Wound History : Mr. Is had diagnosed with diabetic foot ulcer since 5 years ago. He get stabeed thorn. Diabetic foot ulcer on his left lower limb. He done wound care by nurse homecare. But wound healing delayed. The Wound more wide and no progress wound healing. His family refered to Kitamura Clinical.. When his wound care in Kitamura wound bed not good.
Wound Assessment : The first wound size 13 x 8, 5 cm The condition are smell, inflammation, granulation 20 %, slough, 80 %, high exudates, Necrotic 80 %, biofilm thich, depth until cavity until facia, tendon and bone. Tuneling 3 cm no epithelization. Maceration more than 2 cm. erythema, induration edema. MUNGS score 13.
The second wound size 6 x 4 cm The condition are smell, inflammation, granulation 80 %, slough, 10 %, high exudates, Necrotic 20 %, biofilm thickh, depth until cavity until facia, tendon and bone. Tuneling 3 cm, epithelization. Maceration. Erythema,induration edema. MUNGS score 12.
Wound Management : Cleansing : Normal saline 0,9 % Debridement Type : sharp. Management Exudate The second Wound is management exudates by insicion for drainage : Irigation Dressing product used: Honey, Metronidazole. Iodosorb, gamat, alginate.
Management edema : bandage with 30 mmHg.
ABI : The first Day on 12 Dec 2015 ABI left lower limb 0,9 mmHg, 1 mmHg. Right limb lower 0.9 mmHg. Monofilament Test Right is normo and monofilament test left abnormal
The First Day
The last day
Conclusion
- Honey is the main dressing. Another dressing product : iodosorb, intrasite gel and calcium alginate is asuitable dressing product chosen for this patient’s wound. Iodosorb powder and intrasite gel act as autolytic debridement in order to soften the slough and the alginate provide absorbent properties to absorb the exudate. Metronidazole for reducing odor.
- Wound Healing influenced albumin, Hb and vaskularisasi
- Healing process Mr. Is’s of wound is good
Tidak ada komentar:
Posting Komentar