Authors (including presenting author) :
Shit FKY (1),Tong SY (1),Ng WY (1),Lam WY (1),Tsang WY (2),Cheung YP (2), Ip WK (2),Cheng HM (3),Lam YY (4),Ho BPY (5)
Affiliation :
(1) NTEC Wound Services Team, Department of Surgery, PWH
(2) Department of Orthopaedics & Traumatology, PWH
(3) Community Outreach Services Team (COST), PWH
(4) Department of Surgery, NDH
(5) Central Nursing Division, NTEC
Introduction :
Wound care remains a challenging area in clinical practice, especially when wound chronicity and infection are present. Technological advances and intensive therapies have enabled the achievement of better clinical outcomes in managing wound bioburden and accelerating wound healing.
Objectives :
To perform evidence-based wound assessment and documentation by visualized fluorescent bacteria and measure wound size at the point of care.
To remove slough and biofilm over wound bed effectively by combined therapy of specific wound irrigation solution and debridement cloth.
Methodology :
Different types of wounds were recruited from Surgical, Orthopaedics Departments and COST team, PWH. Intensive wound bed preparation regime with the use of Octenilin wound irrigation solution and Debridement Cloth was designed. Wound size and bacterial load will be monitored precisely by MolecuLight Wound Intelligence Device. Recruited wounds will be applied with 2 weeks’ (4 wound round visits) intensive team approach therapy: daily dressing with Octenilin solution irrigation and prescribed advanced dressing by ward staff, Debridement Cloth for conservative wound debridement by wound nurses 2 times per week. Wound culture swab or antibiotics will be arranged as needed. MolecuLight device will be used to measure wound size accurately and check fluorescent bacterial status 2 times per week. Study protocol, quick guide and staff training have been implemented in all concerned areas.
Result & Outcome :
Total 67 patients (male:46, female: 21) with 92 wounds (acute wound: 64%, wound developed more than 4 weeks: 36%) were recruited from 13-1-2020 to 30-5-2020. Age ranged from 15 to 92 years old with mean age 63.3. Wound progress after 2 weeks’ intensive therapy: healed (1.2%), improving (80.7%). Total 12 (18%) in 67 improving wounds found bacterial load cleared after the regime. Besides, 64 (69%) wounds with decreased in wound size recorded. Wounds detected negative fluorescent bacteria with 6%-13% increased after intensive treatments from 1-4 visits. Appropriate wound management regime has been modified after each visit. In additions, 184 staff have completed the project’s questionnaires with good comments on the wound program. Also, 41 (61%) patients’ questionnaires have been returned with satisfactory results.