFLUENCE OF EARLY AMBULATION PROGRAM IN WOUND HEALING OF POST OPERATIVE PATIENTS IN RSUD dr. ADJIDARMO RANGKASBITUNG ABSTRACT The wounds and pain resulting from surgery make the patient unable to move so that many surgical wounds experience interference with the wound healing process, to assist in the healing process of surgical wounds an ambulation technique can be used. Early ambulation is one of the factors that can affect postoperative wound healing and can reduce the risk of complications. The aim of the sudy was to determine the effect of early ambulation programs in the wound healing process of postoperative patients. A quasy-experimental research design was used with a sample size of 99 respondents, 75 respondents (intervention group) and 24 respondents (control group), which were taken by purposive technique sampling. The data were collected through questionnaires and observation sheets, and then analyzed using ordinal logistic regression test. The results showed that the mean age was 31 years (control), 45 years (intervention), the number of male patients with surgery is 58%, major surgery is 78%, and normal HB is (73.7%). The adequate wound healing in the intervention group is 50 respondents (66.7%) while the control group healed adequately for 6 respondents (25%). Independent difference test of early ambulation patients with postoperative wound healing process value (p = 0.000). It was concluded that the early ambulation program had an effect on postoperative wound healing. This study recommends further research and the use of this exercise as one of the nurses' independent interventions in providing nursing care to postoperative patients.Keywords: early ambulation; wound healing process; of surgery

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Implementation of the policy on standard protocol for care of septic and aseptic wounds in selected public health facilities in Ghana: an analytic case study

10.21203/rs.2.22815/v1 ◽

2020 ◽

Author(s):

Robert Alhassan ◽

Benedicta Quarshie-Odoo Karley ◽

Francis Ennin Ackah ◽

Irene Adodoaji

Keyword(s):

Public Health ◽

Nursing Staff ◽

Work Experience ◽

Wound Care ◽

Health Facilities ◽

Wound Management ◽

Rank Test ◽

Standard Protocol ◽

Public Health Facilities ◽

Surgical Wounds

Abstract Background It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relations to septic and surgical wounds has been largely attributed to poor adherence to standard policy protocols on wound management by clinical staff especially nurses. Objective Explore the extent to which nursing staff adhere to the policy protocol on management of septic and surgical wounds in selected public health facilities in Ghana. Methodology An analytic cross-sectional study among nursing staff (n=140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to standard policy protocols on septic and surgical wound care. Findings Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound healing (Coef.= -0.49, CI=-0.93 -0.05, p=0.036). Conversely, being a senior nursing officer relative to other professional ranks increases staff likelihood of complying with standard policy protocol for wound care (Coef. 5.27, CI=0.59 9.95, p=0.027) relative to lower rank of nurses. Conclusion There is the need for accelerated in-service training for staff on standard protocols for wound are coupled with supportive supervisions. Staff adherence to standard quality care should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.

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