EBN terkait keefektivan modern dressing

1. Tradi&onal Evidence Base
To Dressing
H a m k a
Ns (Ners) Register Nurses (RN) Enterostomal Therapist(E.T.)
NCI Centre Kalimantan
A Professional Nurse Lead Services For OSTOMY, Wound,
Continence Need

2. 13.466 ISLANDS AND 34
PROVINCIES AND 236.641.326
PEOPLE AND 2.380 HOSPITAL

3. Evidance base
Best Practce
Care studies
Summary
Learning ObjecEves

4. Luka…
Tutup atau
Buka?

5. MOIST WOUND HEALING
• George D Winter (1962): proved that
wounds that were kept moist, healed better
than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING

6. JUSTIFIKASI
1. FIBRINOLISIS : fibrin cepat hilang pada suasana lembab oleh netrofil
dan sel endotel
2. ANGGIOGENESIS : proses akan lebih terangsang pada suasana
lembab
3. INFEKSI : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. PERCEPATAN PEMBENTUKAN SEL AKTIVE : invasi netrofi
yang diikuti olehmakrophag, monosit dan limfosit ke daerah luka akan
berfungsi
lebih dini.
5. PEMBENTUKAN GROWTH FACTOR : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.

7. Your Best Choice
Your
GAUZE
Best
Friends

8. GAUZE
Always
& Forever

9. Menyerapkah?
EfekESah?

10. GAUZE
Always
& Forever

11. TUJUAN PEMILIHAN BALUTAN
q Membuang jaringan mati, benda
asing dan partikel
q Balutan dapat mengontrol kejadian
infeksi / melindungi luka dari trauma
dan invasi bakteri
q Mampu
mempertahankan
kelembaban
q Mempercepat proses penyembuhan
luka,
q Absorbs cairan luka
q Nyaman digunakan, mengurangi
nyeri,
q Proteksi periwound
q Kontrol bau, .

12. MODERN DRESSING VS TRADITIONAL
DRESSING

13. HIDROCOLOID GAUZE
Luka Tekan Sembuh 72% lebih Cepat dibanding dengan
Kasa (Singh et al., 2004)

14. Silver Foam mendukung penyembuhan luka kronis lebih unggul
dan mampu menjaga kelembaban lebih baik (Münter et al.,
2006)
FOAM SILVER DRESSING GAUZE

15. Hidrogel diganE per empat hari dan kasa povidone-iodine diganE seEap hari.
Penyembuhan Engkat yang lebih Enggi menggunakan hidrogel (84%) vs kasa
povidone-iodine-direndam (54%) (Kaya et al., 2005)
HIDROGEL GAUZE + IODINE

16. E
X
P
E
N
S
I
V
E

18. Modern Dressing : BHP dalam 15 Hari rawat
Rp.335.500 dengan Kemajuan Penyembuhan
Luka 7,75point
Tradi&onal Dressing : BHP dalam 15 Hari
rawat Rp.234.375 dengan kemajuan
penyembuhan luka 2,62point
Reference : Dhalia Care Bali

19. Biaya Perawatan dibandingkan
dengan Percepatan Perbaikan
Luka : Lebih efek&f
dibandingkan Konvensional
Reference : Dina (2009)

20. Evidence Sources
Reference : Medical Technology AssociaEon Of Australia

21. Expensive??

22. CLINICAL
PRACTICES
• Cleansing
• AdjuncEve treatment
• Dressing (modern and
alterna,ves)

23. PhotoGrid_1409932205717.jpg PhotoGrid_1409932205717.jpg
COURTESSY BY NCI CENTRE KALIMANTAN

24. COURTESSY BY NCI CENTRE KALIMANTAN

25. CASE STUDY: DFU HEALED IN 14 WEEKS
Mr.T wound healed at 14 weeks.
COURTESSY BY WOCARE CENTRE BOGOR

26. CASE STUDY : DFU COMPLECATED GAS GANGREN
HEALED IN 12 WEEKS
COURTESSY BY IKRAM WOUND CARE MAJENE

30. COURTESSY BY LUDY BINTARO

33. INDONESIAN NURSING PRIVATE
PRACTICE

34. SERVICES
HOSPITAL AND HOME VISIT PRIVATE CLINIC

35. New project- MOBILE CLINIC, 2014
Adopted from SILVER CHAIN Clinic- Perth

37. NCI CENTER
KALIMANTAN
JL. ANGGUR NO.22 RT56 SIDODADI
SAMARINDA
0541-206053/085250575811
KONSUL VIA WA (085656856834)
www.ncicentre.com
Dapatkan Update Materi di
FANSPAGE NCI CENTRE :
1. Klik
hhps://
www.facebook.com/
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2. Like
3. Get Your PPT

38. Reference :
• Angsko, Arizona. www.footcaredirect.com.
• Bryant A, Ruth, et.al. Acute and Chronic Wounds: Current Management Concepts. 3rd Ed.
Philadelphia: Mosbi Elsevier (2007), p.
• Dina Dewi Sar,ka Lestari Ismail , et.all (2009). Penggunaan Balutan Modern Memperbaiki Proses
Penyembuhan Luka DiabeEk. Jurnal Kedokteran Brawijaya
• Carville, Kerlyn. Wound Care Manual. 3rd Ed. Western Australia: Silver Chain Foundation
(1998)
• Carville, Kerlyn. Wound Care Manual. 5rd Ed. West rn Australia: Silver Chain Foundation
(2013)
• N.n (2014). Cost-EffecEvness of MWCDs. Australia : Medical Technology AssociaEon Of Australia,
hhp://www.mtaa.org.au/about-the-industry/value-of-technology/wound-care/cost-effecEveness
• Heyer, K, et.all. (2013) EffecEveness of Advanced versus ConvenEonal Wound Dressings on Healing of
Chronic Wounds: SystemaEc Review and Meta-Analysis. Dermatology Journal. Germany
• Haddad L, Steven, et.al. AAOS (American Academy of Orthopedic Sugeons). October
2007 www.orthoinfo.org
• http://www.foot.com/info