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Effects of Topical Negative Pressure Treatment on Grade III and IV. Pressure Ulcers

Yıl 2014, Cilt: 16 Sayı: 3, 28 - 37, 01.12.2014

Öz

Objective:This study was conducted as a quasi-experimental research to determine the effect of Topical Negative Pressure Treatment on healing of Grade III and IV pressure ulcers. Method: The sample consisted of 14 pressure ulcers in seven patients at one university and two state hospitals in Ankara, Turkey. The data was collected through Patient Data Form prepared by the researcher including sociodemographic information and contributing factors for pressure ulcer development, Pressure Ulcer Healing Chart for pressure ulcer assessment, and Wong-Baker Pain Scale for procedure related pain assessment. Means, standard deviations, and percentages, Wilcoxon Signed Pair Ranks Tests, McNemar and Friedman Tests were used for analysis. Results: At the end of eight Topical Negative Pressure Treatments 2 weeks , pressure wound surface area was reduced in nine of Grade III and IV pressure ulcers compared to initial measurements. No change in tissue appearance was observed in six ulcers, reduction was detected in pressure wound depth in ten ulcers, and necrotic tissue initially present at the wound area reduced in eleven ulcers. The difference between the first and last session mean scores of surface area, exudate amount, and wound depth was statistically significant p

Kaynakça

  • National Pressure Ulcer Advisory Panel (NPUAP)[Online]. Available from:http://www.npuap.org/resources.htm, (Accessed 2009 January14)
  • Bennett G, Dealey C, Posnett J. The cost of pressure ulcers in the UK. Age Ageing 2004;33(3):230-235.
  • Butler F. Essence of care and the pressure ulcer benchmark-an evaluation. J Tissue Viability 2008; 17(2):44-59.
  • Casimiro C, Garcia-de-Lorenzo A, Usan L. Prevalence of decubitus ulcer and associated risk factors in an institutionalized Spanish elderly population. Nutrition 2002;18(5): 408-414.
  • Hug E, Ünalan H, Karamemetoğlu ŞS, Tüzün S, Gürgöze M, Tüzün F.Bir eğitim hastanesinde bası yarası prevalansı ve bası yarası gelişiminde etkili risk faktörleri. Turk J Phys Med Rehab2001;47(6):3-11.
  • Keller AJBP, Wille J, Ramshorst VB, Werken VDC. (2002). Pressure ulcers in intensive care patients: a review of risks and prevention. J Intensive Care Med 2002;28(10):1379-1388.
  • Theaker C. Pressure sore prevention in the critically ill: what you don’t know, what you should know and why it’s important. Intensive Crit Care Nurs 2003;19(3):163-168.
  • Bergquised S. The quality of pressure ulcer prediciton and prevention in home health care. Appl Nurs Res 2005;18(3):148-154.
  • Brem H, Lyder C. Protocol for the successful treatment of pressure ulcers.Am J Surg2004;188(1):9-17.
  • Pearson A, Francis K, Hodgkinson B, Curry G. Prevelance and treatment of pressure ulcers in Northern New South Wales. The Aust J Rural Health 2000;8(2):103-110.
  • Smith M. A comprehensive review of risk factors related to the development of pressure ulcers. Journal of Orthopaedic Nursing2003;7(2):94 – 102.
  • Hunter JE, Teot L, Horch R, Banwell PE. Evidence-based medicine: Vacuum-assisted closure in wound care management.Int Wound J 2007;4(3): 256-269.
  • Horn SD, Buerhaus P, Bergstrom N, Smouth RJ. RN staffing time and outcomes of long-stay nursing home residents. Am J Nurs 2005;105 (11):58-70.
  • Baldwin KM . How to prevent and treat pressure ulcers. LPN 2005;1(2):18-25.
  • Uzun Ö, Tan M. A Prospective, descriptive pressure ulcer risk factor and prevalence study at a university hospital in Turkey, Ostomy Wound Manage 2007; 53(2): 44-56.
  • Inan DG, Oztunç G.Pressure ulcer prevalence in Turkey: a sample from a university hospital.J Wound Ostomy Continence Nurs 2012 Jul-Aug;39(4):409-13.
  • Ülker Efteli E, Yapucu Günes Ü. A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units. Ostomy Wound Manage 2013;59(7):22–27.
  • Cervo FA, Cruz AC, Posillico JA. Pressure Ulcers: analysis of guidelines for treatment and management. Geriatrics 2000;55(3):55-60.
  • Cooper SM, Young E. Topical negative pressure. Int J Dermatol 2000; 39(12):896-898.
  • Deva AK, Buckland GH, Fisher E, et al. Topical negative pressure in wound management. MedJ Aust 2000;173(3):128- 131.
  • Fabian TS, Kaufman HJ, Lett ED, et al. The evaluation of subatmospheric pressure and hyperbaric oxygen in ischemic full-thickness wound healing. Am Surg 2000;66(12):1136-1143.
  • Genecov DG, Schneider AM, Morykwas MJ, et al.Parker D, White WWL, Argenta LC. A controlled sub-atmospheric pressure dressing increases the rate of skin graft donor site reepithelialization. Ann of Plast Surg 1998;40(3):219-225.
  • Hersh RE, Jack JM, Dahman MI, Morgan RF, Drake DB. The Vacuum assisted closure device as a bridge to sternal wound closure. Ann of Plast Surg 2001;46(3):250-254.
  • Sahin E. Bası yarasında fizik tedavi uygulamaları. Türkiye Klinikleri JInt Med Sci 2007;3(45):36-44.
  • Joseph E, Hamori CA, Bergman S, et al. New therapeutic approaches in wound care. A prospective randomized trial of TNBT vacuum-assisted closure versus Standard therapy of chronic nonhealing wounds. Wounds 2000;12(3):60-67.
  • Moues CM, Van Den Bemd GJ, Heule F, Hovius SE. Comparing conventionel gauze therapy to Vacum-assisted closure wound therapy: a prospective randomised trial. J Plast Reconstr Aesthet Surg2007; 60(6):672-681.
  • McCallon SK, Knight CA, Valiulus JP, et al. Vacuum-assisted closure versus saline moistened gauze in the healing of postoperative diabetic foot wounds. Ostomy Wound Manage 2000;46(8): 28-34.
  • Ferreira MC, Wada A, Tuma P. The Vacuum assisted closure of complex wounds: report of 3 cases. Rev Hosp Clin Fac Med Sao Paulo2003;58(4):227-230.
  • Müllner T, Mrkonjic L, Kwasny O, Vecsei V. The use of negative pressure to promote the healing of tissue defects a clinical trial using the TNBTuum sealing technique. Br J Plast Surg 1997;50(3):194-199.
  • Tauro LF, Ravikrishnan J, Satish Rao BS, Shenoy HD, Shetty SR, Menezes LT. A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds. Indian J Plast Surg 2007;40(2):133-140.
  • Isago T, Nozaki M. Negative-pressure dressings in the treatment of infected pressure ulcers. Wound Repair Regen January-February 2005; 13(1):A14.
  • National Pressure Ulcer Advisory Panel (NPUAP2007) [Online].Available from:http://www.npuap.org/resources/educational-and-clinical-resources/push-tool (Accessed 2008 December 23).
  • Mani R. Chronic wound management: the evidence for change. Newyork: The Parthenon Publishing Group, 2003;113- 121.
  • Dealy C. The care of wounds. A guide for nurses. Malden: Blackwell Publishing Company,1999;110-127.
  • Lee BY. The Wound Management Manual. Newyork: The McGraw – Hill Companies Inc, 2005;65-72.
  • Lambert KV, Hayes P, McCarthy M. Vacuum assisted closure: a review of development and current applications. Eur J Vasc Endovasc Surg 2005;29(3):219-226.
  • O’Rourke ME. Vacuum-assisted closure therapy. Clin J Oncol Nurs 2006;10(6): 825-826.
  • CopsonD. Topical negative pressure and necrotising fasciitis. Nurs Stand2003;18(6): 71-80.
  • Coggrave M, West H, Leonard B. Topical negative pressure for pressure ulcer management. Br J Nurs 2002;11(6):29- 36.
  • Demir A, Demirtaş Y, Çifci M, Öztürk, N. ve Karacalar, A. Topikal Negatif Basınç (Vakum Yardımlı Kapama [TNBT]) Uygalamalarımız. TurkPlast Surg2006;14(3):171-177.
  • Heyneman A, Beele H, Vanderwee K, Defloor T. A systematic review of the use of hydrocolloids in the treatment of pressure ulcers. JClin Nurs2008;17:1164–1173.
  • Kaufman MW, Pahl DW. Vacuum-assisted closure therapy: wound care and nursing implications. Dermatol Nurs2003;15(4):317-325.
  • Lee SS, Lin SD, Chen HM, Lin MT, Yang CC, Lai CS, Chen YF, Chiu CC. Management of intractable sternal wound infections with topical negative pressure dressing. J Card Surg 2005;20(3):218-222.
  • Banwell PE, Musgrave M. Topical negative pressure therapy: mechanisms and indications. Int Wound J 2004;1(2):95- 106.
  • Ayello EA, Baranoski S, Salati DS. Wound care. Nursing 2005;35(6):36-45.
  • Cutting KF. Identification of infection in granulating wounds by registered nurses. J Clin Nurs1998;7(6): 539-546.
  • Yücel A.Bası Yaraları. E.H. Aydemir, M. Altındaş (Ed.). Cilt Hastalıkları ve Yara Bakım Sempozyumu: 18-19 Ekim 2001-İstanbul: (s.131-150)(internet),Ulaşım adresi:http://www.ctf.edu.tr/stek/pdfs/27/2714AY.pdf (Ulaşım tarihi: 01 Aralık 2008).
  • Chester DL, Waters R. Adverse alteration of wound flora with topical negativepressure therapy: a case report. Br J Plast Surg 2002;55(6):510-511.
  • Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound TNBT enhance bacterial clearance?AnnPlast Surg 2004;52(3):276-279.
  • Gwan-Nulla, DN, Casal RS.Toxic shock syndrome associated with the use of the Vacuum assisted closure device. Ann Plast Surg 2001;47(5):552-554.
  • Mendez-Eastman S. New treatment for an old problem: negative-pressure wound therapy. Nursing 2002;32(5):58-63
  • Krasner DL. Managing wound pain in patients with vacuum assisted closure devices. Ostomy Wound Manage2002;48(5):38-43.
  • Caniano DA, Ruth B, Teich S. Wound management with Vacuum-assisted closure: experience in 51 pediatric patients. J Pediatr Surg 2005;40(1): 128-132.

Topikal Negatif Basınç Terapisinin III. ve IV. Evre Basınç Yaralarının İyileşmesine Etkisi

Yıl 2014, Cilt: 16 Sayı: 3, 28 - 37, 01.12.2014

Öz

Amaç: Bu çalışma, basınç yaralarının bakımında kullanılan Topikal Negatif Basınç Terapisi'nin III. ve IV. evre basınç yaralarının iyileşmesi üzerine etkisini değerlendirmek amacıyla yarı deneysel olarak yapılmıştır. Yöntem: Çalışma, Ankara’daki bir üniversite ve iki devlet hastanesi olmak üzere üç hastanede toplam yedi hastadaki 14 III. ve IV. evre basınç yarası ile gerçekleştirilmiştir. Çalışmada veriler, araştırmacı tarafından hazırlanan ve hastaların sosyo-demografik bilgileri ve basınç yarası gelişimini etkileyebilecek özellikleri içeren Tanıtıcı Bilgiler Formu, basınç yaralarının değerlendirilmesi için Basınç Yarası İyileşme İzlem Çizelgesi ve hastaların işleme bağlı ağrı düzeylerini belirlemek amacıyla Wong-Baker Ağrı Skalası aracılığı ile toplanmıştır. Verilerin analizinde, ortalama, standart sapma, yüzdelik, Wilcoxon eşleştirilmiş iki örnek testi, McNemar ve Friedman testlerinden yararlanılmıştır. Bulgular: Araştırmada yara üzerine uygulanan sekiz Topikal Negatif Basınç Terapisi sonunda iki hafta III. ve IV. evre basınç yaralarının dokuzunda yara alanında başlangıç ölçümüne göre küçülme görülmüştür. Altı yarada doku tipinde bir değişme görülmemiş, 10 yarada yara derinliğinde azalma saptanmış ve 11 yarada başlangıçta yara bölgesinde var olan nekrotik dokuda azalma belirlenmiştir. Alan, eksuda ve derinlik değişkenleri, başlangıç ve bitiş puan ortalamaları arasındaki fark istatistiksel olarak anlamlı bulunmuştur p

Kaynakça

  • National Pressure Ulcer Advisory Panel (NPUAP)[Online]. Available from:http://www.npuap.org/resources.htm, (Accessed 2009 January14)
  • Bennett G, Dealey C, Posnett J. The cost of pressure ulcers in the UK. Age Ageing 2004;33(3):230-235.
  • Butler F. Essence of care and the pressure ulcer benchmark-an evaluation. J Tissue Viability 2008; 17(2):44-59.
  • Casimiro C, Garcia-de-Lorenzo A, Usan L. Prevalence of decubitus ulcer and associated risk factors in an institutionalized Spanish elderly population. Nutrition 2002;18(5): 408-414.
  • Hug E, Ünalan H, Karamemetoğlu ŞS, Tüzün S, Gürgöze M, Tüzün F.Bir eğitim hastanesinde bası yarası prevalansı ve bası yarası gelişiminde etkili risk faktörleri. Turk J Phys Med Rehab2001;47(6):3-11.
  • Keller AJBP, Wille J, Ramshorst VB, Werken VDC. (2002). Pressure ulcers in intensive care patients: a review of risks and prevention. J Intensive Care Med 2002;28(10):1379-1388.
  • Theaker C. Pressure sore prevention in the critically ill: what you don’t know, what you should know and why it’s important. Intensive Crit Care Nurs 2003;19(3):163-168.
  • Bergquised S. The quality of pressure ulcer prediciton and prevention in home health care. Appl Nurs Res 2005;18(3):148-154.
  • Brem H, Lyder C. Protocol for the successful treatment of pressure ulcers.Am J Surg2004;188(1):9-17.
  • Pearson A, Francis K, Hodgkinson B, Curry G. Prevelance and treatment of pressure ulcers in Northern New South Wales. The Aust J Rural Health 2000;8(2):103-110.
  • Smith M. A comprehensive review of risk factors related to the development of pressure ulcers. Journal of Orthopaedic Nursing2003;7(2):94 – 102.
  • Hunter JE, Teot L, Horch R, Banwell PE. Evidence-based medicine: Vacuum-assisted closure in wound care management.Int Wound J 2007;4(3): 256-269.
  • Horn SD, Buerhaus P, Bergstrom N, Smouth RJ. RN staffing time and outcomes of long-stay nursing home residents. Am J Nurs 2005;105 (11):58-70.
  • Baldwin KM . How to prevent and treat pressure ulcers. LPN 2005;1(2):18-25.
  • Uzun Ö, Tan M. A Prospective, descriptive pressure ulcer risk factor and prevalence study at a university hospital in Turkey, Ostomy Wound Manage 2007; 53(2): 44-56.
  • Inan DG, Oztunç G.Pressure ulcer prevalence in Turkey: a sample from a university hospital.J Wound Ostomy Continence Nurs 2012 Jul-Aug;39(4):409-13.
  • Ülker Efteli E, Yapucu Günes Ü. A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units. Ostomy Wound Manage 2013;59(7):22–27.
  • Cervo FA, Cruz AC, Posillico JA. Pressure Ulcers: analysis of guidelines for treatment and management. Geriatrics 2000;55(3):55-60.
  • Cooper SM, Young E. Topical negative pressure. Int J Dermatol 2000; 39(12):896-898.
  • Deva AK, Buckland GH, Fisher E, et al. Topical negative pressure in wound management. MedJ Aust 2000;173(3):128- 131.
  • Fabian TS, Kaufman HJ, Lett ED, et al. The evaluation of subatmospheric pressure and hyperbaric oxygen in ischemic full-thickness wound healing. Am Surg 2000;66(12):1136-1143.
  • Genecov DG, Schneider AM, Morykwas MJ, et al.Parker D, White WWL, Argenta LC. A controlled sub-atmospheric pressure dressing increases the rate of skin graft donor site reepithelialization. Ann of Plast Surg 1998;40(3):219-225.
  • Hersh RE, Jack JM, Dahman MI, Morgan RF, Drake DB. The Vacuum assisted closure device as a bridge to sternal wound closure. Ann of Plast Surg 2001;46(3):250-254.
  • Sahin E. Bası yarasında fizik tedavi uygulamaları. Türkiye Klinikleri JInt Med Sci 2007;3(45):36-44.
  • Joseph E, Hamori CA, Bergman S, et al. New therapeutic approaches in wound care. A prospective randomized trial of TNBT vacuum-assisted closure versus Standard therapy of chronic nonhealing wounds. Wounds 2000;12(3):60-67.
  • Moues CM, Van Den Bemd GJ, Heule F, Hovius SE. Comparing conventionel gauze therapy to Vacum-assisted closure wound therapy: a prospective randomised trial. J Plast Reconstr Aesthet Surg2007; 60(6):672-681.
  • McCallon SK, Knight CA, Valiulus JP, et al. Vacuum-assisted closure versus saline moistened gauze in the healing of postoperative diabetic foot wounds. Ostomy Wound Manage 2000;46(8): 28-34.
  • Ferreira MC, Wada A, Tuma P. The Vacuum assisted closure of complex wounds: report of 3 cases. Rev Hosp Clin Fac Med Sao Paulo2003;58(4):227-230.
  • Müllner T, Mrkonjic L, Kwasny O, Vecsei V. The use of negative pressure to promote the healing of tissue defects a clinical trial using the TNBTuum sealing technique. Br J Plast Surg 1997;50(3):194-199.
  • Tauro LF, Ravikrishnan J, Satish Rao BS, Shenoy HD, Shetty SR, Menezes LT. A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds. Indian J Plast Surg 2007;40(2):133-140.
  • Isago T, Nozaki M. Negative-pressure dressings in the treatment of infected pressure ulcers. Wound Repair Regen January-February 2005; 13(1):A14.
  • National Pressure Ulcer Advisory Panel (NPUAP2007) [Online].Available from:http://www.npuap.org/resources/educational-and-clinical-resources/push-tool (Accessed 2008 December 23).
  • Mani R. Chronic wound management: the evidence for change. Newyork: The Parthenon Publishing Group, 2003;113- 121.
  • Dealy C. The care of wounds. A guide for nurses. Malden: Blackwell Publishing Company,1999;110-127.
  • Lee BY. The Wound Management Manual. Newyork: The McGraw – Hill Companies Inc, 2005;65-72.
  • Lambert KV, Hayes P, McCarthy M. Vacuum assisted closure: a review of development and current applications. Eur J Vasc Endovasc Surg 2005;29(3):219-226.
  • O’Rourke ME. Vacuum-assisted closure therapy. Clin J Oncol Nurs 2006;10(6): 825-826.
  • CopsonD. Topical negative pressure and necrotising fasciitis. Nurs Stand2003;18(6): 71-80.
  • Coggrave M, West H, Leonard B. Topical negative pressure for pressure ulcer management. Br J Nurs 2002;11(6):29- 36.
  • Demir A, Demirtaş Y, Çifci M, Öztürk, N. ve Karacalar, A. Topikal Negatif Basınç (Vakum Yardımlı Kapama [TNBT]) Uygalamalarımız. TurkPlast Surg2006;14(3):171-177.
  • Heyneman A, Beele H, Vanderwee K, Defloor T. A systematic review of the use of hydrocolloids in the treatment of pressure ulcers. JClin Nurs2008;17:1164–1173.
  • Kaufman MW, Pahl DW. Vacuum-assisted closure therapy: wound care and nursing implications. Dermatol Nurs2003;15(4):317-325.
  • Lee SS, Lin SD, Chen HM, Lin MT, Yang CC, Lai CS, Chen YF, Chiu CC. Management of intractable sternal wound infections with topical negative pressure dressing. J Card Surg 2005;20(3):218-222.
  • Banwell PE, Musgrave M. Topical negative pressure therapy: mechanisms and indications. Int Wound J 2004;1(2):95- 106.
  • Ayello EA, Baranoski S, Salati DS. Wound care. Nursing 2005;35(6):36-45.
  • Cutting KF. Identification of infection in granulating wounds by registered nurses. J Clin Nurs1998;7(6): 539-546.
  • Yücel A.Bası Yaraları. E.H. Aydemir, M. Altındaş (Ed.). Cilt Hastalıkları ve Yara Bakım Sempozyumu: 18-19 Ekim 2001-İstanbul: (s.131-150)(internet),Ulaşım adresi:http://www.ctf.edu.tr/stek/pdfs/27/2714AY.pdf (Ulaşım tarihi: 01 Aralık 2008).
  • Chester DL, Waters R. Adverse alteration of wound flora with topical negativepressure therapy: a case report. Br J Plast Surg 2002;55(6):510-511.
  • Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound TNBT enhance bacterial clearance?AnnPlast Surg 2004;52(3):276-279.
  • Gwan-Nulla, DN, Casal RS.Toxic shock syndrome associated with the use of the Vacuum assisted closure device. Ann Plast Surg 2001;47(5):552-554.
  • Mendez-Eastman S. New treatment for an old problem: negative-pressure wound therapy. Nursing 2002;32(5):58-63
  • Krasner DL. Managing wound pain in patients with vacuum assisted closure devices. Ostomy Wound Manage2002;48(5):38-43.
  • Caniano DA, Ruth B, Teich S. Wound management with Vacuum-assisted closure: experience in 51 pediatric patients. J Pediatr Surg 2005;40(1): 128-132.
Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Fatoş Korkmaz Bu kişi benim

Hülya Uçar Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 16 Sayı: 3

Kaynak Göster

APA Korkmaz, F., & Uçar, H. (2014). Topikal Negatif Basınç Terapisinin III. ve IV. Evre Basınç Yaralarının İyileşmesine Etkisi. Hemşirelikte Araştırma Geliştirme Dergisi, 16(3), 28-37.