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Wound Care Udate

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Page 1: Wound Care Udate

BIODATA Irma Puspita Arisanty, SKp. RN.

WOC(ET)N.

Bersama Prof. Elizabeth Ayello, Editor WCET Journal , china - 2009

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NAMA LENGKAP : IRMA PUSPITA ARISANTY, SKp. RN. WOC(ET)N.

PANGGILAN : “Bunda Irma”

PROFESI : SARJANA KEPERAWATAN

(FIK – UI) tahun 2001 REGISTERED NURSE

tahun 2009

SPESIALISASI ENTEROSTOMAL THERAPIST(ETN) / WOUND OSTOMY CONTINENCE NURSE (WOCN) ATAU (PERAWAT LUKA, STOMA, KONTINENSIA) tahun 2007

Bersama Carmen George, Komite

Edukasi WCET , 2008

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STATUS : MENIKAH DENGAN 2 ANAK

ALAMAT : BOGOR KONTAK : +6281802926390 EMAIL :

[email protected]  ALAMAT PRAKTEK :

KLINIK MOIST (Luka, Stoma, Kontinensia) – MH Thamrin, Jl. Raya Pondok Gede, No. 23-25, Kel. Kp Dukuh, Kec. Kramat Jati – Jakarta Timur 13550. Telp: 021 80887175, fax: 021-80887174

WEBSITE : www.perawatanluka.com

(website edukasi untuk perawat / tenaga kesehatan lainnya)

www.klinikmoist.com

Bersama Prof. Vera Lucia Santos (Brazil) ketua komite edukasi WCET periode 2012 -

2014

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RIWAYAT PEKERJAAN KONSULTAN LUKA, STOMA DAN

KONTINENSIA SEJAK 2008 - sekarang Penanggung Jawab Klinik MOIST – MH

Thamrin 2012 – sekarang Direktur FAST HEALTH 2012 – sekarang Direktur perawatanluka.com 2011 –

sekarang Perawat spesialis luka, stoma dan

kontinensia MOIST Clinic 2011 – sekarang

Direktur operasional WOCARE Clinic2010 – 2011

Manajer Operasional WOCARE Clinic2007 – 2009

Kepala diklat RS MH THAMRIN INTERNATIONAL SALEMBA 2006 – 2007

Staff Bidang Keperawatan RS MHTIS Salemba 2004 – 2005

Perawat NICU – PICU RS MHTIS Salemba2002 – 2003

Bersama FAST HEALTH dan

Direktur RUMAT

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ORGANISASI

2012 – 2014 Ketua Bidang P4 APMPI (Asosiasi Praktek Mandiri Perawat Indonesia)

2012 – sekarang Pendiri IPLI (Ikatan Perawat Luka Indonesia) 2011 – sekarang Founder BAWCP (Basic Advance in Wound Care Program)

sertifikasi CBWT (Certified Basic Wound Therapist) dan CWT (Certified Wound Therapist)

2011 – sekarang Anggota ICS (International Continence Society) 2010 – sekarang Anggota AWMA (Australian Wound Management

Association) 2012 – 2014 Anggota komite komunikasi dan publikasi WCET (World

Council of Enterostomal Therapy) 2007 – sekarang Anggota WCET (World Council of Enterostomal Therapy) 2010 – 2012 Presiden InWOCA (Indonesian Wound Ostomy Continence

Association) 2009 – 2011 Presiden APKI (Asosiasi perawat keluarga Indonesia) atau

InFNA (Indonesian Family Nursing Association) 2009 – sekarang Delegasi internasional InWCCA (Indonesian Wound Care

Clinician ssociation) Komite Sertifikasi InWCCA 2009 – 2011 Ketua P2B (Continues Development Program) CWCC,

InWCCA 2009 Founder CWCCP, CSTP, CCTP sertifikasi CWCC, CST, CCT 2007 – sekarang Anggota InETNA (Indonesian Enterostomal therapy Nurse

Association)

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PENGEMBANGAN PROFESIONAL NASIONAL

2012 Penulis buku konsep dasar manajemen perawatan luka, penerbit EGC (sedang proses), insyaallah Juli/ Agustus 2012 terbit

Desember 2011 Penemu salep herbal “TRIBEE” dan “serum TTO” untuk luka dengan FAST HEALTH

Nov 2011 – sekarang Coordinator program Basic Advance Wound Care Program (BAWCP) – www.perawatanluka.com

Okt - Des 2011 Konsultan manajemen klinik luka RSUD Depok 2011 Seminar dan workshop di RS Dr. Kanujoso Balikpapan Perawatan luka

Diabetes June 2010 Pendiri InWOCA (Indonesian Wound Ostomy Continence

Association) 2009 – Juni 2011 Clinical instructor dan coordinator program CWCCP –

WOCARE Clinic November 2009 Pendiri InWCCA (Indonesian Wound Care Clinician

Association) dan CWCC Oktober 2009 Pendiri of APKI (Asosiasi Perawat Keluarga Indonesia) 2008 – Juni 2011 Clinical Instructor Indonesia ETNEP – WOCARE Clinic July 2008 Nursing expo, sbg pembicara, materi: Sharing experience on

developing nursing clinic in Indonesia DAN Manajemen perawatan luka DM  August 2008 In ostomate gathering & graduation of InETNEP poster

presentation: Effective Burn Management With Patient’s QOL 2008 Kontributor buku Manajemen perawatan luka DM

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PENGEMBANGAN PROFESIONAL

INTERNASIONAL April 2012 16th WCET Congress, Adelide Australia, 19-23 April

2012 : Presentasi Oral “Application Aloe Vera On Arterial Ulcer For Wound Bed Preparation”

Oktober 2010 6th ASSR congres: workshop and seminar speaker, poster presentation (5), Workshop: “EFFECTIVE DRESSING SELECTION IN WOUND MANAGEMENT (A NEW GUIDELINES) with WEI”, Seminar: “ALTERNATIVE WOUND DRESSING with Metcovazin” Poster presentation: HIGH EXUDATE WOUND MANAGEMENT: A FAMILY AS CARE

GIVER AT HOME , COLOSTOMY BAGS FOR LEG ULCER MANAGEMENT , BABY PERISTOMAL “BURN” MANAGEMENT AFTER PLASTIC BAG APLICATION, DIABETIC FOOT SPA® with WOCARE Clinic, THE AMAZING SALF OF METCOVAZIN® with WOCARE Clinic

Juni 2010 WCET & WOCN joint conference: poster presentation: The outpatient management in indonesia: provides comfort care

December 2009 APETNA congress: oral & poster presentation, Best oral presentation: Developing Nursing Clinic In Developing Country:

WOCARE CLINIC A Clinic in Wound, Ostomy, Continence – A Nursing Excistencesie in Indonesia.

Presentasi poster: A Case Study: the amazing fixation on lower extremity & movement for low economic level

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Poster presentasi

APETNA 2009

Guangzou - China

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Bersama Elizabeth English, Presiden WCET 2008 – 2010, Mendapatkan juara Best Oral

Presentation, China 2009

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Kongres WCET ke 19 di Adelaide – Australia 19 – 23 April 2012

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Bersama Judith Weller sekretaris AWMA (Australian Wound Management Association)

Australia 2012

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WOUND CARE UDATE

IRMA P. ARISANTY, SKp. RN. WOC(ET)N

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KULIT

Masih ingat lapisan kulit?

Masih ingat fungsinya?

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KULIT

Masih ingat lapisan kulit? Epidermis Dermis Hipodermis

Masih ingat fungsinya? Pelindung Sensasi dll

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PENTING

SAAT TERJADI LUKA

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PENTING

SAAT TERJADI LUKA PENGGANTI KULIT

DIBALUT

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PROSES PENYEMBUHAN Bagaimana proses

penyembuhan luka akut?

Bagaimana penyembuhan luka kronis?

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PROSES PENYEMBUHAN Bagaimana proses

penyembuhan luka akut? Inflamasi Proliferasi Maturasi

Bagaimana penyembuhan luka kronis? Sama dengan luka

akut

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PERBEDAAN?????

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PRINSIP PERAWATAN LUKA KRONIS

Kontrol & hilangkan penyebabnya Ciptakan dukungan sistemik Ciptakan & pertahankan lingkungan

luka: lembab yg seimbang (moisture balance)

Persiapan dasar luka

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KONSEP “moisture balance” Lembab / MOIST: proses penutupan luka dan migrasi sel

lebih 2 x lebih cepat dibandingkan dengan tehnik kering Dr. George D. Winter 1962 Mendukung proses “autolysis debridement”

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AUTOLYSIS DEBRIDEMENT

KERING - SCAB

MOIST - DRESSING

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MANFAAT?

Pada kondisi lembab yang seimbang, maka luka:

Sembuh 50% lebih cepat dari konsep kering

Meminimal risiko infeksi Meminimal nyeri saat ganti balutan Meminimal bekas luka

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BAGAIMANA CARANYA?

MOISTURE BALANCE bisa terjadi jika: Menggunakan balutan yang tepat sesuai

dengan dasar luka (W), jumlah exudate (E) dan ada tidaknya infeksi (I), irma 2008.

Menutup luka (occlusive dressing)

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WEI, irma 2012WOUND BED(AUTOLYSIS

DEBRIDEMENT & MOITURE BALANCE)

EKSUDATE AMOUNT(MENYERAP CAIRAN & MOITURE BALANCE)

INFECTION CONTROL

(MENGURANGI JUMLAH KUMAN)

Salep Tea Tree Oil / TribeeZinc creamHydroactive gel / hydrogelHydrocolloid paste / lembaranMaduAloe veraBromelainEnzim papainCoconut oil

Transparent filmHydrocolloid lembaran / powderCalcium alginateHydrocelullosaPolyurethane foamAbsorben: Kasa / gammge / low adherent (LA)Kantong stoma

Silver ionizedCadoxemer iodineHydrofobic / DACCSerum Tea Tree OilMetronidazole Madu

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WOUND BED(AUTOLYSIS DEBRIDEMENT & MOITURE BALANCE)

Salep herbal TTO (Tribee®)

TTO = Tea Tree Oil Kandungan: Meleauca

alternifolia (Tea Tree Oil) 2%, Virgin Coconut Oil, D Alpha Tocopherol 400 iu, Madu, campuran lainnya

Manfaat: antifungal, antimikrobial, antiviral, anti MRSA, mempercepat proses inflamasi

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WOUND BED(AUTOLYSIS DEBRIDEMENT & MOITURE BALANCE)

Hydroactive gel / hydrogel

Meng-hidrasi luka kering

Memberi efek dingin untuk luka bakar derajat 1 atau 2

Bentuk: tube, spray, impregmented

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WOUND BED(AUTOLYSIS DEBRIDEMENT & MOITURE BALANCE)

Hydrocolloid paste / lembaran

Melembabkan Kemampuan

menyerap sedikit hingga sedang exudate (bentuk lembaran dan powder)

Sifat: waterproof, adhesive, Occlusive

Bentuk: lembaran, powder, pasta

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WOUND BED(AUTOLYSIS DEBRIDEMENT & MOITURE BALANCE)

Madu : hyperosmolarAloe vera : 90 % airBromelain : enzim proteinase, antiinflamasiEnzim papain : support proses debrisCoconut oil : oil base, vitamin dan mineral

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CONTOH APLIKASI ALOE VERA UNTUK PERSIAPAN

DASAR LUKADipresentasikan oleh

Irma P. Arisanty, SKp. RN. WOC(ET)N. pada kongres WCET

(World Council of Enterostomal Therapist) ke 19, Adeliade – Australia 2012

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PROCEDURE: Aloe Vera Application on A Wound

Preparation: Cleans the aloe

vera, Peel the skin (green one)

Cut of the aloe vera body as needed (do

not refine it) left whole in piece

Cleans the wound

Debrided as needed,

escharotomy if it dry necrotic wound

Protect surrounding skin,

to prevent maceration

Apply dressing for autolysis (hydrogel,

zinc cream, salf herbal, ect)

Cover with thin sterile

gauze

Apply aloe vera on top of it

using roll gauze

Cover again with extra absorbent

if needed

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KOMBINASI ALOE VERA

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RESULT CASE 1 (first & second methods)

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Presentasi oral “Application Aloe Vera On Arterial Ulcer For Wound Bed

Preparation”, 19th WCET congress – Australia 2012

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TERIMAKASIHADA PERTANYAAN?