Authors (including presenting author) :
Wong Y.T.
Cheng Y.S.
Hui S. L. F.
Yip L. L. V.
Affiliation :
Central Nursing Division, Kowloon Hospital
Introduction :
Pressure injuries can be debilitating, not only causes suffering because of pain, but also psychological and soccial impact to the patient. Despite improved efforts in prevention, assessment, documentation and treatmemnt. According to HAHO NSD Prevalence on Pressure Injury 2023, the overall pressure injury prevalence rate in HA was 11.97% (community acquired 11.21%; hospital acquired 0.87%). In those stage 4 pressure injuries, if go untreated, or not managed well can soon developed infection, invasion to blood vessels, deeper tissues etc.. It was indicated that patients with complicated pressure injuries are estimated to have 2 folds higher risk on mortality compared with patients without pressure injuries.
Objectives :
Over past decades, there are evidences about the potential benefits and eficacy of negative-pressure wound therapy which led to improved oucomes of wound care. However, there were literatures saying this NPWT was not suitable in cases of infected wound. In recent years, the technique of NPWT was evolving and there were many publications mentioned about the safe indications of NPWT for most types of wounds like chronic, diabetes ulcers, dehisced wounds and grafts.
Methodology :
Ms X, a case of CVA and dementia, was admitted with a stage 4 pressure injury of 8.3cmx7.8cmx0.9cm (wound surface area of 64.74cm2) with undermining and tendon exposure.There was necrotic tissue at wound bed. Debridement had been done for 4 times, wound bed was cleared but still with heavy exudate. There was on and off wound infection with foul smell which needed betadine painting and packing. Discussion with cliical team and after consideration, NPWT wa applied to Ms X.
Result & Outcome :
After one day of NPWT, there was improvememnt in wound bed color and circulation. in subsequent 10 days, wound depth decreased from 1.8cm to 1.2cm though there was no significant change in wound surface area. After 20 days, the wound depth decreased from 1.8cm to 0.8cm and the wound surface area was improved from the original 64.74 cm2 to 37cm2.
Making reference to the "Middle East Consensus- Wounds International Middle East Expert Forum on NPWT in Infected Wounds" that not as a standalone option, NPWT could be used with caution and in addition to appropriate treatment of infection.
