320 likes | 2.49k Vues
Hydrotherapy & Burn Wound Care. Bailey Burge RN, BSN Burn Intensive Care Unit April 28, 2011. Objective. Identify important aspects of hydrotherapy and wound care. Hydrotherapy Room. Procedure Room Environmental comfort Patient’s room remains “safe-haven” Water pressure
E N D
Hydrotherapy & Burn Wound Care Bailey Burge RN, BSN Burn Intensive Care Unit April 28, 2011
Objective • Identify important aspects of hydrotherapy and wound care.
Hydrotherapy Room • Procedure Room • Environmental comfort • Patient’s room remains “safe-haven” • Water pressure • Availability of specialized equipment and products • Aids in maintenance of ROM
Burn Wound Care • Greatest threat to survival after resuscitation • Goal: • Early wound closure • Maintain function • Prevent infection • Introduction of topical antibiotics has significantly reduced mortality
Process • Cultures • On admission and every Monday & Thursday • Assists in treatment modality & reduces cost • Debridement • On admission • Get between dead and viable tissue • Pictures • On admission, every Wednesday and graft T/D day • Clean • PI sponges & sterile gloves per body part • Dressings • Determined by cultures, degree of burn, staff experience, physician • Wrap • Kerlex, surginet, ace, burn vests
Specific Agents Silver Dressings: Topicals: • Aquacel Ag • Silver Nitrate • Silver Matrix • Neosporin • Mafenide acetate (Sulfamylon) • Santyl • Bactroban • Nystatin • Povidone Iodine Temporary wound coverings: • Porcine xenograft • Human cadaver allografts • Biobrane
Graft & Donor Sites Graft: Graft care: • Split thickness skin graft • Meshed (1:1.5, 1:2, 1:3, 1:4) • Unmeshed (sheet graft) • Full thickness skin graft • Permanent wound coverage • Initial dressings provide security and compression • Splint applied if crosses joint • Protect from pressure, shear and movement • Keep initial dressing on until 3 days post-op • Take down day: • % adhered • Remove every other staple • Picture • Cultures
Graft Site Retrieved from: http://apps.tpta.org/courses/Burn06/Graft.htm
Graft & Donor Sites Donor: Donor Care with Glucan: • Harvested tissue site • Painful • Monitor bleeding • Heals by reepithelialization • Initial dressing remains intact for 48 hrs post-op • Take down day: • Remove outer dressing • Observe site • May appear yellowish and “soupy” • Remove staples • May leave open to air • Treat like a scab
Donor Site Retrieved from: http://www.woundsinternational.com/pdf/content_196.pdf
Summary • Hydrotherapy treatment continually washes away dead skin and bacteria and decreases the risk of infection • Patient’s room can remain a safe place • Burn wound care is performed to promote healing, maintain function and prevent infection and burn wound sepsis.
References • American Burn Association. 2007. Advanced Burn Life Support Course: Provider Manual. Chicago, IL.: American Burn Association. • Beldon, P. (2007). What You Need to Know about Skin Grafts and Donor Site Wounds. Retrieved from http://www.woundsinternational.com/pdf/content_196.pdf • Herndon, D. N. (2007). Total Burn Care. Galveston, TX: Elsevier Health Sciences. • Weber, J., & McManus, A. (n.d.). Infection Control in Burn Patients. Retrieved from http://www.worldburn.org/documents/infectioncontrol.pdf • Wiegand, D. & Carlson, K. (2005). AACN Procedure Manual for Critical Care. St. Louis, MO: Elsevier Saunders