Journal of Nursing Theory and Practice

[Non-healing (chronic) wounds on lower limbs]

DARÓCZY Judit

FEBRUARY 28, 2013

Journal of Nursing Theory and Practice - 2013;26(01)

[The incidence of chronic wounds is high (5-7% of the population); these include ulcers developing due to venal and arterial circulation failure, diabetes, tumours and pathological pressure. Chronic wounds represent serious economic and communal/individual social problems. Their treatment takes place at every level of healthcare: primary care, home nursing, specialist clinics, acute inpatient care and rehabilitation wards. Treating the wounds requires specialist expertise. Continuous training is essential, not only for doctors but also for nurses. Doctors and nurses have to work together in order to treat the wounds. The author sets out to describe the physiological basics of the healing of the wounds, the clinical properties of the wounds, and the principles of their professional treatment. ]

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[Diabetic foot syndrome is an array of symptoms with a complex pathomechanism, the complications of which (if treated late) can make it necessary to amputate the limb. Approximately 15% of diabetes patients can expect foot sores to develop in the course of their illness. The author presents the vascular complications of diabetic that underpin the development of diabetic foot syndrome, the tests serving to diagnose them, and the typical clinical manifestations and complications of diabetic foot ulcers. The most important factors in the successful treatment of diabetic foot sores are summarised: normalisation of the general medical condition; alleviation of chronic pressure points; ensuring arterial circulation; infection control; regular and appropriate mechanical debridement; wound treatment in keeping with the given phase of healing; patient education; prevention of relapse. The author places particular emphasis on the screening tests, treatment methods and patient education tasks that can be performed by specialist nurses. ]

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[Aspects of the treatment plan for chronic foot wounds on the basis of practical experience ]

IGNÁTH Györgyi

[When treating chronic wounds the nurse works responsibly as a member of the team, and this cannot be limited to simply following the doctor’s instructions and appropriately dressing the wound. During the treatment of the patient the nurse has to make assessments and observations, carry out tests, evaluate the results, and warn the doctor in good time of any symptoms that depart from the typical healing process that is to be expected in the treated wound. The author presents the principles and methods applied in the practice of wound treatment, highlighting the nurse’s tasks and scope of authority in this regard. ]

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[The development and healing of pressure ulcers depends on a combination of several factors. The factors related to the patient (physical impacts, biological and psychosocial factors), as well as the influencing factors arising in relation to the lingering wound (e.g. the content, situation, size and blood supply of the sore, the condition of the wound bed, the presence of infection, the response to treatment) are all closely related to the patient’s general condition and the underlying disease. An important role is also played by the factors associated with the healthcare personnel (ability, professional qualifications, attitude), and the healthcare system (level of technical and economic advancement, preventive and wound care equipment, quality assurance, training). The author has set out to give a detailed description of these factors, supported by professional evidence. ]

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[European Council of Nursing Regulators]

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