This document summarizes a presentation on chronic wound management in primary care. It discusses identifying the etiology of chronic wounds, assessing systemic factors, executing basic treatment including wound bed preparation and dressing selection, providing patient education, and establishing long term management plans. Specific guidance is provided on managing common chronic wound types like diabetic foot ulcers, venous leg ulcers, and pressure injuries. Data on chronic wound cases in one primary care setting is also presented, showing most wounds are chronic and related to diabetes. The full presentation is accessible online for free.
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LUMUT WOUND CARE CONFERENCE
2018
CONFERENCE PORTFOLIO
DIABETIC
FOOT
ULCER
VENOUS
LEG ULCER
PRESSURE
INJURY
ARTERIAL
ISCHEMIC
ULCER
SURGICAL
SITE
INFECTION
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CHRONIC WOUND
wounds do not progress normally through the stages
of healing (often getting ‘stalled’ in one phase) and do
not show evidence of healing within four weeks
– Laurie Swezey
Disclaimer : This presentation contain intermediate level of information of wound medicine
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Answer 3
From healthcare
personnel involve directly
in wound clinic (HEALTH
CLINIC)
Answer 4
Answer from the speaker
Answer 1
From healthcare
personnel not involve
directly in wound clinic
(HOSPITAL)
Answer 2
From healthcare personnel
involve directly in wound
clinic (HOSPITAL)
ENGAGEMENT TESTQUESTION: PLEASE OUTLINE THIS WOUND MANAGEMENT
PLAN
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01 03
02 04
CONFIRM AETIOLOGY
IDENTIFY SYSTEMIC FACTOR
EXECUTE BASIC TREATMENT
ADD ON SPECIFIC
TREATMENT
PATIENT’S EDUCATION &
FOLLOW UP
Management Strategy
CHRONIC WOUND MANAGEMENT
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Review behavior that
works against
desired outcome
Motivation for
healing potential /
modify feelings
Overview signs and
symptoms of
complications & how
to report
Reason for chosen
plan of care
Patient’s role in this
plan of care
Discuss plan of care
5 64
2 31
02 Educate Patient & CaretakerCHRONIC WOUND
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01 02 03 04 05
Ischemia with
ABI < 0.4,
TcPo2 < 30
mmHg
Inability to
comply with
treatment
Significant
change over 24
– 48hr
Severe change
in wound pain
Foot infection
with T 38C or <
36C, HR > 90,
RR > 20, SBC >
12000 or < 4000
CRITERIA FOR REFERRALCHRONIC WOUND
06 07 08 09 10
Exposed organ
not previously
exposed
Wound bed
discoloration to
black
Worsening
redness around
the wound
Deteriorating
flap or graft
Worsening foul
smell wound
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Long term application of
compression stockings
Consider referral for
surgical ablation / injection
Reduce pressure in the
venous system of the LL
Control obesity and
exercise
VENOUS LEG ULCERSPECIFIC MANAGEMENT
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Compression TherapyVenous Leg Ulcer
ABI Bandage Sub-
bandage
pressure
> 0.8 4-layer 35 – 40
0.7 2-layer 17 – 25
0.6 2-layer 17 – 25
< 0.5 Only with
medical
supervision
-
ABI: Ankle brachial index
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Repositioning Support surfaces
Heel offloading
devices
Silicone foam and
dressing to prevent
pressure and shear
Increase protein
intake and calories
Prevent and treat
incontinence
associated dermatitis
PRESSURE INJURYSPECIFIC MANAGEMENT
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73% 7% 6% 4%
DIABETIC RELATED
WOUND
VENOUS LEG
ULCER
PRESSURE
INJURY
ATYPICAL
WOUND
Chronic Wound by Aetiology
PKD KUALA LANGAT, SELANGOR
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MANAGEMENT
STRATEGY
Short term and long term goals
KNOWLEDGE
Of different type of wound
SUPPORTIVE
THERAPY
Systemic therapy, topical and
adjunctive treatment in wound care
PRE-ELIMINARY REQUIREMENT
C H R O N I C W O U N D M A N A G E M E N T
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CHLORHEXIDINE
01 HYDROGEN
PEROXIDE02 KMNO4
03
PVP - IODINE
04 ACETIC ACID
05 SILVER
SULFADIAZINE06
THE OLD ARMY – What’s Common in Our
Setting?
S H A H A L A M H O S P I T A L W O U N D & O S T O M Y C O N F E R E N C E
2 0 1 8
4%, 5% 3% 1 : 1000/5000
1%0.25%, 0.5%7 - 10%
ALCOHOL
07 METHYLATED
SPIRIT08 ACRIFLAVINE
SOLUTION09 0.1%96%70%
*Full presentation is accessible @ www.slideshare.net, key word: wan zuraini, the old army
42. C H R O N I C W O U N D
HOME CARE WOUND CARE
5.1
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SKOP
PERKHIDMA
TAN DCS
• Perkhidmatan perawatan termasuk
latihan teknik mencegah berlakunya kudis
tekanan, pendidikan mengenai rawatan
luka dan penjagaan kebersihan, menukar
tiub nasogastrik, kateter urethral,
pemeriksaan darah ujian gula darah dan
mengambil tekanan darah dan
penyediaan sokongan emosi.
1. Perawatan
• Aktiviti rehabilitasi bagi kes yang
memerlukan termasuk rehabilitasi
pergerakan aktif dan pasif serta latihan
activity of daily living.
2. Rehabilitasi
• Perkhidmatan ini merangkumi perawatan
yang melibatkan penjagaan paliatif.
3. Paliatif
DOMICILIARY CARE
SERVICES
46. THIS PRESENTATION IS
ACCESSIBLE FREELY
THROUGH:
C H R O N I C W O U N D M A N A G E M E N T
www.slideshare.ne
t
Key term: wan Zuraini, wound, wound
wound, wound dressing
1. Minta list nama 2. chill as a teacher….3. isi kan soalan pada kertas 4. introduce yourself
1. Combine 2 in 1 presentation 2. dilemma question
Clump all management into 1 ..regardless any etiology and to reduce clumsiness
To change the image behind the Mock up.
Select the layer - > Right Click -> Send to Back -> Delete the image -> Drag & Drop your Own Picture -> Send to Back (again)
Intrcellular Hyperglycemia – aldose reductase – increase sorbitol from glucose – abnormal management of matrix protein (collagen)
bacteria and endotoxins can lead to the
prolonged elevation of pro-inflammatory cytokines such as
interleukin-1 (IL-1) and TNF-α and elongate the inflammatory
phase.
increased level of matrix metalloproteases (MMPs), degrade ECM
Supression fibroblast proliferation and
collagen synthesis – poor granulation, hypoxia-inducible factor-1 (HIF-1)
Chemo drugs decrease RNA DNA – fibroplasia
neutropenia, anemia, and thrombocytopenia, - impede inflammation
If you want to change the picture background.
1) Select the shape (in front of the image) and send it to back
2) Delete the image and drag and drop you own // 3) Send to back the new image