Here - EWMA 2013

ORAL PRESENTATIONS
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Free Paper Session: Dressings and Wound Assessment
PERISTOMAL COMPLICATIONS IN OLD AGE – RETROSPECTIVE ANALYSIS
Andrea Pokorná 1 , Monika Antonová 2
1 Masary university, Faculty of Medicine, department of Nursing (Brno, Czech Republic);
2 Teaching Hospital Brno (Brno, Czech Republic).
Aim: The contribution is focused on caring for the elderly patients with stoma in relation
to the occurrence of parastomal complications.
The main goal was to evaluate the incidence of peristomal complications in a sample of
the senior population with a stoma and to asses the influence of factors which influence
the observed incidence of these complications (age, level of the self care, cognitive
functions, nutritional status – etc.).
Methods: The retrospective analysis of documentation was used (2006 till 2011). For
the objectification of some measured data standardized rating scales were used (ADL,
BMI, for cognitive function evaluation MMSE and DET Score). For statistical evaluation
Pearson’s chi-square test and Mann Whitney U test were used. The investigation
examined 192 elderly patients over the age of 65 years. Age variance ranged from 65 to
97 years. Average age was 75.18 years (SD 7.42).
Results: Most of the patients had a colostomy (115) rest had ileostomy (77). 138
patients (71.9 %) had peristomal complications. 90% of the complications occurred
within 36 weeks after surgery, leading to the establishment of the stoma, more
complications occurred in ileostomy, which also had an earlier and faster increase in the
incidence of complications. The most common skin complication was maceration (29.7
%).
Conclusions: Patients in the home care services had higher percentage of peristomal
complications (p 0,005). The time period from surgery is statistically significantly
associated with the occurrence of peristomal complications (p 0,005) as well as age
(p 0,000).
FREE PAPER SESSION: DRESSINGS AND WOUND ASSESSMENT
30
Free Paper Session: Dressings and Wound Assessment
THE USE OF HUMAN AMNIOTIC MEMBRANE AS A PRIMARY DRESSING
MATERIAL IN ACUTE AND CHRONIC WOUNDS
Mohammad Khaleel Baghdadi 1 , Tauqeer Ahmed Malik 1 , Ahmed Afandi 1 ,
Nashat Ghandoura 2 , Kareemuddin Mohammad Majid 1 , Samia Faraj Mushara 2
1 King Fahad Armed Forces Hospital (Jeddah, Saudi Arabia);
2 King Fahad General Hospital (Jeddah, Saudi Arabia).
Aim: The use of human amniotic membrane as a primary dressing material in acute and
chronic wounds.
Methods: Human Amniotic Membrane (HAM) is extracted under strict sterile conditions
during an elective C section in an operating room. Written consent is obtained from
HIV1, HIV2, HTLV, HBV, HCV and Syphilis negative mothers. HAM is washed with
normal saline to remove blood clots and then preserved in normal saline in a sterile
container with 160 mg of Gentamicin. Patients are screened for seronegativity. Patients
with Diabetic foot ulcers, pressure ulcers and acute wounds are selected. Swabs for
culture and sensitivity are taken from wounds and from the HAM before application.
Written consent is obtained from recipients. HAM is applied as a primary dressing with
non adherent silicon dressing to protect the membrane. Dressing is done as an OPD
under sterile protocols. Dressing is changed one to two times a week. Photographs are
taken at all stages of wound treatment.
Results: 68 patients are treated with HAM: Diabetic Foot: 35, Crush Injuries:7, Burn:14,
Pressure ulcers 8, Post operative 4. Complete healing was achieved in 95 percent of
patients.
Conclusions: With HAM healing was faster with no adverse affects. HAM is HLA
negative, donates epithelium, has many growth factors, antibacterial properties and has
minimal stroma. It is readily available, easy to harvest, preserve and easy to apply. It is
cost effective as compared to advanced dressings. It reduces patient’s daily visits to
hospital. We are including more patients from other hospitals in this study.
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