RESUMEN
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.
Asunto(s)
Antiinfecciosos/uso terapéutico , Lechos/efectos adversos , Desbridamiento/métodos , Úlcera por Presión/terapia , Cuidados de la Piel/métodos , Cicatrización de Heridas/efectos de los fármacos , Algoritmos , Desbridamiento/educación , Humanos , Dolor/prevención & control , Planificación de Atención al Paciente , Guías de Práctica Clínica como Asunto , Úlcera por Presión/etiología , Úlcera por Presión/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Índice de Severidad de la Enfermedad , Factores de Tiempo , Cicatrización de Heridas/fisiología , Infección de Heridas/prevención & controlRESUMEN
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.
Asunto(s)
Heridas y Lesiones/enfermería , Desbridamiento/métodos , Técnicas Hemostáticas , Humanos , Dimensión del Dolor , Irrigación TerapéuticaAsunto(s)
Anabolizantes/uso terapéutico , Anorexia/complicaciones , Anorexia/prevención & control , Oxandrolona/uso terapéutico , Heridas y Lesiones/etiología , Heridas y Lesiones/prevención & control , Anciano , Anabolizantes/farmacología , Apetito/efectos de los fármacos , Enfermedad Crónica , Humanos , Evaluación en Enfermería , Evaluación Nutricional , Oxandrolona/farmacología , Pérdida de Peso , Cicatrización de Heridas/efectos de los fármacosRESUMEN
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.