RESUMO
Pressure ulcer prevention and treatment remains a challenge for interprofessional teams in all health care sectors. Evidencebased pressure ulcer guidelines can be simplified with a bedside enabler utilizing the wound bed preparation paradigm. Key steps involve treatment of the cause, addressing patient-centered concerns, and administering local wound care (debridement, infection/ inflammation control, and moisture balance before considering advanced therapies with the edge effect). Optimal outcomes are achievable with a multi-disciplinary approach that supports patients and their circle of care, which is central to every evaluation and course of treatment decisions.
Assuntos
Anti-Infecciosos/uso terapêutico , Leitos/efeitos adversos , Desbridamento/métodos , Úlcera por Pressão/terapia , Higiene da Pele/métodos , Cicatrização/efeitos dos fármacos , Algoritmos , Desbridamento/educação , Humanos , Dor/prevenção & controle , Planejamento de Assistência ao Paciente , Guias de Prática Clínica como Assunto , Úlcera por Pressão/etiologia , Úlcera por Pressão/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Fatores de Tempo , Cicatrização/fisiologia , Infecção dos Ferimentos/prevenção & controleRESUMO
This clinically focused article addresses the nuts and bolts of wound bed preparation. Preparing the wound bed is a frequently ignored step in the process of treating chronic wounds. In these days of high-tech instrumentation use for chronic wound care (i.e., adjunctive therapies, growth factors, and skin substitutes), clinicians should not forget the basics that are essential for optimizing wound healing. This article introduces the PREPARE Model (see Figure 1) as an aid for guiding care providers in wound bed preparation.
Assuntos
Ferimentos e Lesões/enfermagem , Desbridamento/métodos , Técnicas Hemostáticas , Humanos , Medição da Dor , Irrigação TerapêuticaRESUMO
This article highlights the nurse's role within a holistic, interdisciplinary approach to chronic wound management. Best practices for chronic wound care are discussed, drawing on evidence-based science when it is available. The fundamentals of chronic wound care, including cleansing, irrigation, débridement, infection control, and topical treatment are addressed. New devices and technologies are briefly reviewed. Implementing these best practices across the continuum of care will result in greater advances in the management of chronic wounds.