Here - EWMA 2013

ORAL PRESENTATIONS
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WOUND DEBRIDEMENT IN CHILDREN’S PRACTICE
Free Paper Session: Dressings and Wound Assessment
Ruben Nalbandyan 1 , Valery Mitish 1 Pavel Medinskiy 1 Andrey Nikonov 1
1 Clinical and Research Institute of Urgent Pediatric Surgery and Trauma
(Moscow, Russia).
Aim: To improve the results of treatment, to decrease the terms of hospitalization and
increase considerably the quality of administered aid to children.
Materials and Methods: The present study is based on experience in treatment of 128
children with wounds (26,6%), open fractures of long bones (12,5%), traumatic
amputations of extremities (6,3%), infected wounds (46,9%), pressure ulcers (7,7%),
who underwent treatment in the Children’s clinical and research institute of emergency
surgery and trauma from 2005 to 2011 years. The age of patients ranged from one
month to eighteen years old. The area of wound surface varied between 5 and 30 cm 2 .
The patient treatment was provided according to the principles of active surgical wound
healing method, included:
1) radical debridement;
2) additional treatment of wound with different physical methods;
3) local wound treatment;
4) primary or early immobilization;
5) early plastic and reconstructive surgery.
Results: Debridement was carried out with the anatomical features of affected segment.
Hydrosurgical system (54 patients), ultrasound cavitation of wound (64 patients), wound
treatment with defocused ray of plasmic scalpel (30 patients), VAC- therapy (58 patients)
were used during the surgery in order to facilitate the surgical treatment and improve
results. Hydrosurgical wound treatment was carried out simultaneously with plasty in
24,2 %.
Conclusion: Combined use of traditional and up-to-date methods of wound treatment
has allowed to bring the course of complicated wound process to not complicated one,
reduced the number of repeated debridements and allowed to prepare wound surface
for further plastic closure.
FREE PAPER SESSION: QUALITY OF LIFE AND NUTRITION
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Nurse-patient consultations in primary care
– do patients disclose their concerns?
Free Paper Session: Quality of Life and Nutrition
Julie Green 1
1 Keele University (Staffordshire, United Kingdom).
Background: Person centred care (PCC) and shared decision making (SDM) are
important for the management of long term conditions. Interventions to improve them
have been inconclusive which may reflect variable disclosure by patients of their
concerns.
Aim: To explore the extent to which patients disclose concerns to their community nurse
during wound care consultations.
Methods: Using unstructured interviews, the issues which impacted on the quality of life
(QoL) of 9 patient participants with chronic venous leg ulceration (CVLU) were elicited.
The interviews were audiotaped, transcribed and, using thematic analysis, the themes
and subthemes were identified and constructed into an ‘observation checklist’. This was
completed during 4 wound care consultations with their District Nurse for 5 of the
interview participants. Each item on the checklist was scored 0 (not raised by the patient
or the nurse) to 5 (raised by the patient and fully addressed by the nurse).
Results: 4 themes and 28 subthemes were identified. During the 20 observed
consultations, the patient participants had 160 opportunities to raise previously identified
pain, exudate and odour symptoms yet did not on 64 (40%) of occasions. They had 28,
32 and 84 opportunities to raise emotional, wound care and daily living issues but did not
on 16 (57%), 3 (9%) and 32 (38%) of occasions.
Conclusion: Overall patients did not raise 38% of their concerns. If these data are
representative, this has profound implications for PCC and SDM models of care, which
are predicated on patients articulating their needs and the training of health carers.
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