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Nurturing And Nourishing : Hydrogel Dressings

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Question:

Discuss about the Nurturing and Nourishing for Hydrogel Dressings.
 
 

Answer:

Introduction:

The patient, Mr. Brown is a 76 years old male with the history of rheumatoid arthritis, COPD, type 2 diabetes and hypertension. Recently he is representing a chronic wound, i.e. venous ulcer on his left lower leg. This wound is significantly painful and oozing. Thus, the wound have significant impact upon patient’s mobility, due to pain, he would be unable to walk or move adequately (Brown, 2012). Overweight and rheumatoid arthritis will contribute to It would also significantly affect his physical health, as Stapphylococcus sp. Infection has been found from the wound, which may spread significantly. The third impact upon the patient would be upon his socialization and mental trauma. Due to decreased mobility, he would be unable to go out, making him isolated, leading to mental stress.

From the case history of Mr. Brown, it has been revealed that his wife is dependent on him for care and relies on him to manage the family home. It has also been revealed that his daughter lives 500 km away from their house. Therefore, her wife’s life would significantly be troubled as a result of Mr. Brown’s health issue. It would restrict his mobility and he would be unable to help his wife in managing household. His mental distress and isolation would also psychologically and emotionally affect his wife and daughter. In this context, his daughter would have to take care of her parents and manage their household, which would also negatively affect her personal and professional life (Lay-Flurrie, 2017). 

There are several factors that have contributed to his poor wound healing procedure upon venous ulceration. These factors are:

For each contributing factors identified, Mr. Brown would be educated to control his life style factors, for improved wound healing process.

Type 2 diabetes- Due to high blood sugar in type 2 diabetes, wound healing is delayed, which he needs to control through physical exercise and health diet.

High BMI, i.e. 41.5- which is indicating class III obesity- Obesity is significantly contributing in his delayed wound healing. He should continue with regular physical exercise and low fat diet to reduce his weight (Toy & Macera, 2011).

Sugary and high fat diet- Sugary and high fat diet and worsening his T2DM and obesity related issues, which are in turn contributing to his poor wound healing, thus he would be encouraged to eliminate these from his regular diet.

Alcohol consumption and Smoking history- Alcohol consumption and smoking are the triggers of inflammation and making him susceptible to infection at the wound site, delaying the healing process. Thus, he should reduce his alcohol consumption.

Hypertension- Hypertension is related to T2DM and obesity, which needs to be controlled with physical exercise, relaxation techniques and proper medication.

The first resource that would be used for providing education to the client is wound healing guidelines of the hospital, which would be provided with the help of other members in the multidisciplinary team. On the other hand, the second resource that would be used for providing the above mentioned education to the patient is educational resources from Diabetes Service: resource for patient (Gouin & Kiecolt-Glaser, 2011). The first one will be accessed from hospital and the second one will be accessed from www.healthinfonet.ecu.edu.au/.

The first resource that would help to increase a nurse’s knowledge regarding wound healing is the PowerPoint slides provided by the organization during training, which would be accessed from hospital resource data base. The second resource would be resources and tools provided in “wound Australia”, which would be accessed from www.woundsaustralia.com.au.

As wound healing process can be significantly affected by infection and wounds are sensitive to pathogens, several risk control measures are followed; these include:

 

Hand hygiene- It is the most important measure, as infection can spread through unhygienic hands of care staffs or the patient

Selecting the correct dressing- Healing requires moisture in the wound bed, but it should be determined, what kind and how much, which plays significant role in healing progress (Pope et al., 2012). Thus, based on the wound type, specific and appropriate dressing should be selected

Antibiotic cream- Using an antibiotic cream would help to reduce the chance of wound infection

The patient should also be educated to reduce wound infection chance. The education should include:

Hand hygiene- It is the most important point in reducing the rate of wound infection, thus prior dressing, hands should be cleaned properly

Proper dosage of dressing product- As the dressing products are responsible for the progress of wound healing, it is important to maintain the proper dosage of these products, to reduce adverse effects

Wound cleansing- It is the step which determines the amount of moisture left in the dressing material and wound healing needs moisture in wound bed, thus cleansing process should be done properly (Young & McNaught, 2011).

For Mr. Brown’s case, silver impregnated wound dressing would be used. For this, wound dressing products are discussed below:

Wound cleansing products- Sterile normal saline (0.9 %) are preferred, as it would not irritate patient’s skin

Primary dressing products- silver hydrofiber Aquacel Ag, for maintaining tissue hydration

Secondary dressing products- silver hydrogel Silvasorb or antibiotic cream like cicatrin, as it is active against gram positive microorganisms

While making the discharge plan, the patient and family would be advised for his healthy diet and physical education. In addition, proper dressing schedule would be discussed along with the precautions. He would be provided with referrals of rehabilitation centre, where his wound healing would be facilitated. In addition, Mr. Brown would be provided and discussed about his follow up checkups. All the documentations including consents and referrals would be completed and a thorough assessment would be done prior his discharge (Jefferies, Johnson & Ravens, 2011).

 

Reference List

Brown, P. (2012). Quick reference to wound care. Jones & Bartlett Publishers.

Gouin, J. P., & Kiecolt-Glaser, J. K. (2011). The impact of psychological stress on wound healing: methods and mechanisms. Immunology and allergy clinics of North America, 31(1), 81-93.

Jefferies, D., Johnson, M., & Ravens, J. (2011). Nurturing and nourishing: the nurses’ role in nutritional care. Journal of clinical nursing, 20(3?4), 317-330.

Krasner, D., Rodeheaver, G., Woo, K., & Sibbald, G. (2012). Chronic Wound Care 5. BookBaby.

Lay-Flurrie, K. (2017). The properties of hydrogel dressings and their impact on wound healing. nursing, 7, 00.

Pope, E., Lara-Corrales, I., Mellerio, J., Martinez, A., Schultz, G., Burrell, R., ... & Sibbald, G. (2012). A consensus approach to wound care in epidermolysis bullosa. Journal of the American Academy of Dermatology, 67(5), 904-917.

Toy, L. W., & Macera, L. (2011). Evidence?based review of silver dressing use on chronic wounds. Journal of the American Academy of Nurse Practitioners, 23(4), 183-192.

Young, A., & McNaught, C. E. (2011). The physiology of wound healing. Surgery (Oxford), 29(10), 475-479.

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