Authors (including presenting author) :
AU SC
Affiliation :
Nursing Quality and Safety, Nursing Services Division, Hong Kong Children's Hospital
Introduction :
The paper shared the effectiveness on using negative pressure wound therapy (NPWT) for a 17-year old male patient having pilonidal cyst with abscess in Hong Kong Children’s Hospital (HKCH). The patient suffered from pilonidal sinus with on and off pussy discharge over 3 years. Excision of pilonidal sinus was performed by Surgical team in HKCH at the end of Oct 2020. Post operation wound dimensions was 14cm (L) x 5cm (W) x 3cm (D) with 5cm depth undermining toward at 6 o’clock. Large amount of purulent exudate was noted. Staphylococcus aureus was reported in swab culture. The patient felt anxiety and pain during daily dressing.
Methodology :
NPWT could promote wound healing by removing wound exudates, stimulating vascularization, and supporting closure of wound edges. It was the first patient to apply for this wound therapy in HKCH. Wound management plan was discussed among the patient and his family, nurses, doctors, Stoma and Wound Nurse Consultant of KCC and Wound Coordinator of HKCH in order to get mutual consensus. Wound bed was prepared with conservative sharp wound debridement and Enzyme algino-gel for autolytic debridement before the application of NPWT. Progressive adjustment on the degree of negative pressure was based on wound condition and nursing observation. Patient was home leave after wound care education was provided.
Result & Outcome :
After 14 days of NPWT, there was a significant decrease of wound dimensions to 10 cm (L) x 3cm (W) x 2cm (D). A clean and healthy wound bed with 100% red granulation was observed. No discomfort nor wound pain was reported by the patient in this period. Treatment continued with conventional dressings until wound closure. The emotional status of patient was better and was discharged from HKCH with regular follow up. The right therapy could accelerate wound healing and put patients on the road to recovery faster. The essential element of the NPWT was evidence based practice and the therapy was being widely used on adult patients. The successful key factors were 5C as COMPETENCY of professional nurses and doctors, COMMUNICATION among all stakeholders, COUNSELLING to the patient, COOPERATION of patient and COLLABORATION within professional teams. In conclusion, the result of NPWT was a great encouragement to nurses for caring of patient with complicated wounds in future.
