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Free Paper Session: Acute Wounds
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THE DEVELOPMENT AND IMPLEMENTATION OF A HOSPITAL WIDE SKIN TEAR
MANAGEMENT PLAN
Melissa Ward 1.
1 Sydney Adventist Hospital (Sydney, Australia).
Aim:
1. To create a hospital wide skin tear management plan
2. To assess patients with skin tears and treat using the hospital wide skin tear
management plan, to provide consistent and optimal wound healing
3. Documentation and reporting of patients with skin tears
Method:
• Staff awareness audit in August 2011 – surveying staff knowledge on initial treatment,
risk factors and documentation.
• Extensive literature search and benchmarking with other healthcare facilities.
• The plan was developed and launched on March 28th 2012 using a hospital wide
professional development workshop.
• A3 laminated posters of the skin tear management plan provided to all clinical areas
• Creation of an educational e-learning package placed on the hospital’s intranet
system
• A series of clinical area in-services were carried out to assist the roll out
• A follow up identical staff awareness survey was conducted 5 months post
implementation.
Results: Summary of key findings from staff awareness surveys
Initial treatment Pre implementation Post implementation
Use of silicone based dressing 37% 90%
Use of adhesive strips 35% 1%
Documentation
Document on wound chart/Riskman/integrated notes 54% 75%
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Free Paper Session: Acute Wounds
Treatment of abdominal wall defects: a challenge for surgeon
Lenka Veverkova 1 , Jan Žák 1 , Petr Vlček 1 , Katerina Krejsova 1
1 1st Surgical Department, St. Anne’s University Hospital, Brno and Faculty of Medicine,
(Brno, Czech Republic).
Introduction: 30% of patients in intensive care contract an intra-abdominal infection and
according to literature complications related to a previous surgery or the recurrence of an
infection causing morbidity are as high as 50%. In clinical practice we often need to
select the most appropriate method for the treatment of an abdominal wall defect or
open abdomen. Various methods are available and their aim is the same – to cure the
patient’s defect.
Method: In the period between June 2011 and December 2012 we observed 32 patients
with an abdominal wall defect following surgery who were treated using NPWT. Four of
these patients were treated for an “open abdomen,” according to Bjorck’s open abdomen
classification they were in category 2B, 3 and also 4. We evaluated the length of
treatment, wound size, onset of infection, level of pain and the price of treatment. We
assessed wound size using the WHAT method and to assess the risk of infection we
used W.A.R. classification.
Results: The patients’ average age was 52.7 years. The wound sizes varied from
8cmx5cm to 38cmx35cm. Treatment with NWPT averaged 13 days, and dressings were
changed every 4.5 days. All wounds were infected, no mortalities occurred and all the
wounds healed. A split-thickness skin graft or secondary suture were used. No significant
complications occurred. The wounds detracted by 21 to 90.4% during the NWPT
treatment.
Conclusion: The NPWT is an excellent method of treatment for open abdomen and
abdominal wall defects following surgery.
The initial survey showed that staff had extensive knowledge of risk factors pertaining to
skin tears.
Conclusions:
• Positive evaluation/feedback from launch day
• Development and implementation of the skin tear management plan was greatly
supported by the hospital Directors
• Silicone based dressings now available in all clinical areas.
FREE PAPER SESSION: ACUTE WOUNDS
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
59