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Wound management in Buruli ulcer patients
This document provides guidance on wound management and dressing for patients with Buruli ulcer wounds. It discusses the different types of wounds including intentional surgical wounds and accidental wounds caused by injury or disease. It describes the various presentations of Buruli ulcer wounds from clean to infected. The essential steps for wound dressing are outlined, including explaining the procedure, preparing materials, removing the old dressing gently, cleaning the wound, applying a new sterile dressing, and documenting findings. Proper wound management and dressing is important for Buruli ulcer patients to monitor the wound and prevent further infection.
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Wound management in Buruli ulcer patients
- 1. Wound management in Buruliulcer patients BY : JUSTICE ABOTSI
- 2. 2 Wound A break inthe continuity of the skin or membrane. It may be due to Injury- Rupture- “Oedematous form” of BU Disease-
- 3. 3 Types of wound •Intentional wound – Surgical excision, incisions, skin grafting • Accidental wounds – Lacerations, stab wound, burns, traumatic injury, disease (Buruli ulcer)
- 4. 4 Buruli Ulcer Presentation ofBU wounds – Clean wounds – Contaminated wound – Clean-contaminated wounds – Dirty or infected wounds (septic wound) – Grafted wound
- 5. Example of cleanwound 5
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- 8. 8 Dirty and septicwound
- 9. Early and aftergrafting 9
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- 11. 11 Wound Dressing Essentials •Get all requirements set/ready • Ensure privacy and explain procedure • Wound dressing is done after complete/partial bath (of the patient).
- 12. 12 Lotions & Ointmentsused Lotions • Normal saline . • Savlon • Povidone Iodine (aqueous) • Acetic acid ( 1 part of white vinegar in 9 parts of normal saline) is used to clean wound with bluish green discharge. (Pseudomonas infection) after adequate cleaning of the wound , Ointments Betadine or Wokadine Vaseline gauze with betadine or wokadine ointment is applied followed by several layers of sterile gauze or other absorbent sterile materials for adequate absorption of fluid.
- 13. 13 DRESSING REQUIREMENT Top Shelf •Gallipot(s) for lotions. • Dressing forceps. • Dissecting forceps. • Sinus forceps. • Probe • Stitch scissors. • Covered bowl with sterile cotton wool and gauze swabs. Bottom Shelf • Bottles of lotions & ointment e.g. savlon, normal saline, acetic acid Povidone Iodine (Aqueous), wokadine or betadine. • Adhesive plaster • Vaseline gauze • Scissors. • Bandages, crepe. • Covered receiver containing parazone 1:10 for soiled instruments. • Mackintosh with cover. • Receptacle for soiled dressings
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- 15. 15 REMOVING OLD DRESSING Loosenthe soiled dressing by holding the patient’s skin and pulling the plaster or dressing towards the wound. • If the gauze adheres to the wound loosen it by moistening with sterile normal saline solution. • Observe the dressing for the amount, colour, odour and amount of exudates. • Discard the dressing and gloves in a water proof trash “polythene” bag
- 16. Dressing of wounds(steps) •Explain procedure to patients and ensure privacy • Wash and dry hands,prepare and take trolley to patient’s bedside. • Position patient comfortably and protect bed cloths and exposed the wound. • Pour out lotion into gallipots and remove plaster or bandages 16
- 17. continue • Wash anddry hands • Remove soiled dressing with dissecting forceps or gloved hand and discard. • Wash and dry hands again. • Create a sterile field • Clean wound from within outward using one swab only once. 17
- 18. continue • Clean woundwith swabs soaked in saline or boiled cooled water using sterile forceps or gloves • Clean wound with series of swabs until clean. • Apply enough sterile dressing and secure into position (plaster or bandage) • Make patient comfortable in bed. 18
- 19. continue • Explain relevantfindings to patient and thank him/her. • Discard trolley and decontaminate instruments and wash hand. • Remove gloves and screen,wash hands and dry hands. • Document and report state of the wound. 19
- 20. 20 Conclusion • BU woundsrequire special attention • Always make dressing environment is clean • Provide privacy for patient • Observe and record findings • Be looking for signs of restriction of movement at any joint and act accordingly • If possible reffer to the physiotherapist.
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