EVIDENCE BASE TOPIKAL

THERAPY UNTUK MENGURANGI

NYERI

WIDASARI SRI GITARJA

WOUND NEGLECTED
WOUND NEGLECTED
 PEDIATRIC WOUND
NEGLECTED

BURN ABSES PERIANAL

 MENG-CREATE PERUBAHAN

COURTESY BY IWCC
 PROBLEMS OF CONVENTIONAL WOUND CARE

In-Effective cost
Patient cost
Hospital cost
Nursing care cost

Takes time: 3 x /day

changing wound dressing

Wounds not really healed

or healed over time
 NEW CONCEPT OF WOUND
CARE

Moist Wound
Healing
Dressing change
every 3
days or more
Painless dressing
change
Cost effective
 MODERN NURSING CARE

International
Education Program
(Specialized):

Wound Ostomy
Continence Nurse
(www.wocn.org)
or
Enterostomal Therapy
Nurse (www.wcetn.org)
 WOCN

CONTINENC
WOUND OSTOMY
E
 SKIN FUNCTIONS

Maintains fluid and

electrolyte balance
Protects body from
invasion bacteria.
Regulates body
temperature
Sensation
Appearance
 :
CASE STUDY
APAKAH BALUTAN YANG DITARUH DI LUKA SAMA ?
JIKA YA ? JIKA TIDAK ?

M E N G G U N A K A N A PA ? M E N G G U N A K A N A PA ?
WOUND DRESSING
 WOUND DRESSING

EVIDENCE
BASE WOUND
DRESSING

EFFECTIVENE
EFFICACY EFFESIENSY
SS

HEALTH
CLINICAL OUTCOME
ECONOMIC
RESEARCH RESEARCH
ANALYSIS
 TUJUAN PEMILIHAN
BALUTAN
1.membuang jaringan mati, benda asing dan
partikel
2. balutan dapat mengontrol kejadian infeksi /
melindungi luka dari trauma dan invasi bakteri
3. mampu mempertahankan
kelembaban
4. mempercepat proses penyembuhan luka,
5. absorbs cairan luka
6. nyaman digunakan,
MENGURANGI NYERI
7. Proteksi periwound
8. Kontrol bau, .
 WOUND CONTINUM

NYERI BERHUBUNGAN ERAT DENGAN KEMUNGKINAN TERJADINYA INFEKS

Critical
CONTAMINATIO COLONITATIO
N N colonizatio INFECTION
n
 WOUND MANAGEMENT

KRONIK
WOUND

PENDEKATAN
PERBAIKI PERAWATAN
SECARA
PENYEBAB LUKA
HOLISTIK

DEBRIDEMEN BACTERIAL EXUDATE

T BALANCE BALANCE

EVIDENCE
BASE WOUND
DRESSING
 CARA MEMBALUT LUKA

BALUTAN
BALUTAN
SEKUNDE
PRIMER
R

BALUTA
N LUKA
GAUZE / KASA

Secondary
dressing
Absorban
Alat untuk
mechanical
debridement
BALUTAN PRIMER
TRADITIONAL VS
TECHNOLOGY
 LIPIDO - COLLOID

S U P P O RT E N D O F E P I T H E L I Z AT I O N
P R O L I F E R AT I O N P R O C E SS
MOIST WOUND HEALING
 HYDROCOLOID AND SILICON
HYDROCOLLOID
D R E SS I N G b a l u t a n penutup
luka berbentuk lembaran, kedap
a i r, m a m p u a b s o r b e k s u d a t e
sedikit sampai sedang ( grade II)
dan bertahan hingga 3-5 hari
S I L I C O N PA D -
balutan dengan
technology tinggi denga lapisan
silicon pada permukaan, absorb
eksudate sedikit sampai sedang,
grade II, tapi tidak tahan air
 FOAM DRESSING AND NPWT

FOAM DRESS IN G - terbuat dari NPWT negative pressure wound

polyurethane foam, bentuknya t h e r a p y, t e c h n o l o g y d a l a m w o u n d
seperti bantalan, mampu absorb dressing, absorb eksudate banyak >
eksudate dari sedang sampai 200cc/24 jam, suport pertumbuhan
banyak, bertahan hngga 4-7 hari sel, bertahan 3 5 hari.
 SECONDARY DRESSING

TA P E SURGINET
 CARA MERAWAT LUKA

SAAT INI MANAGEMENT

PERAWATAN luka AKUT DAN luka
kronik adalah :
(3M)

A. Mencuci Luka
B.Membuang Jaringan
Nekrotik, ATAU BENDA
ASING pada Luka

C.Memilih topikal therapy

tepat guna

( wocare clinic, 2007 )

 DRESSING SELECTION

DR MOIS WE SATURATE
SATURATE LEAKIN
Y T
T T D
D G

Adhesive
Adhesive foam
foam

Super
Super

Film
Film
Non-adhesive
Non-adhesive foam
foam
absorbent
absorbent

Hydrogel
Hydrogel
Alginate
Alginate
dressing
dressing

Clear
Clear absorbent
absorbent

NPWT
NPWT
Hydrocolloid
Hydrocolloid acrylic
acrylic

Kantong
Kantong

Barrier
Barrier film
film Adhesive foam

Adhesive
Adhesive foam
foam

Non-adhesive
Non-adhesive foam
foam Alginate

Contact
Contact material
material Super absorbent

Clear
Clear absorbent
absorbent acrylic
acrylic . dressing Barrier film
 CASE
STUDY

COURTESY BY DIAN AYU NOVITA

 CASE
STUDY
 CASE
STUDY
CASE STUDY
CASE STUDY
CASE STUDY
CASE STUDY
KESIMPULAN

Balutan luka disebut ideal

apabila mampu
menciptakan kondisi
lingkungan yang optimal
dan dapat melindungi luka
dari cidera YANG DAPAT
MENYEBABKAN RASA SAKIT
SAAT GANTI BALUTAN
 REFERENSI

Johnson, G. Management of A Flush or Retraction Stoma. -. Available

at http://www.svosg.org/ManagementofFlushorRetractedStoma.htm
WOCN. Mechanical injury. 2007. Available at
http://images.wocn.org/photos/116
WOCN. Peristomal ulcers. 2007 Available at
http://images.wocn.org/photos/34
WOCN. Peristomal ulcers. 2007 Available at
http://images.wocn.org/photos/35
Whiteley, I. Management of a peristomal pressure ulcer. -. Available
at
http://www.eakin.eu/casestudies/6/management_of_a_peristomal_pres
sure_ulcer.aspx
Colwell, J.C., Badberg, M.T., Carmel, J.E. Fecal and urinary diversions
management principles. 2004. China:Mosby Inc.
Backley, P. Practical stoma wound and continence manajemen. 2004.
Australia:Research Publication Pty.
Breckman, B. Ed. Stoma Care and Rehabilitation. 2005.
China:Elsevier Churchill Livingstone