Recommended
Recommended
More Related Content
What's hot
What's hot (18)
Viewers also liked
Similar to PRESSIONE NEGATIVA
Similar to PRESSIONE NEGATIVA (20)
Recently uploaded
Recently uploaded (20)
PRESSIONE NEGATIVA
- 1. MANAGEMENT OF PERISTOMAL SKIN COMPLICATIONS WITH NEGATIVE PRESSURE WOUND THERAPY: A CASE STUDY Danila Maculotti - Enterostomatherapist
- 2. INTRODUCTION • The occurrence of a complex peristomal lesion in an ostomy patient implies many issues • It worsen the already severe clinical situation, especially because managing the stoma becomes harder and the healing of the wound is delayed
- 3. OBJECTIVES 1. Evaluate the effectiveness of the Negative Pressure Wound Therapy in the management of a severe peristomal skin complication in an urostomy patient 2. Improve skin conditions as to allow the stoma management with an ostomy device
- 4. PATIENT OVERVIEW • Woman (72 years old) • Advanced metastatic bladder cancer • Urostomy (Wallace 2) • Overweight patient • Arterial hypertension • Diabetic • Impaired mobility • Peristomal skin lesion TI TII TIV TIII L4-TV (S.A.C.S. Scale)
- 5. METHOD • PHASE 1 - Treatment with Advanced Dressings according to the current Protocol No improvement in the patient’s clinical conditions • PHASE 2 - Negative Pressure Wound Therapy
- 6. CASE STUDY - NP Step 1 Protection of the periwound skin with a sterile grease gauze Step 2 Application of Stomahesive Paste to flatten and protect peristomal skin from urine leakages
- 7. CASE STUDY - NP Step 3 Protection of the peristomal skin with a sterile gauze
- 8. CASE STUDY - NP Step 4 Application of the VAC Therapy 4 dressings were used and changed every 72 hours
- 9. CASE STUDY - NP (after 72 hours) (after 12 days) L3; T1-T4 (at baseline) L4; TV
- 10. RESULTS VAC THERAPY ALLOWS TO: draw wound edges together remove infectious materials actively promote granulation VAC THERAPY KIT
- 11. CONCLUSION This case study also allows us to consider the Negative Pressure Therapy as a valid alternative treatment in case of complex peristomal skin disorders. The treatment proved to be: • effective • secure • comfortable for the patient • cost- effective
- 12. THANKS FOR YOUR ATTENTION
Editor's Notes
- IL TRATTAMENTO DELLE LESIONI PERISTOMALI MEDIANTE PRESSIONE NEGATIVA: CASO CLINICO PERISTOMAL SKIN COMPLICATION MANAGEMENT WITH NEGATIVE-PRESSURE WOUND THERAPY: CASE STUDY Good morning to everybody My name is Danila Maculotti and I am an ET nurse from Brescia, Italy. I have been working at Fondazione Poliambulanza for 17 years and I am very proud to tell you that this hospital was recently rated among the best Hospitals in Italy in terms of Health Care Services offered to Patients and has just received the Joint Commission International accreditation. In my presentation today i will deal with the treatement of a peristomal skin lesion with negative pressure wound therapy “Gud moning tu evrybady. Mai neim is DM end ai em en IT ners from Brescia in Italy. I hev biin uorching et Fondazione Poliambulanza for seventiin iars end I em very praud tu tell iu det dis ospital uas risently reitid among de best hospitals in Italy in terms of helty Cher Servisis offerd tu pescents end hes giast risaivd de Gioint Commiscion Internescional accreditetion. In may presentetion tudey ai uill dil wit de tritment ov e peristomal skin lijon wid negativ pressciar vund terapy.”
- The occurrence of a complex peristomal lesion in an ostomy patient implies many issue. It worsen the already severe clinical situation, especially because managing the stoma becomes harder and the healing of the wound is delayed “De occurrans ov e complex peristomal skin lijon in an ostomy pesscient implais meny iscius. It uorsen de olreadi sevier clinical situetion, espescially bicos menaging de stoma becoms arder end de hiling of de vund is delaid.”
- The goal of this case study was to evaluate the effectiveness of the Negative Pressure Wound Therapy in the management og a severe peristomal skin complication in a urostomy patient. Because of the challenging skin condition, any ostomy device couldn’t stay in place at the beginning. So the second goal was to obtain the improvement of the skin conditions in order to manage the ostomy with a proper device. “De gol ov dis ceis stady wos tu evalueit de effectivness of de negativ pressciar vund terapy in de menagment of e seviar peristomal skin complichescion in e iurostomi pescient. Bicous ov de ciallenging skin condiscion, eny ostomy devais cudn’t stey in pleis et de bighinning. So de second gol wos to obtein de impruvment ov de skin condiscion in order tu manag de ostomy uit e proper divais.”
- The patient of this case study is a 72 year old woman who experienced an advanced metastatic bladder cancer. She has a complex medical case: Urostomy overweight Arterial hypertension diabetic - Impaired mobility The patient has a severe peristomal skin lesion L4 – TV, according to the SACS Scale. The treatment of the skin complication was a priority in order to manage the ostomy with a proper medical device. De pescient ov dis ceis stady is e seventytu iar old uoman uo expiriencd en advancd metastatic bladder canser. Sci hes a complex medical ceis: Iurostomy overweit Artirial haipertenscion daiabitic - Imperd mobility De pescient hes e seviar peristomal skin lision El For – Ti Five, according tu dee SACS scheil. De tritment ov de skin complichescion wos e praiority in order to manag de ostomy wid e proper medical divais.
- At first the patient was treated with advanced dressings according to the current protocol with no improvement in the patient clinical conditions In a second phase the patient was treated with negative pressure wound therapy. Let’s go through the various steps of this succesful procedure “Et ferst de pescient wos tritid wid advancd dressings according to de carrent protocol wid no impruvment in the petient clinical condiscions In e second fase de pescient wos tritid wid negativ presciar vund terapy. Lez go tru de varius steps ov dis suxxesful procidur”
- I will now show you step by step how we treated the patient’s wound: We started protecting the periwound skin with a sterile grease gauze, in order to preserve that area from Negative Pressure Then we applied the Stomahesive Paste to flatten and protect peristomal skin from urine leakages “Ai will nau sciou iu step bai step hau ue trited de pescients uond: Wi started protecting de perivund skin wid e sterail grisi gous, in order tu priserv dat aria from Negativ Presciar Den wi applaid de Stomahesiv Peist tu flatten ed protect peristomal skin from iurin likagis”
- As we experienced some challenges in adapting the Polyurethane Foam to the peristomal area, we decided to protect the skin with a sterile gauze “es wi espiriensd sam ciallengis in adapting de Poliurethan Fom tu de peristomal eria, wi desaided to protect de skin wid e sterail gouz”
- The last step was applying the VAC Therapy. The patient was treated with a new wound dressing every 72 hours. In each follow-up visit, we assessed a constantly improving condition of peristomal skin. The treatment was well accepted by the patient; neither negative effects nor intolerance occurred. “De last step uas applaing de VAC Terapi. De pescient wos trited wid e niw vund dressing evry seventitu Auars. In ich follou-ap visit, wi assessd e constantly impruving condition ov peristomal skin. De tritment wos well axeptid bai de pescient; naider negativ effects nor intolerans occurrd.”
- After 12 days a significant improvement of the lesion was reported. The skin condition, initially rated L4, improved to L3; this allowed the management of the stoma with an ostomy device. “After tuelv deis e significant imprivment ov de lijion wos reportid. De skin condiscion iniscially reitid l for impruvd tu El trii; dis ellowd de managment ov de stoma uid en ostomy divais.”
- Analyzing this case study we can conclude that: VAC THERAPY ALLOWS TO: draw wound edges together remove infectious materials actively promote granulation Analaising dis cheis stadi ue chen conclud det: De VAC THERAPY ELLAUS TU: draw vund egis tughder remuv infectious matirials activli promot granulescion
- The case study also allows us to consider the Negative Pressure Therapy as a valid alternative treatment in case of complex peristomal skin disorders. The treatment proved to be effective, secure, cost-effective and comfortable for the patient. “De cheis stadi oslo ellaus as tu consider de Negativ Presciar Therapy es e valid alternativ tritment in ceis ov complex peristomal skin disorders. De tritment pruvd tu bi effectiv, sechiur, cost-effectiv end comfortebol for de pescient.“
- Thanks for your attention. *** *** *** Tenks for ior attenscion