Remodeling Phase A) 3 weeks to 2 years B) New collagen forms which increases tensile strength to wounds C) Scar tissue is only 80% as strong as original tissue Background Recent estimates suggest that 1% of the total health care dollar is spent on wound care in the U.S. (Lane, 1995)
As indicated by Larson (1993), the costs associated with nursing care escalate substantially once pressure ulcers develop, with 50% more nursing time required to care for the patient. Iatrogenic ulcers have resulted in up to $92 million in malpractice awards (Larson, 1993)
Chronic non-healing wounds, most often associated with inadequate blood flow, are suffered by an estimated five million people in the U.S. (Liang, 1999)
7% (Allman, Larade & Noel, 1986) to 9.2% (Meehan, 1990), with other estimates suggesting a range of 3% to 14% in hospitalized patients to 25% in nursing home residents (Allman et al
7% (Allman, Larade & Noel, 1986) to 9.2% (Meehan, 1990), with other estimates suggesting a range of 3% to 14% in hospitalized patients to 25% in nursing home residents (Allman et al
An estimated $5 billion to $7 billion is spent on chronic wound treatment annually in the U.S. (Morgan, & Hoelscher, 2000)
The number of those affected by chronic wounds is increasing at an annual rate of 10%. Venous ulcers account for 80% to 90% of all lower extremity ulcers (Neil, & Munjas, 2000)
Diabetic amputations average 67,000 procedures per year at a cost of $98 billion in health care dollars (Burdette-Taylor, 1999; USDHHS Diabetes Surveillance, 1997). Similarly, lengthy hospital stays are often experienced by patients with pressure ulcers who frequently remain hospitalized for more than 35 days (O'Brien, Gahtan, Wind, & Kerstein, 1999)
Risk Factors Associated with Wound Healing As identified within the literature, it appears that there are three major factors that have been found to influence failure of wound healing in chronic wounds. These factors include conditions related to the patient's medical and physical status, conditions related to an environmental source, and iatrogenic causes related to specific wound care management techniques and/or products (Sussman, 1998)
The emotional costs associated with the presence of a chronic wound compound the escalating financial burden of wound care for patients, families, and society. Statement of Purpose Evidence suggests that a number of factors are wound care management is becoming more complex for nurses due to new insights into wound healing (Hayward & Morrison, 1996) and because of the wide variety of wound dressings that are available (Wikblad & Anderson, 1995; Miller, 1994)
8 million people developing new pressure ulcers each year (Maklebust & Siggreen, 1991). The elderly and persons with spinal cord injury are two groups well-known to be at risk for pressure ulcer development (Young, Burns, Bowen & McCutchen, 1982; Stover & Fine, 1986; Allman, 1989)
H's wound. Intervention: Properly saturate the wound with oxygen to speed healing and reduce risk of ischemia/reperfusion events (Beckert, Konigsrainer, & Coerper, 2007)
A conclusion highlights the main points of the paper for topic synthesis. Chronic Wound Care: Issues Categories of Chronic Wounds A chronic wound is one that does not heal in the expected fashion of other wounds; a wound that last longer than three months may be considered a chronic wound (Bryant & Nix, 2007)
Human Needs Assessment The nurse is responsible for assessing the patient and determining the best model of care, with a client care plan. Notwithstanding the reason for the patient/nurse encounter, the nurse must make an assessment and using an assessment model is the chosen and most efficacious means of accomplishing this (Buluta, Hisara, & Guler Demir, 2010)
Pressure points include the sacrum, heels, elbows, and shoulder blades. Due to the ongoing nature of the pressure on these areas, a loss of blood flow to capillaries and veins occurs, leading to tissue damage (e Laat, Scholte op Reimer, & van Achterberg, 2005)
Evidence-based nursing medicine necessitates utilizing empirical clinical information and sound knowledge resources to find answers to questions for the clinical setting. This is a skill set and is effective for identifying the best practices for clinical questions (Gerrish & Lacey, 2010)
Second, the nurse must generate a positive attitude where the wound can be successfully treated. Lastly, the nurse must instruct the patient through hands-on direction how to dress and treat their wounds (Gethin, 2002)
A chronic wound falls into one of three primary categories. A venous wound accounts for the majority of chronic wounds; the group typically affected by these wounds are the elderly, with the wound typically being found on the legs (Gist, Tio-Matos, Falzgraf, Cameron, & Beebe, 2009)
H was admitted to an acute care facility following the fall, and was later transferred to a sub-acute care facility. He was assessed by a wound care nurse for evaluation of the anterior pelvic wound, which was evolving into a chronic wound (Glenn, 2006)
Green and Jester (2010) not that in caring for the patient with leg ulcerations, the nurse is not only dealing with the chronic wound; the nurse is also dealing with the physical and psychological effect of the wound upon the patient. Factors of pain, odor, wound exudates, and the social marginalization experienced by the patient are issues the nurse must deal with (Green & Jester, 2010)