Implementing wound dressing protocol to reduce post cesarean section surgical site infections in Mibilizi District Hospital, Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 369-376 ◽  
Author(s):  
Augustin Bahufite ◽  
Albert Ndagijimana ◽  
Eva Adomako ◽  
Abraham Zerihun ◽  
Calliope Akintije Simba ◽  
...  
Keyword(s):  
Wound Dressing ◽  
District Hospital ◽  
Management Practice ◽  
Wound Care ◽  
Surgical Site Infections ◽  
Wound Management ◽  
Standards Of Care ◽  
Care Practice ◽  
Content Type ◽  
Management Protocol

Purpose Caesarean section (CS) is one of the most common surgeries in the world. Although the procedure saves lives, it poses important risks such as post-caesarean surgical site infection (PCS-SSI). Basic patient care procedures can prevent PCS-SSI, however, they are not always followed. The purpose of this study is to describe how strategic problem solving (SPS) was used to implement a wound dressing protocol in a district hospital in Rwanda to reduce PCS-SSI rates. Design/methodology/approach To address variations in wound care practice, a new clinical protocol was developed and implemented by a quality improvement team which included clinicians. Training and supervision was also provided to the maternity team. Findings The intervention reduced PCS-SSI from 5.1 to 1.8 per cent. It also significantly improved the compliance to recommended wound dressing practices. Practical implications By applying SPS and effective leadership skills, the authors secured buy-in and support from stakeholders and introduced a wound management protocol in a district hospital of Rwanda. The intervention significantly improved wound management practice; however, long term follow-up will be necessary to sustain the improvements. Originality/value The results will inform hospitals in resource-limited settings of how to improve basic standards of care using SPS and leadership without additional cost to the hospital.

scholarly journals Telemedicine for wound management

2012 ◽  
Vol 45 (02) ◽  
pp. 412-417 ◽  
Author(s):  
Ravi K. Chittoria
Keyword(s):  
Health Care ◽  
Chronic Wounds ◽  
Wound Care ◽  
Cost Effective ◽  
Skin Lesions ◽  
Wound Management ◽  
Care Practice ◽  
Telemedicine Technology ◽  
Store And Forward ◽  
Financial Burdens

ABSTRACTThe escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

scholarly journals Study of hydrocellular functional material as microbicidal wound dressing for diabetic wound healing

2021 ◽  
Vol 19 ◽  
pp. 228080002110549
Author(s):  
Michael Rodrigues ◽  
Thilagavati Govindharajan
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Wound Care ◽  
Cost Effective ◽  
Wound Dressings ◽  
Wound Management ◽  
Histopathological Analysis ◽  
Diabetic Wound ◽  
Functional Material ◽  
Diabetic Wound Healing

A hydrocellular functional material as a wound dressing is developed and it is found to be superior in its efficacy as compared to some of the comparator controls in diabetic wound healing studies. A study on wound contraction and Histopathological analysis is done in rats. The efficacy of the dressing is comparable to the established wound dressings like Carboxymethyl cellulose alginate dressings and autolytic enzyme based hydrogel. It is found to be superior to Polyhexamethylene biguanide dressing used as reference controls in this study. The reason for good wound healing performance of the dressing can be attributed to a combined property of effective exudates management and broad spectrum antimicrobial effect. The concept of functional hydro cellular material has shown good results due to the excellent balance of exudates pickup and drying it out. This ensures moist wound healing conditions on the wound. Because of its porous nature it allows good air flow and gaseous exchange in the structure. The cationic sites created on the surface of the dressing ensure a good antimicrobial action on the exudates in the dressing. It reduces the infection load on the wound. The nonleaching property of the dressing also helps in preventing the generation of more resistant and mutant strains of the microbes. The developed dressing can be used as a relatively durable long lasting dressing for wound management in diabetic wounds. The need of repetitive wound dressing changes can be brought down with this concept of dressing. It is not only cost effective in terms of its material cost but also is a cost effective solution when entire wound management cost is considered. Such novel wound dressing material can change the quality of life of diabetic wound patients especially in developing world, where access to functional advanced wound care dressings is limited.

scholarly journals Wound care with traditional, complementary and alternative medicine

2012 ◽  
Vol 45 (02) ◽  
pp. 418-424 ◽  
Author(s):  
Ananda A. Dorai
Keyword(s):  
Wound Healing ◽  
Alternative Medicine ◽  
Traditional Medicine ◽  
Care Management ◽  
Wound Care ◽  
Healing Process ◽  
Wound Management ◽  
Care Practice ◽  
Wound Therapy ◽  
The Ideal

ABSTRACTWound care is constantly evolving with the advances in medicine. Search for the ideal dressing material still continues as wound care professionals are faced with several challenges. Due to the emergence of multi-resistant organisms and a decrease in newer antibiotics, wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management. People′s perception towards traditional medicine has also changed and is very encouraging. The concept of moist wound healing has been well accepted and traditional medicine has also incorporated this method to fasten the healing process. Several studies using herbal and traditional medicine from different continents have been documented in wound care management. Honey has been used extensively in wound care practice with excellent results. Recent scientific evidences and clinical trials conducted using traditional and alternative medicine in wound therapy holds good promise in the future.

Wound care

2016 ◽  
Author(s):  
Patricia Davies
Keyword(s):  
Wound Dressing ◽  
Wound Care ◽  
Surgical Site Infections ◽  
Surgical Patients ◽  
Wound Infections ◽  
Site Infection ◽  
Secondary Intention ◽  
Wound Assessment ◽  
Healing Wound ◽  
Operative Assessment

It is imperative that the surgical nurse has a good understanding of wound care, as all surgical patients will have a wound of some description. Prevention of surgical site infection begins with a pre-operative assessment and continues post-operatively with the assessment of the wound dressing and the surgical site. This chapter discusses the physiology of wound healing, wound assessment, and dressings for primary- and secondary-intention wounds. This chapter also outlines the prevention of surgical site infections, and common wound infections and their treatment.

Crossroads at Salerno: Eldridge Campbell and the writings of Teodorico Borgognoni on wound healing

1995 ◽  
Vol 83 (1) ◽  
pp. 174-179 ◽  
Author(s):  
A. John Popp
Keyword(s):  
World War Ii ◽  
Wound Care ◽  
Geographical Location ◽  
Wound Management ◽  
Medical Community ◽  
Wound Treatment ◽  
Modern Biology ◽  
Content Type ◽  
Mediterranean Theater ◽  
Fine Print

✓ During Eldridge Campbell's tour of duty as the neurosurgical consultant to the Mediterranean theater of World War II operations, he was introduced to a then-revolutionary method of wound treatment. Ironically, Campbell's diligent research efforts later revealed that this method of wound treatment had first been advocated seven centuries earlier—in the same geographical location—by the Italian surgeon Theodoric. Although controversial, this method of wound care was subsequently applied and supported by Theodoric's outspoken pupil, Henri de Mondeville, despite intense opposition from the prevailing medical authorities who supported the doctrine of “laudable pus” for wound management. With Mondeville's death, Theodoric's technique lapsed into obscurity, relegated to a historical footnote until modern biology and the discoveries of Lister and Pasteur would again bring to light the benefits of nonsuppurative wound treatment. In this article the author discusses the work of Theodoric, Mondeville, and Campbell in light of the medical climate of their times and explores the contemporary parallels noted by Campbell in terms of the neglect of other, more recent medical discoveries. These examples encourage us to accept or reject medical treatments based on a thorough examination of their efficacy and not on the stature of their advocates within the medical community.

A photometric stereo approach for chronic wound measurement

Sensor Review ◽  
2015 ◽  
Vol 35 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Jiuai Sun ◽  
Xiaoping Xu ◽  
Abdul Rehman Farooq ◽  
Lyndon Neal Smith ◽  
Melvyn Lionel Smith
Keyword(s):  
Chronic Wounds ◽  
Wound Care ◽  
Skin Surface ◽  
Photometric Stereo ◽  
Wound Management ◽  
Clinical Settings ◽  
Content Type ◽  
Good Potential ◽  
Review State ◽  
Color Texture

Purpose – This paper aims to review state of the art of techniques for dimensioning chronic wounds, and validate the possibilities of employing a new proposed optical imaging approach for general task of wound assessment. Design/methodology/approach – Current techniques used for quantifying wound surface are reviewed and evaluated from various perspectives to exam their usability in wound care clinical settings. A photometric stereo (PS) approach will be identified and verified to work as an alternative solution to better satisfy practical requirements on quantifying the dimension of real and mocked wounds. Findings – Both contact and contactless approaches provide some useful functions for wound management; however, new imaging modalities are still required for achieving good portability, affordability and applicability in assisting decision-making in clinical settings. The PS approach can work as a potential solution to provide these functionalities as well as dense geometrical and color texture information of measured areas. The experiments demonstrate that the new approach is able to conveniently produce comparable results to those from latest stereo vision-based techniques. Research limitations/implications – This work proposed and initially verified the potential of PS technique for the task of wound measurement. Substantial improvements on the prototype and more clinical trials are still required to validate the new technique before it is accepted as a tool for practical wound measurement. Originality/value – This new PS approach has good potential to reliably measure the dimension of wounds as well as recover their color texture which could contain additional valuable information for predicting a healing procedure for those wound occurring deeper underneath the skin surface.

Measured Wound Outcome Feedback Improves Surgical Site Infection Rates

2021 ◽  
Vol 33 (12) ◽  
pp. 334-336
Author(s):  
Laura Bolton
Keyword(s):  
Hand Hygiene ◽  
Randomized Clinical Trials ◽  
Chronic Wounds ◽  
Wound Care ◽  
Surgical Site Infections ◽  
Care Practice ◽  
Written Feedback ◽  
Outcome Feedback ◽  
Hygiene Practices ◽  
Orthopedic Surgeons

Feedback supports learning. No matter how effective medical professionals think they are, evidence of measured patient wound outcomes helps inform their wound care practice, empowering them to improve patient outcomes. Prospective randomized clinical trials (RCTs) proved this principle in relation to healing chronic wounds. Measuring wound healing outcomes and providing caregivers with feedback about the 4-week healing progress increased the percentage of diabetic foot ulcers healed within 20 weeks and venous leg ulcers healed within 24 weeks. Longitudinal research2 suggests this principle holds true in preventing surgical site infections (SSIs). When individual orthopedic surgeons were provided written feedback about their hand hygiene practices and corresponding SSI rates, surgeon hand hygiene improved and SSI rates in their patients were reduced. This Evidence Corner describes systematic review evidence indicating that feedback given to responsible wound care professionals reduced SSI incidence for patients undergoing orthopedic or trauma surgery3 and abdominal surgery.

scholarly journals Unprecedented Silver Resistance in Clinically Isolated Enterobacteriaceae: Major Implications for Burn and Wound Management

2015 ◽  
Vol 59 (8) ◽  
pp. 4734-4741 ◽  
Author(s):  
Phillip J. Finley ◽  
Rhy Norton ◽  
Cindy Austin ◽  
Amber Mitchell ◽  
Sara Zank ◽  
...  
Keyword(s):  
Wound Care ◽  
Phenotypic Expression ◽  
Heavy Metal Resistance ◽  
Metal Resistance ◽  
Wound Dressings ◽  
Wound Management ◽  
Klebsiella Pneumonia ◽  
Content Type ◽  
Ionic Silver ◽  
High Silver

ABSTRACTIncreased utilization of inorganic silver as an adjunctive to many medical devices has raised concerns of emergent silver resistance in clinical bacteria. Although the molecular basis for silver resistance has been previously characterized, to date, significant phenotypic expression of these genes in clinical settings is yet to be observed. Here, we identified the first strains of clinical bacteria expressing silver resistance at a level that could significantly impact wound care and the use of silver-based dressings. Screening of 859 clinical isolates confirmed 31 harbored at least 1 silver resistance gene. Despite the presence of these genes, MIC testing revealed most of the bacteria displayed little or no increase in resistance to ionic silver (200 to 300 μM Ag+). However, 2 isolates (Klebsiella pneumoniaandEnterobacter cloacae) were capable of robust growth at exceedingly high silver concentrations, with MIC values reaching 5,500 μM Ag+. DNA sequencing of these two strains revealed the presence of genes homologous to known genetic determinants of heavy metal resistance. Darkening of the bacteria's pigment was observed after exposure to high silver concentrations. Scanning electron microscopy images showed the presence of silver nanoparticles embedded in the extracellular polymeric substance of both isolates. This finding suggested that the isolates may neutralize ionic silver via reduction to elemental silver. Antimicrobial testing revealed both organisms to be completely resistant to many commercially available silver-impregnated burn and wound dressings. Taken together, these findings provide the first evidence of clinical bacteria capable of expressing silver resistance at levels that could significantly impact wound management.

scholarly journals Hydrogel Dressings for Advanced Wound Management

2019 ◽  
Vol 25 (41) ◽  
pp. 5782-5797 ◽  
Author(s):  
Antonio Francesko ◽  
Petya Petkova ◽  
Tzanko Tzanov
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Therapeutic Potential ◽  
Wound Care ◽  
Wound Management ◽  
Stimuli Responsive ◽  
Dermal Tissue ◽  
Healing Efficiency ◽  
Sensor Molecules ◽  
Responsive Hydrogels

Background: Composed in a large extent of water and due to their nonadhesiveness, hydrogels found their way to the wound dressing market as materials that provide a moisture environment for healing while being comfortable to the patient. Hydrogels’ exploitation is constantly increasing after evidences of their even broader therapeutic potential due to resemblance to dermal tissue and ability to induce partial skin regeneration. The innovation in advanced wound care is further directed to the development of so-called active dressings, where hydrogels are combined with components that enhance the primary purpose of providing a beneficial environment for wound healing. Objective: The objective of this review is to concisely describe the relevance of hydrogel dressings as platforms for delivery of active molecules for improved management of difficult- to-treat wounds. The emphasis is on the most recent advances in development of stimuli- responsive hydrogels, which allow for control over wound healing efficiency in response to different external modalities. Novel strategies for monitoring of the wound status and healing progress based on incorporation of sensor molecules into the hydrogel platforms are also discussed.

scholarly journals Medical honey and the role in pediatric emergency wound management

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Stefan Bittmann 1 ◽  
Anne Weissenstein 2 ◽  
Gloria Villalon 3 ◽  
Elisabeth Luchter 4
Keyword(s):  
Medical Treatment ◽  
Complementary Medicine ◽  
Wound Dressing ◽  
Wound Care ◽  
Large Body ◽  
Pediatric Emergency ◽  
Present Knowledge ◽  
Wound Management ◽  
Wide Range ◽  
The World

The use of complementary medical treatment in wound management has continued to grow throughout the world. There is a large body of evidence to support the use of honey as a wound dressing for a wide range of types of wounds. Clear guidelines for the use of honey in pediatric wound care do not exist. We present an update of present knowledge using honey as a form of complementary medicine in pediatric wound management.

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