EVIDENCE BASE TOPIKAL

THERAPY UNTUK MENGURANGI NYERI

WIDASARI SRI GITARJA

WOUND NEGLECTED
WOUND NEGLECTED
 PEDIATRIC WOUND NEGLECTED

BURN A B S E S P E R I A NA L
 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

WOUND OSTOMY CONTINENCE

 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 ?

MENGGUNAKAN APA ? MENGGUNAKAN APA ?

woc c l i n
e i c
a P r o fe s s io n a l N u r s e L e a d S e r v ic e fo r P e o p le w ith S to m a s , W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
WOUND DRESSING
 WOUND DRESSING

EVIDENCE BASE
WOUND
DRESSING

EFFICACY EFFESIENSY EFFECTIVENESS

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, . woc c l i n
e i c
a P r o fe s s io n a l N u r s e L e a d S e r v ic e fo r P e o p le w ith S to m a s , W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
 WOUND CONTINUM

NYERI BERHUBUNGAN ERAT DENGAN KEMUNGKINAN TERJADINYA INFEKSI

COLONITATION
Critical INFECTION
CONTAMINATION
colonization
 WOUND MANAGEMENT

KRONIK WOUND

PENDEKATAN
PERBAIKI PERAWATAN
SECARA
PENYEBAB LUKA
HOLISTIK

BACTERIAL EXUDATE
DEBRIDEMENT
BALANCE BALANCE

EVIDENCE BASE
WOUND
DRESSING
 CARA MEMBALUT LUKA

BALUTAN BALUTAN
PRIMER SEKUNDER

BALUTAN
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 A T I O N P RO C E S S
P RO L I F E R A T I O N
MOIST WOUND HEALING
 HYDROCOLOID AND SILICON

HY DROCOL LOID
DR ES S I N G – b a l u t a n penutup
l u ka b e r b ent u k l e mb a ran , ke d a p a i r,
mampu absorb eksudate sedikit
sampai sedang ( grade II) dan
ber tahan hingga 3-5 hari
S I L I C ON PA D - balutan dengan
technolog y tinggi denga lapisan
silicon pada per mukaan, absorb
eksudate sedikit sampai sedang,
grade II, tapi tidak tahan air
 FOAM DRESSING AND NPWT

F OA M DR ESSIN G - terbuat NPWT – negative pressure wound

dari 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
seper ti bantalan, mampu absorb dressing, absorb eksudate banyak >
eksudate dari sedang sampai 200cc/24 jam, supor t per tumbuhan
banyak, ber tahan hngga 4-7 hari sel, ber tahan 3 – 5 hari.
 SECONDARY DRESSING

TA P E S U RG I N E T
 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
therapy
topikal

tepat guna
( wocare clinic, 2007 )
 DRESSING SELECTION

MOIST SATURATE
DRY WET LEAKING
D

• Adhesive foam • Super absorbent

• Film • Non-adhesive foam dressing
• Hydrogel • Alginate • NPWT
• Hydrocolloid • Clear absorbent acrylic
• Barrier film • Kantong

• Adhesive foam • Adhesive foam

• Non-adhesive foam • Alginate
• Contact material • Super absorbent dressing •
• Clear absorbent acrylic. 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_pressure_
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