The management of surgical wounds Patient assessment

This is essential to identify any factors that can affect healing. This topic is covered in more detail in Chapter 2. Potential problem areas include Maintaining a safe environment the risk of infection must be considered. Communicating identify patient understanding of the operative procedure. Postoperative pain must be assessed and controlled. Breathing recording of vital signs for indication of haemorrhage. Eating and drinking assessment of nutritional status is essential as patients may...

Burn oedema

Almost immediately after injury, oedema starts to collect beneath the damaged tissue. This is typically maximal within 24 hours of the injury, but may last for up to three or four days. As plasma continues to leak into the tissues, there is a risk of hypovolaemia developing. Without treatment, burns shock can develop and is potentially fatal. If the burn is on the face, neck or chest, the swelling from the oedema may cause obstruction of the airway. Patients with facial burns are admitted for...

Incidence

Little information seems to be available on this aspect of fungating wounds. Ivetic and Lyne (1990) have reviewed the literature and found no significant research. There seems to be some evidence that fungating lesions of the breast are less common than they once were, but it is not conclusive. Thomas's survey (1992) found that breast lesions were most commonly seen, followed by head and neck lesions. However, the survey did not attempt to assess incidence. 5.4.3 The management of fungating...

Nursing interventions

Problem Disruption of normal sleeping patterns. Goal Patients are able to sleep a number of hours at night and feel well rested. Hospitals are not restful places. Many patients joke about going home for a rest. Noise is a major factor which disturbs patients, especially irritating noises. Florence Nightingale (1859) discussed the importance of sleep to the sick. She described some of the noises that disturbed patients. They included rattling keys, creaking shoes and stays (corsets) and the...

The Prevention And Management Of Pressure Sores

Release The Pressure Sore With Equipment

Pressure sores are also called 'pressure ulcers', 'bed sores' and 'decubitusulcers'. A pressure sore can be described as localised damage to the skin caused by disruption of the blood supply to the area, usually caused by pressure, shear or friction, or a combination of any of these. There has not been a national survey of pressure sore prevalence in the UK however, a survey by O'Dea (1995) of over 8000 patients found that 18.6 of hospital patients had pressure sores. A national survey in the...

Antiseptics

After saline, the commonest type of lotion in use is an antiseptic. An antiseptic can be defined as a non-toxic disinfectant which can be applied to skin or living tissues and has the ability to destroy vegetative compounds, such as bacteria, by preventing their growth. If they are simply used to wipe across the wound surface they will have little effect. Antiseptics need to be in contact with bacteria for about 20 minutes before they actually destroy them (Russell et al., 1982). In some...

The epidemiology of leg ulcers

There have been two major surveys carried out within the UK to identify the numbers of people with leg ulcers. The largest was the Lothian and Forth Valley survey in Scotland (Callam et al, 1985). Cornwall et al. (1986) surveyed an urban London health district. Surveys have also been carried out in Sweden and Australia (Nelzen etal, 1991 Baker & Stacey, 1994 Ebbeskog etal, 1996). They all found similar results with prevalence rates of 1.3-3.0 per 1000 population which increase to 20 per 1000...

References

Alvarez, O.M., Dellanoy, O.A. (1987) Moist wound healing. Paper presented at American Academy of Dermatology. Argenta, L.C., Morykwas, M.J. (1997) Vacuum-assisted closure a new method for wound control and treatment clinical experience. Annals of Plastic Surgery, 38 (6), 563-576. Arnold, F. (1996) Growth factor treatment for wounds magic bullets or high-tech hype in (eds) Cherry, G.W., Gottrup, F., Lawrence, J.C., Moffatt, C.J., Turner, T.D., Proceedings of the 5th European Conference on...