Wound care practice. Case History and Wound Profile of the Patient

Wound Care Practice
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Various people think that wounds are the result of accidents, but it is not the truth. Even a clean surgical incision can be regarded as the wound, so are the places through which the catheters or tubes are entered into the body. Skin is the largest and most prominent organ of the body, and it helps protect the internal organs from germs like viruses, fungi and bacteria and other harmful effects (Mohan, 2012). An open wound is an injury that involves an internal or external break in the body cells. There are risks of microbes getting into the body and causing infections due to the wound. All people experience open wounds at some points in their life, most of which are minor and can easily be treated at home. However, road accidents or cuts with sharp objects are the more serious cases that require the victim to seek medical assistance as soon as possible. There are four main types of wounds: abrasion, laceration, puncture, and avulsion.
At her 62, Mrs. C was suffering from long-term insulin dependent diabetes mellitus and Addison’s disease. She was married but had no children at all. Throughout her life, she did not drink alcohol and hated smoking. She belonged to a family where diabetes mellitus was found in every second person. The patient was referred to the Wesley Centre for Hyperbaric Medicine where she was treated for seven ulcers that were ruining Mrs. C’s health for nearly 3 years. It was found that the ulcers varied in severity and creating more problems for the patient since the time she started getting hydrocortisone injections.
Case History and Wound Profile of the Patient
Mrs. C was having a history of diabetes mellitus, retinopathy, Addison’s disease, and hypertension. In recent years, she had gained a lot of weight, developed the peripheral vascular disease, and underwent a femoral popliteal bypass. She also had a revision of the graft that was partially blocked one year later. In order to recover from ulcers, Mrs. C had to rely on hydrocortisone injections to the wound beds, but the current regimen for the illness consisted of dressings only.
The doctor of Mrs. C recommended her Somac, Zocor, Avapro, Cortrate, Florinch, and Colgout, whom she once told that she was having allergies of serious nature. During the assessment, Mrs. C talked about her diabetes-related wounds, which were getting serious with time. She was asked to rely on hyperbaric oxygen therapy for some days, and during the same assessment period, it was found that Mrs. C had seven ulcers. They were located on the lower parts of her legs, on the calves and other external parts of her body, and their sizes varied from one another with an approximate length of 45mm and width of 32mm. The wound beds were 100 percent delicate, and the bases were getting deeper with the passage of time.
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From this figure, it is clear that the wounds were visible and ill-looking, but they were odorless. At a point, they damaged the lower parts of both of her legs, and at the other points, they began bleeding; the exudate was moderate, but it used to be controlled with dressings on a daily basis. The wound swabs that were taken during assessment turned to Staphylococcus aureus and showed a moderate growth, and the ABI (ankle-brachial index) could not be attempted because of the pain associated with the wounds and their sensitive location. When asked how would you rate the pain on a scale of 0 to 10, Mrs. C clarified that the pain was in the range of 3 to 5. However, it used to get worse sometimes, creating a mess for the patient.
This initial assessment was done to determine the level of oxygen needed by the patient and to evaluate how the wound beds should be dealt with. More than 98 percent of oxygen was found to be needed to lower the surface pressure. Mrs. C’s recordings at every 20 minutes of room air were 67mmHg and 68mmHg at 1ATA, highlighting the normal and expected levels of oxygen in her body tissues. When the 100 percent of oxygen was administered, the patient’s readings were found to be jumping between 338mmHg and 308 mmHg at 1ATA, and it indicated that the desired outcomes could be obtained with hyperbaric treatment.
Assessment Tools Used to Access Mrs. C’s Wound
Though there are various assessment tools were used to access the wound of a patient, the most effective tool used in this case was TIME. The International Advisory Board has created it and the acronym TIME stands for Tissue, Infection, Moisture Balance and Edge (Agrawal, 2012). The assessment of the wound bed was done using this tool, and TIME helped us distinguish between the variable and non-variable tissues. The variable tissue consists of epithelial and granulation cells, and the non-viable tissue has necrotic, eschar and slough cells. In order to help the patient recover from the disease, her wound beds were covered with 90 percent of dry necrotic tissue. Later on, the ulcers were treated with compression therapy, combined with wound dressings, which provided a moist environment to the wounds and facilitated healing. Before commencing the wound debridement, it was essential to establish the underlying diagnosis.
The chance was that a significant number of bacteria and viruses would get produced in the wound bed and could delay the wound healing. In order to keep Mrs. C from this problem, she was diagnosed for erythema, pyrexia, swelling, malodor and abscess formation (Shanmugam, 2012). The treatment and diagnoses aimed at providing Mrs. C with 100 percent of oxygen under the barometric pressure of 2.3, for two to three hours in a day and the process was to be repeated five days a week. A total of 30 treatments were planned for her to facilitate wound healing.
Collaborative Interventions Used to Manage the Patient’s Wound Management
Collaborative care was the most powerful disease management technique we could ever use to in case of Mrs. C. It aimed to target her physical injuries and psychiatric problems like depression and stress. They hold promise for the provision of both mental and physical health in acute care (King, 2007). Initially, Mrs. C had undergone psychotherapy and pharmacotherapy in order to determine whether she had some serious mental problem or not. She was then given the refine routine care treatment that helped her recover from the illness at a fast speed.
When Mrs. C commenced treatment, she was asked to complete a number of therapy and discussion sessions. The purpose was to educate her about the significance of different therapies and medications. She joined a group of patients who were already receiving wound care and were admitted to the hospital for some weeks. All of them completed their routine checkup and treatment sessions under the supervision of a qualified and ...