Tradi&onal EvidenceBaseTo Dressing

H a m k a Ns (Ners) Register Nurses (RN) Enterostomal Therapist(E.T.)

NCI Centre Kalimantan A Professional Nurse Lead Services For OSTOMY, Wound,

Continence Need

13.466ISLANDSAND34PROVINCIESAND236.641.326

PEOPLEAND2.380HOSPITAL

EvidancebaseBestPractce

CarestudiesSummary

LearningObjecEves

Luka…TutupatauBuka?

MOIST WOUND HEALING

•  GeorgeDWinter(1962):provedthatwoundsthatwerekeptmoist,healedbetterthanthosethatwereexposedtotheair.

THEFATHEROFMOIST

WOUNDHEALING

JUSTIFIKASI 1.   FIBRINOLISIS:fibrincepathilangpadasuasanalembabolehnetrofil

danselendotel

2.  ANGGIOGENESIS:prosesakanlebihterangsangpadasuasanalembab

3.  INFEKSI:lebihrendahdibandingkansuasanakering(2.6%vs7.1%)

4.  PERCEPATANPEMBENTUKANSELAKTIVE:invasinetrofiyangdiikutiolehmakrophag,monositdanlimfositkedaerahlukaakan

berfungsi

lebihdini.

5.   PEMBENTUKANGROWTHFACTOR:lebihcepatpadasuasanalembab

*EGF,FGFdanInterleukin1dikeluarkanolehmakrophag

untukprosesangiogenesisdanpembentukanstr.Korneum

*Platelet-derivedGrowthFactor(PDGF)danTransforming

GrowthFactor-beta(TGF-beta)dibentukolehplateletuntuk

prosesproliferasifibroblast.

YourBestChoice

Your

GAUZE

BestFriends

GAUZE

Always&Forever

Menyerapkah?EfekESah?

GAUZE

Always&Forever

TUJUANPEMILIHANBALUTANq Membuang jaringan mati, benda

asing dan partikel q  Balutan dapat mengontrol kejadian

infeksi / melindungi luka dari trauma dan invasi bakteri

q Mampu mempertahankan kelembaban

q Mempercepat proses penyembuhan luka,

q Absorbs cairan luka q Nyaman digunakan, mengurangi

nyeri, q  Proteksi periwound q  Kontrol bau, .

MODERNDRESSINGVSTRADITIONALDRESSING

HIDROCOLOID GAUZE

LukaTekanSembuh72%lebihCepatdibandingdenganKasa(Singhetal.,2004)

SilverFoammendukungpenyembuhanlukakronislebihungguldanmampumenjagakelembabanlebihbaik(Münteretal.,

2006)

FOAMSILVERDRESSING GAUZE

HidrogeldiganEperempatharidankasapovidone-iodinediganEseEaphari.PenyembuhanEngkatyanglebihEnggimenggunakanhidrogel(84%)vskasa

povidone-iodine-direndam(54%)(Kayaetal.,2005)

HIDROGEL GAUZE+IODINE

EXPENSIVE

Modern Dressing : BHP dalam 15 Hari rawatRp.335.500 dengan Kemajuan PenyembuhanLuka7,75point

Tradi&onal Dressing : BHP dalam 15 Harirawat Rp.234.375 dengan kemajuanpenyembuhanluka2,62point

Reference:DhaliaCareBali

BiayaPerawatandibandingkandenganPercepatanPerbaikanLuka:Lebihefek&fdibandingkanKonvensional

Reference:Dina(2009)

EvidenceSources

Reference:MedicalTechnologyAssociaEonOfAustralia

Expensive??

CLINICALPRACTICES

•  Cleansing•  AdjuncEvetreatment•  Dressing(modernand

alterna,ves)

PhotoGrid_1409932205717.jpgPhotoGrid_1409932205717.jpg

COURTESSYBYNCICENTREKALIMANTAN

COURTESSYBYNCICENTREKALIMANTAN

CASESTUDY:DFUHEALEDIN14WEEKS

Mr.Twoundhealedat14weeks.COURTESSYBYWOCARECENTREBOGOR

CASESTUDY:DFUCOMPLECATEDGASGANGRENHEALEDIN12WEEKS

COURTESSYBYIKRAMWOUNDCAREMAJENE

COURTESSYBYLUDYBINTARO

INDONESIANNURSINGPRIVATEPRACTICE

SERVICES

HOSPITALANDHOMEVISIT PRIVATECLINIC

Newproject-MOBILECLINIC,2014

AdoptedfromSILVERCHAINClinic-Perth

NCICENTERKALIMANTAN

JL.ANGGURNO.22RT56SIDODADISAMARINDA0541-206053/085250575811KONSULVIAWA(085656856834)www.ncicentre.com

DapatkanUpdateMateridiFANSPAGENCICENTRE:1.  Klik

hhps://www.facebook.com/ncicentre/?ref=bookmarks

2.  Like3.  GetYourPPT

Reference:•  Angsko, Arizona. www.footcaredirect.com. •  Bryant A, Ruth, et.al. Acute and Chronic Wounds: Current Management Concepts. 3rd Ed.

Philadelphia: Mosbi Elsevier (2007), p. •  Dina Dewi Sar,ka Lestari Ismail , et.all (2009). Penggunaan Balutan Modern Memperbaiki Proses

PenyembuhanLukaDiabeEk.JurnalKedokteranBrawijaya

•  Carville, Kerlyn. Wound Care Manual. 3rd Ed. Western Australia: Silver Chain Foundation (1998)

•  Carville, Kerlyn. Wound Care Manual. 5rd Ed. West rn Australia: Silver Chain Foundation (2013)

•  N.n (2014). Cost-EffecEvness of MWCDs. Australia : Medical Technology AssociaEon Of Australia,hhp://www.mtaa.org.au/about-the-industry/value-of-technology/wound-care/cost-effecEveness

•  Heyer, K, et.all. (2013) EffecEveness of Advanced versus ConvenEonalWound Dressings on Healing ofChronicWounds:SystemaEcReviewandMeta-Analysis.DermatologyJournal.Germany

•  Haddad L, Steven, et.al. AAOS (American Academy of Orthopedic Sugeons). October 2007 www.orthoinfo.org

•  http://www.foot.com/info