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Malunggay And Guava Leaves Decoction


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Malunggay And Guava Leaves Decoction

Malunggay And Guava Leaves Decoction

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  • Sir, hindi po definition ng wound ang nilalagay sa Theoretical Framework. Theoretical Framework can be a whole Chapter that presents the basis of your research, describing established theories relevant to your study that provides the logic of your own theorizing.
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  • Good day sir..our experimental thesis is quite similar on ur study. Can we ask to have a video on how can we extract malunggay leaves to get its antiseptic compound.. I will leave my number on this site 09469242856.
    Thank u and more power,!
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  • ung abstract! :(
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  • Good day sir!!! our thesis was somewhat related to ur study...can we have ur contact number..for somequestions regarding the results of ur study and we would also like to adopt ur methodology regarding the formulation of ur malunggay decoction...hoping for ur reply..I will leave my number on this site...09062698839.thanks! and Godbless!
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  • pls let me download this! I really need it for my masterals!
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  • 1. MALUNGGAY AND GUAVA LEAVES DECOCTION ON WOUND HEALING: BASIS FOR HEALTH EDUCATION _______________________ A Research Proposal Presented to the Faculty of the Graduate School Cebu Normal University __________________________ In Partial Fulfillment Of the Course Requirement for the Research Process I ___________________ Dave Jay S. Manriquez September 2008 1
  • 2. ACKNOWLEDGMENTS “There is no failure except in no longer trying. There is no defeat except from within, no really insurmountable barrier save our own inherent weakness of purpose.” A. Kin Hubbard The researcher is extremely grateful to the very significant people who helped him realize this study … My parents Patricio & Celestina, for their imperishable support, inspiration and encouragement… My sisters, who have been pushing and giving me their friendly pieces of advice, constantly prod me to finish... My brothers, whose love and kindness and prayer thoughts make me strong… My friends and relatives, who boost my morale, always inspire me… To the respondents for their support, help, and sparing time to answer the questionnaire… ALMIGHTY GOD, my perpetual guide, praised for the indescribable gift... 2
  • 3. This research work is dedicated to: God Almighty My parents Patricio & Celestina To my brothers & sisters And to nurses who endure……………… 3
  • 4. TABLE OF CONTENTS Page Title Page…………………………………………………………………. i Acknowledgment…………………………………………………………. ii Dedication…………………………………………………………… …… iii Table of Contents………………………………………………………… iv List of figures……………………………………………………………… v CHAPTER I THE PROBLEM AND ITS SCOPE Rationale of the Study…………………………… 1 Theoretical Framework………………………….. 3 Conceptual Framework………………………….. 12 Statement of the Problem……………………….. 14 Hypothesis………………………………………… 14 Significance of study……………………………… 15 Definition of terms………………………………… 17 Scope and delimitation of the study……………. 18 II RESEARCH METHODOLOGY Research Design…………………………………. 19 Research Locale………………………………….. 19 Research Respondents………………………….. 19 Research Procedure……………………………… 20 Statistical Treatment……………………………… 25 BIBLIOGRAPHY………………………………………….. 27 CURRICULUM VITAE……………………………………. 28 4
  • 5. LIST OF FIGURES Figure Title Page 1. Theoretical Framework 11 2. Conceptual Framework 13 3. Guava Leaves Decoction-Steps of Application 23 4. Malunggay Leaves Decoction-Steps of Application 24 5
  • 6. Presented by: Dave Jay S. Manriquez RN. MALUNGGAY AND GUAVA LEAVES DECOCTION ON WOUND HEALING: BASIS FOR HEALTH EDUCATION RATIONALE: Human being as known to all have this great thirst for knowledge. Through the years technology has gone advanced. The introduction of medicines which has become a big part to human race. The increasing cost of medicines nowadays prompts the people to use herbs efficiently. In the past few years, a renewed interest on this natural method of treatment arose not only in the Philippines but worldwide. Research and studies have been made and conducted and so far it was found out that medicinal plants are also effective as well. To bring back to natural healing the utilization of medicinal plants is need in our time. We need practical remedies for our common illness how we must rediscover the healing powers in our nature. Plants known for their efficacy and usefulness is observe to be beneficial to countrymen for a numbers of reasons. Firstly, this would provides on alternative mode of theory for common ailments which otherwise would be treated with pharmaceuticals medicines. Secondly, there would be less dependency imported medicines for our health needs and consequently minimize 6
  • 7. dollar drain. Lastly, these herbal plants would be readily available and would serves as a cheap source of relief to the people. People are exposed to environmental hazards as sharp objects and others that can inflict wound. Untreated wounds can result into some complication like infection, thus it must be proper to treat it promptly and effectively. Among Filipino two must common herbal plants use in their immediate environment known for centuries are malunggay (moringa lietera) and guava (psidium guajava). Malunggay or horse radish, is particularly valuable on account of its iron and phosphorus content, especially calcium. Calcium plays a very important function is wound healing. While guava in rural folks used to treat fresh wound in a procedure they call “hunad” no result have ever been documented to confirm any positive or negative outcome of such practice hence this study was considered the proper approach of finding out possible effective use of these two, herbs and which of these two herbs is more effective in enhancing wound healing that would later become an alternative treatment for people who have less access to antiseptics or antibiotics 7
  • 8. Theoretical Framework Wound is a break in the continuity of the skin .the body’s response to injury and the healing process is both local and systemic, that is, the total body as well the local area is involved. Classification of wounds Close and Open wounds – A close wound, wound that has no break in skin integrity .In an open wound, there is desruption in the continuity of the skin and mucus membrane. Intentional and Accidental wound –A surgical operation is an intentional wound wherein there is disruption of the skin integrity. Incision and Lacerated wound – An intentional wound made up with sharp instruction is often called an incised wound and characterized by sharp. Clean cut edges. An accidental wounds is laceration wherein the wound edges maybe similar confused star like or ovules with tissue Abrasion and Superficial wounds –covered by scraping of skin directly over a firm fixed surface wherein the epidermis or possibly the dermis is removed. When skin is broken, wound is exposed to additional hazards, since the tissue may be invaded by foreign materials such as bacterial, dirt and general 8
  • 9. complication. The seriousness of and open wound depends on the extent of tissues damage skin being tough and elastic and with a rich blood supply, role rates injury well and recovers quickly while subcutaneous fatty tissue are more easily deprived of their blood supply(Benton 1991) Wound Healing Process Healing is a result of a series of complex biological events taking place over the period of time. Viewed in a simplest way, in untreated but complicated wound, the steps are as follows: when tissues are cut, the edges of the wound separates, apparently pulled apart by the elasticity of the skin. Blood from the severed blood vessels fill the cavity of the wound and overflows from its edges. Blood clots and eventually the surface of the dries out and becomes shard forming scab. During the first twenty four hours the scab shrinks drawing the edges of wound close together. If the scab sloughs off or is removed after a week layer of reddish granulation tissue will be seen to have covered the cut edges of the subcutaneous tissue. Gradually, grayish thin membranes extend out from the skin edges and eventually covered the whole surface. The actual size of the wound, meanwhile is steadily reduced by a process of contraction until finally no raw surface is seen. After the wound is sustained, several changes occur simultaneously bleeding either stops spontaneously or is controlled by other means. If the surface of the wounds are in fairly close contact, the area is filled with blood and tissue juices which is addition to other functions, effectively cover the wound. A scaffold 9
  • 10. consisting of a fine network of protein molecules called fibrin then forms, and into this grow two tissues essential for repair: these are the connective tissues and tiny capillary blood vessels. At this stage the repair tissues called granulation tissue, can be seen in healing open wound as red, velvety granular surface. As time passes, several changes take place simultaneously. The fibroblasts produce fibrous protein called collagen which gives the wound strength. The histocytes scavenge cellular debris and foreign bodies. The replacement of red capillaries by white collagen explain why a new scar is red at first but then gradually becomes white over the course of weeks (Benton, 1991:345). In wound healing, scaling occurs within hours by the formation of blood clots the surface of which becomes dehydrated to create a scab. Epithelial continuity is restored within the twenty-four hours to forty-eight hours. Fibroblastic bridging does not become evident until three to five days following the incision and demonstrable collagenation only begins to appear in the later part of the first week. Thereafter, the process of accumulation of collagen and the slow compression and devascularization of the newly formed connective tissue occur within twenty-four hours; neutrophils appear at the margins of the incision, moving forward along the margins of the dermis beneath the surface scab, to fuse in the midline, thus producing a more continuous but thin epithelial layer, this epithelial response is amazingly fast and epidermal continuity is reestablished in twenty-four to forty -eight hours, long before the subjacent connective tissue reaction has begun to evolve. 1
  • 11. By day three, the neutrophils have largely disappeared and are replaced by macrophages. Granulation tissue progressively invades the incisional space. Collagen fibers are now present in the margins of the wound. Epithelial cell proliferation continues, thickening the epidermal layer covering. By day five and seven the incisional space is filled with granulation tissue, neovascularization is maximal. Collagen fibrin become more abundant and begins to bridge the incision. The epidermis recoveres its normal thickness and differentiation surface cell yields natural epidermal architecture, with surface keratinization. During the second week there is continued accumulation of collagen and proliferation of the fibroblasts and leukocytic infiltrates edema and increased vascularity disappear. At this time, the long process begins, accompanied by increased accumulation of collagen within the incisional scar, accompanied by a regression of vascular channels. By the end of the first month, the scar compresses a cellular connective tissue devoid of inflammatory infiltrates covered now by intact epidermis (Robbins, 1985). Factors Affecting Wound Healing These are several factors that affect healing the wound according to Luckmann and Sorensen (1988:85-89). 1. Age. Years of exposure to the ultraviolet lights results in decreased blood perfusion to the skin and atrophy of tissue macrophages system in older people. Healing is therefore faster and less complicated by 1
  • 12. infection in younger person. But it is of less importance compared to the other factors. 2. Nutritional Status. Optimal body functioning is most like to occur in a well nourished person. The malnourished person may not have the nutritional reserve to facilitate healing. Wound in obese person heals slowly because adipose tissue has poor perfusion. 3. Tissue Involved. Tissues with good blood supply heal better than those with less vascular tissue. Wounds on hand and head heal faster than those on the leg and foot. Muscle tissue heals faster than those adipose tissue. 4. Blood Supply to Injured Tissue. Although tissues with blood supply heal faster, inflammation of the wound site may reduce circulation and impede healing. 5. Presence of Infection. Infection inhibits wound healing and should be prevented by strict asepsis. Wound should be cleansed first with soap and water thoroughly before its treatment. Hence, to prevent infection, materials for wound treatment should be cleansed and sterilized. 6. Presence of Foreign Bodies. Foreign bodies inhibits wound heal and may cause infection. Removing penetrating objects is usually done. Wound must also be covered with dressing not to tightly place. 7. Wound Treatment. In the Philippines, the medicinal plants have acquired great significance, considering their availability in the community and the arising cause of drugs. However these medicinal 1
  • 13. herbs are not fully endorsed by the Bureau of Food and Drug especially, if there are herbal supplements to be taken in orally. Clinical data on many herbs are scare, making predictions for interactions with medication difficult or impossible. Most human trials performed with these herbs have been small scale fewer than 100-200 subjects. Safety assumes appropriate when the utilization of the herb is short- term and not medically contraindicated (Nettina, 2001:1680). Guava (Psidium guajava). Bayabasa originated form south America, where the Spaniards found it as a cultivated tree and supposed to have carried it from one country to another, across the Pacific to the Philippines. Being hardy and resistant to drought, it readily adjusted to the new climate. Its seeds were easily dispersed by birds and it rapidly grew and formed thickly. The plant is known scientifically as Psidium Guajava Linn and is a member of the family Myrtaceae. It has many local names in the country, among them are; Bayabas in Bicol; Geyabas in Bontoc; Bayabas in Cebu Bisaya, Ibanag and Tagalog; Gaiyabit in Ifugao; Bagabas in Igorot; and Baibes in Sulu. The Guava is one of the most popular and common fruits in the Philippines. The fruit is a favorite of the Filipinos. It is extensively used iin the manufacture of jellies, owing to the presence of a considerable amount of pectin. The ripe fruit is eaten as a vegetable and is used as seasoning for food. It is also used to induce contraction of the tissue or to arrest bleeding. A decoction of the 1
  • 14. unripe fruit, leaves, cortex of the bark and roots, is used in washing ulcers and wounds. The bark and leaves are utilized to promote the healing of wounds. They are also anti-diarrhetic. The dry bark decoctions are internally given to remedy stomachaches. Guavas are excellent sources of Vitamin C. The tree reaches a height of about 8 meters. The young branches are four-angled. The 5-to12-centimeter-long oblong leaves are oppositely arranged and are pointed at the tip and rounded at the base. The stalks bear 3-to 4- centimeters wide white, solitary or 2 to 3 flowers. The fruit is rounded, 4 to 9 centimeters long, and green but yellowish when ripe. It contains numerous seeds imbedded in an aromatic and edible pulp (Gutierrez, 1980). Malunggay (Moringa Oleifera). Malunggay, moringa oleifera Lam., of the family Morinngaceae, was introduced from Asia or Malayasia during the prehistoric times. It is generally found in the tropics and is widely cultivated throughout the Philippines; Malunggay, Malunggai, Kalungai, Kalamungi; Malnagai in Tagalog; Arunggai in Pangasinan; Balungai in Bisaya, Maronggay in Ilocano and Ibang; Monongoi in Sambali. The plant is known in English as Horse- radish tree. Filipinos are not fully aware of the medicinal qualities of this common backyard. Its pods, flowers, leaves and twigs are, however, frequently used as vegetables which are considered to be rich in Calcium, Phosphorus and Iron. A decoction of the roots is externally employed to cleanse sores and ulcers, and to cure scurvy and high fever. The young roots are extensively used as local 1
  • 15. medicines for epilepsy, hysteria, urinary complaints, paralysis, chronic rheumatism, gout, dropsy, indigestion and enlargement of the spleen and liver. They are likewise employed as a stimulant, a diuretic and an antidote for snakebites. Root decoction is very helpful in relaxing the throat, curing hoarse voice, and in relieving sudden abnormal involuntary contraction of the muscles. Root extracts are regarded as cure for hiccups, asthma, lumbago and inflammations. They are also employed for earaches and tooth decay. The powdered rootbark is used as a snuff for headaches. The bark is considered as cardiac stimulant, a cure for asthma and cough, and as relief for pain. The young leaves are popularly used as stimulant for secretion and flow of milk. They are also employed to promote digestion and nausea, and to alleviate constipation, hysteria and flatulence. Leaf intake is recommended for gonorrhea. Similarly, leaf extracts are employed as a poultice on the abdomen to expel intestinal worms, and are mixed with honey to produce a healing ointment for the eyes. The flowers, boiled in milk, are employed as an aphrodisiac. This tree attains a height of 8 meters. It grows rapidly even in poor soil. It has a corky, grummy bark and soft, white wood. The compound leaf is composed of 3 to 9 thin, egg-shaped, 1-to 2-centimeter-long leaflets arranged on a compound (thrice pinnate) leafstalk. The white and fragrant flowers are 1.5 to 2 centimeters wide. The fruit is a 15- to 30-centimeter-long pendulous, three angled pods. The 3-angled seeds are winged. The roots posses the pungent taste of horse-radish (Gutierrez, 1980). 1
  • 16. WOUND Close and open wound Intention and accidental wound Incision and lacerated wound Abrasion and superficial wound Wound healing process Wound Treatment Guava decoction Malunggay decoction Figure 1. Theoretical Framework of the Study 1
  • 17. Conceptual Framework The study focus primarily on determining the effectiveness of guava and malunggay leaves decoction on wound healing among selected individuals in San Fernando, Cebu. The following subsidiary problems were formulated to answer the main problem. First, the profile of the selected study participants in terms of: age, height and weight are determine. This is followed buy obtaining the total measurement of the wounds before and three days after application of the medicinal herb decoction of guava and malunggay. The significant mean difference in the wound size before and after application of the leave decoction was tested. The outcome of the study is the basis for a propose health education program. 1
  • 18. SELECTED CHILDREN WITH WOUNDS SAN FERNANDO, CEBU Guava Leaves Decoction Malunggay Leaves Decoction Effectiveness in promoting wound healing Basis for Health Education Program Figure 2. CONCEPTUAL FRAMEWORK 1
  • 19. Statement of the Problem This study aims to determine the effectiveness of malunggay and guava leaves decoction on wound healing among selected individuals in Brgy. Tisa, Cebu City. It will answer the following specific questions: 1. What is the profile of the selected study participants in terms of: 1.1 age; 1.2 height and 1.3 Weight (in cm)? 2. What is the total measurement of the wounds in terms of length, width and depth: 2.1 before and 3 days after application of the guava leaves decoction, and 2.2 before and 3 days after application of the malunggay leaves decoction? 3. Is there a significant mean difference in the wound size before and after application of decoction? 4. What health education program can be proposed based on the findings? Statement of Hypothesis Ho1 There is no significant mean difference of the wound size before and after the application of the two types of decoction. Significance of the Study 1
  • 20. Nowadays, pharmaceutical medicines are getting expensive in addition to the minimal income of our people. The chances of purchasing these medicines are getting slender and more people are suffering great complications that sprung only from small-uninfected wounds. As a remedy, there is a need to find some alternatives that can be equally effective bit less in cost. Nursing Education. The findings of this study would serve as a valuable reference in classroom discussions on indigenous medicinal sources that can be benefit the larger population of the Philippines society due to its accessibility to the masses and affordability. Nursing Practice. For nursing practice to be more effective, it needs to be affordable and more accessible to the masses. With the rising cost of antiseptic agents, some people with wound fails to take appropriate measures for the promotion of wound healing. This would be where herbal plants can do so much help. Wait its accessibility and very low cost more and more people could have more options in “nursing wounds”. Nursing research. The findings of this study would serve as a significant contribution to the field of nursing research. Presenting remarkable results will stimulate researchers to conduct further studies on local and overlooked plants that would provide cure to wounds, hence creating a breakthrough on the effectiveness of herbal medication. Furthermore, this may attract the attention of drug laboratories and prompt them to do more scientific studies could be utilized for therapeutic purpose. 2
  • 21. Families. The intrinsic, health promoting value of the study will surely contribute to the community’s self-help programs. This will be beneficial to families in the community especially those considered less fortunate. The knowledge that natural resources are readily available to treat fresh out wounds reduces the waste of money and effort in purchasing pharmaceutical medicines. 2
  • 22. Definition of Terms The terms use in the study are operationally define as follows: Effectiveness – this terms refers to the ability of an herbal leaves decoction in desired wound healing. Wound – this terms refers to the fresh, uninfected break in the skin caused by physical injury located between the knee and ankle. Decoction – this phase refers to the liquid obtain by boiling a desired amount of leaves in one liter of water for five minutes. Healing – the process or act of regaining skin integrity through granulation formation as evidence by decrease in length, width and depth of wound in milliliters and absence of discharges. Health Education – this term refers to the proposal health teaching program base on the outcome of the study. 2
  • 23. Scope and Delimitation of the Study The study focus on the effectiveness of the guava leaves decoction versus malunggay leaves decoction (independent variable) in promoting wound healing (dependent variable) after three days application. It covers ten respondents who are living in San Fernando, Cebu between the ages 6 to 12 years old, regardless of sex. Furthermore, each individual did not have conditions which could affect the normal healing process, like Diabetes Mellitus and presence of foreign bodies, infection and malnutrition. The open is found in the areas between the ankle and knee, regardless of length, width and depth. They are one day old uninfected wounds. The criteria set for selection on study subjects serve as the means of controlling extraneous variables as nutritional status, blood supply to the area affected, and presence of infection and some factors that may influence healing. 2
  • 24. RESEARCH METHODOLOGY Research Design This study utilize the two groups before and after quasi-experimental design to determine the effectiveness of guava and malunggay leaves decoction in the promotion of wound healing after three (3) days application. Research Locale The location of the study is in Barangay Tisa, Cebu City. It has a population of 500 individuals. Research Respondents Ten study participants coming from Brgy Tisa, Cebu City are selected by non-probability purposive sampling considering the criteria for selection of subjects set as follows: B. An individual with a one day old uninfected, open wound located between the knee and ankle regardless of length, width and depth. C. Non-diabetic and absence of foreign bodies. D. Children between the age of 6-12 years old regardless of sex. E. Children whose wound is evaluated by the doctor to be uninfected. F. Children with height and weight in proportion to age according to the standards set by the Department of Health. 2
  • 25. Research Procedure Data collection methods and instrumentation Data Gathering A. For Guava Leaves Decoction 150grams young guava leaves 1 liter of water 1 sterile container 1 sterile strainer B. For Malunggay Leaves Decoction 150grams malunggay leaves 1 liter of water 1 sterile container 1 sterile strainer The steps in preparing the herbal decoction are as follows: 1. Add the desired amount of guava/malunggay leaves to liter of boiling water. 2. Let it boil for 5 minutes. 3. Strain using sterile strainer. 4. Cool the decoction then transfer it to a sterile container. 2
  • 26. Upon permission from the Barangay Captain, the subjects are sought. Each time the subject is found to have a one day old, uninfected open wound, he/she is assume for any history of familial disease of Diabetes Mellitus with ages between 6-12years old, without early signs of infection as swelling, redness, warmth and loss of function; and whose height and weight is in proportion to age according to height/weight standards set by the Philippine Department of Health. A written consent from the parents of the study subject regarding the decoction treatment is sought. The study subjects one day uninfected, open wound is cleanse with running tap water and refer to the physician at Brgy Tisa Health Center for medical prescription of Tetanus Toxoid as prophylaxis if needed. The length, width and depth of the wound is measure with a sterile paper ruler calibrated in milliliters. The measurements as well as the presence of discharges are recorded as the baseline data, to describe the description of the wound before the application of the leaf decoction. After the assessment procedures, the wound is then cleanse with guava and malunggay respectively. It is left uncover to promote dryness and thus promote wound healing. For the next two days of treatment, the guava and malunggay leaves decoction is use to cleanse the wounds ( 5 respondents for guava decoction and 5 respondents for malunggay decoction ) once a day at 8:00 o’clock in the morning. 2
  • 27. Subjects are seen for the last time for final assessment of the wound on the fourth day. The length, width and depth are again measure using the sterile paper ruler calibrated in milliliters. The presence or absence of discharges is noted. All the assessment findings are recorded as data to describe the condition of the wound after three days application of guava leaves decoction and malunggay leaves decoction. The research instruments that are utilize in data collection are the following: observation sheet, sterile paper ruler, height and weight chart, weighing scale and tape measure to determine the height. 2
  • 28. Figure 3. Guava Leaves Decoction Steps of application 2
  • 29. Figure 3. Malunggay Leaves Decoction Steps of application 2
  • 30. Statistical Treatment To facilitate analysis, the data recorded in the observation sheet are assign corresponding scores as follows: 4.1. As to the profile of the correspondents age, weight and height are computed as to mean values. 4.2. The measurements of the length, depth and width in milliliters are taken as the raw scores. 4.3. The scores before guava leaves decoction and malunggay leaves decoction treatment in the observation sheet are sum up to represent the X1 and all the scores of the three days of treatment are sum up to represent the X2. The sum of X1 and X2 are subject to computation for the mean using the formula: Σx X= n Where: Σx = sum of X n = number of the study subject 3
  • 31. To determine if there is a significant difference in the length, width and depth of the wound before and after application of the guava and malunggay decoction, of one of each group the correlated or paired t-test will be perform at 0.05 level of significance. The computed t-value will be obtain using the formula: d t= sd/√n Where: d= mean difference before and after decoction sd = standard deviation of the difference n = is the number of the samples 3
  • 32. Bibliography: BOOKS “Wounds and its Classification” Benton, Williams. Encyclopedia Americana, Vol.9, U.S.A. Grolier Incorporation, 1991. “Healing Powers of Herbal Medicines” Gutierrez, Hermes. Philippine Materia Medical, Vol.1 Public National Research Council of the Philippines, 1980. “Wound” Luckmann and Sorensen. Medical-Surgical Nursing, Philippine Publishing House, 1985. Nettina, Sandra M. The Lippincott Manual of Nursing Practice 7th Edition Philadelphia: Lippincott Williams and Wilkins, 2001. “Wound Healing Process Robbins, George. Pathological Basis of Disease, St. Louis: C.V. Mosby Company, 1985. INTERNET http// http// 3