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WOUND
CARE
dr. H.N.Nazar, SpB, FINACS, Trauma (K),MHKes
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Acute Wound Chronic Wound
Defnitio
n
!!urred in "ast #$%
&ee's
resent or "on*er t+an % &ee's.
Caused - endo*enous me!+anismsre"ated to a predisposin* !onditionor ris' a!tor (diaetes, oesit-,smo'in*, AIDS, !+emot+erap-)&+i!+ eentua""- !ompromisesderma" and epiderma" tissue
stru!tures
/0amp"e Sur*i!a" &ounds, ites,urns, arasions,traumati! &ounds.
1e*2oot u"!ers and pressure sores 3"i'e- rom as!u"ar insu4!ien!- orneuropat+-
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KerusakanJaringan
External = Trauma
nternal = n!eksi" #en$akit
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ato*en en-ea
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%enurut tingkat Kontaminasi terhada& luka 5
6. C"ean 7ounds (1u'a ersi+), "u'a eda+ ta' terine'si -an* mana tida'ter8adi proses peradan*an
:. C"ean$!ontamined 7ounds (1u'a ersi+ter'ontaminasi), "u'a pemeda+an dimana sa"uran respirasi,pen!ernaan, *enita" atau per'emi+an da"am 'ondisiter'ontro", 'ontaminasi tida' se"a"u ter8adi.
;. Contamined 7ounds (1u'a ter'ontaminasi),termasu' "u'a teru'a, "u'a a'iat 'e!e"a'aan dan
operasi den*an 'ontaminasi dari sa"uran !erna
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'ase #en$em(uhan )uka
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%ekanisme#en$em(uhan)uka
6. rimar- Intention:. Se!ondar-
Intention;. Tertiar- Intention
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Fa'tor -an* Berpen*aru+da"am en-emu+an 1u'a
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*+ #enilaian Keadaan Umum #asiendan Keadaan )uka
,+ Wound Cleansing- E.#)ORE"
RR/ATON AND DE0RDE%ENT1+ Dressing2+ #ro3ide a moist 4not 5et6 5ound
(ed
7+ Consider Other To&ical Agent8+ %anage #ain9+ Ensure Ade:uate Ox$gen"
Nutrition
;+ Treat n!ection
%anagement
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eni"aian 1u'a
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Tanda )uka Terin!eksi
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%anagement
Wound Cleansing- E.#)ORE"RR/ATON AND DE0RDE%ENT
The goal of wound cleansing is to:• Remove visible debris and devitalised tissue• Remove dressing residue
• Remove excessive or dry crusting exudates
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%anagement
Principles:• Cleansing should be performed in a way that minimises
trauma to the wound
• Wounds are best cleansed with sterile isotonic saline orwater
• Skin and wound cleansers should have a neutral p and be
non!toxic
• "void alkaline soap on intact skin as the skin p is altered#resistance to bacteria decreases• Antiseptics are not routinely recommended for cleansing
and should only be used sparingly for infected wounds
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Deridement
• Te'ni' Deridement 1u'a5
*+ De(ridement Autolisis
:. Deridement Me'anis
;. Deridement Kimia&i
#. Deridement Bio"o*is
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Deridement
• Te'ni' Deridement 1u'a5
6. Deridement Auto"isis
,+ De(ridement %ekanis
;. Deridement Kimia&i
#. Deridement Bio"o*is
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Deridement
• Te'ni' Deridement 1u'a5
6. Deridement Auto"isis
:. Deridement Me'anis
1+ De(ridement Kimia5i
#. Deridement Bio"o*is
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Deridement
• Te'ni' Deridement 1u'a5
6. Deridement Auto"isis
:. Deridement Me'anis
;. Deridement Kimia&i
2+ De(ridement 0iologis
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1u'a Ba'ar
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Dressin*
• A&a" mun!u"n-amodern dressin*
se'itar ta+un 6• Saat ini suda+ ada
"ei+ dari ;?>> 8enis a"utan
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Memi"i+ a"utan +arus
mempertiman*'an5
• @um"a+ e'sudat
• 7arna dasar "u'a
• Berapa "ama a"utan di+arap'an dapaterta+an
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Tu8uan emi"i+an Ba"utan
• Memuan* 8arin*an mati, enda asin*
• Memunu+ mi'roa
• Men*+indari ter8adi ine'si
• Memperta+an'an 'e"emaan
• Memper!epat proses pen-emu+an "u'a
• N-aman di*una'an
• Steri"
• Cost ee!tie
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@enis$8enis a"utan
• auze 2 'assa• Transparant f"m
• H-dro*e"• Ca"sium a"*inat• H-dro!e""u"osa• o"-uret+ane oam
• Si"er 2 A*• Sa" zin!
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auze 2 Kassa
• rimar- 2se!ondar- dressin*
• Me'ani'a"
deridement
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H-dro*e"
• Memantu prosesauto"-sis
• Di*una'an pada"u'a d*n &arnadasar 'unin*2+itam
• Berentu' *e"
• N-aman di*una'an
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Ca"!ium A"*inate
• Ba+an dasar darirumput "aut
• Berua+ men8adi *e"sete"a+ men-erap
!airan
• Mampu men-erap!airan sedan* $ an-a'
• ntu' "u'a d*n &arna
dasar mera+ danmuda+ erdara+
• Ka"tostat, !urasor
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H-dro!e""u"osa
• Teruat darise"u"osa
• Da-a serap san*attin**i me"ei+ida-a serapa"*inate
• Tida' muda+ 'o-a'
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H-dro!o""oid
• Men*andun* CMC
• Memperta+an'an'e"emaan "u'a
• Me"indun*i "u'a daritrauma
• Men-erap sedi'ite'sudat
•ntu' "u'a &arnadasar mera+2pin'
• Duoderm, !omee",suprasor
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Transparant Fi"m
• Berentu'"emaran p"asti'
tipis• 7aterproo• as permea"e• Se!ondar- dressin*
• psite, te*aderm
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Foam
• Mampu men-erape'sudat an-a'
• N-aman di*una'an
• Bai' di*una'an tu''ontro"+-per*ranu"asi
• ntu' "u'a &arnadasar mera+
• A""e-n, Cutimedsi"te!, Bitain
!omee"
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H-drooi'
• Men*andun* DAAC(Dia"'-!aramoi"!"oride)
• Non asoren, non
ad+esie• ntu' "u'a
ere'sudatsedan*$an-a'
• ntu' "u'a ine'si• er"u a"utan
se'under
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Si"er Dressin*
• /e'ti pada 'asusine'si
• A!ti!oat, Aua!e"
si"er, d""
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Ein! Sa"
• Memper!epat prosespen-emu+an "u'a
• Memperta+an'an 'e"emaan"u'a
• Berun*si support auto"isisderidemen
• Men*uran*i n-eri saat *antia"utan
• @i'a di !ampur d*nmetronidazo" dapatmen*uran*i au pada "u'a
• Bai' di*una'an ut' "u'a &arna
dasar mera+, 'unin*, +itam
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7assa"amN. Nazar