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Chronic wound care - shin ulcer
Kümmelová, Tereza ; Hromádková, Jaroslava (advisor) ; Nikodemová, Hana (referee)
The bachelor thesis Chronic wound care - shin ulcer deals with the issue of chronic wounds focusing on tibial ulcers. The aim of the thesis was: To collect data on treatment options for and to study the available resources. To obtain data from the database "Care of the patient with a non-healing wound" at the University Hospital in Motol. These data were then assessed and statistically processed. To calculate a qualified estimate of the burden of nursing staff related to the care of patients with shin ulcer in internal medicine units, surgical units and in general in the University Hospital in Motol. The theoretical part of the thesis gives a basic overview of the problem. The empirical part of the thesis presents the results of the own investigation and their comparison with the results of previously conducted studies. The method of the research investigation was secondary data analysis from the database "Care of a patient with a non-healing wound" at the University Hospital in Motol. The research investigation included 164 patients with shin ulcer hospitalized in the period from January 1, 2022 to June 31, 2022 at the University Hospital in Motol. Results: It was found that more males were hospitalized with shin ulcer than females in Motol University Hospital during the period. More patients with...
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Knowledge of nurses about methods of treatment of the leg ulcer
Dvouletá, Zuzana ; Sojková, Monika (advisor) ; Pekara, Jaroslav (referee)
The topic of this thesis is "Knowledge of nurses about methods of treatment of the leg ulcer". The purpose of this thesis was to document current methods of treatment of the leg ulcer and to evaluate nurse's knowledge of this area. The thesis is divided into two sections - a theoretical and an empirical one. The theoretical section is devoted to the leg ulcer as a term and its causes, then it concerns wound healing and factors, which it is influenced by. It also describes the currently used methods of treatment of the leg ulcer and other chronic wounds. The empirical section is based on a quantitative research performed as a questionnaire study, which has been carried out in medical and surgical wards in three teaching hospitals in Prague. The goal of this research was to determine nurse's knowledge of chronic wounds, the leg ulcer, its risk factors and prevention, of wound healing, compression therapy and to find out, in which ways nurses get access to information on wound healing and treatment of the leg ulcer. This goal was met. The findings of the research are summarized in the conclusion of the thesis. Key words: moist wound healing; leg ulcer; wound; chronic wound; debridement; compression therapy; nursing care
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Knowledge of nurses about methods of treatment of the leg ulcer
Dvouletá, Zuzana ; Sojková, Monika (advisor) ; Pekara, Jaroslav (referee)
The topic of this thesis is "Knowledge of nurses about methods of treatment of the leg ulcer". The purpose of this thesis was to document current methods of treatment of the leg ulcer and to evaluate nurse's knowledge of this area. The thesis is divided into two sections - a theoretical and an empirical one. The theoretical section is devoted to the leg ulcer as a term and its causes, then it concerns wound healing and factors, which it is influenced by. It also describes the currently used methods of treatment of the leg ulcer and other chronic wounds. The empirical section is based on a quantitative research performed as a questionnaire study, which has been carried out in medical and surgical wards in three teaching hospitals in Prague. The goal of this research was to determine nurse's knowledge of chronic wounds, the leg ulcer, its risk factors and prevention, of wound healing, compression therapy and to find out, in which ways nurses get access to information on wound healing and treatment of the leg ulcer. This goal was met. The findings of the research are summarized in the conclusion of the thesis. Key words: moist wound healing; leg ulcer; wound; chronic wound; debridement; compression therapy; nursing care
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The role of nurses in the care of chronic wounds by using alternative methods and materials of moist wound healing
SKŘÍŠOVSKÁ, Martina
This bachelor?s thesis deals with the actual classification of wounds and the issue of the chronic wound treatment. In the preface of the theoretical part of the thesis, the term wound is defined and the wounds are subcategorized in the terms of their pathological traumatological origin. In the next chapters, the process of the wound healing is analysed from molecular biological aspect, the terms acute and chronic wound are defined and newly introduces the term non-healing wound for the chronic wound. In the special part, the particular pathological-surgical types of chronic wounds are described from their molecular biological, surgical anatomical and therapeutic point of view. Next, the paper specifies risky factors influencing wound healing process aiming their therapeutic influenceability. These factors are further divided into the system ones and the local ones. The thesis continues with the analysis of the therapeutic and nursing possibilities in the chronic wound treatment describing traditional bandages including sterile pieces of gauze and disinfectant solutions for the materials of the moist wound healing. This is followed by the chapters discussing modern methods of the debridement of the chronic wound such as ultrasonic hydrotherapy, negative-pressure wound therapy or larval therapy. Each chapter describes both the indications and the contraindications for the use of these methods, their advantages and benefits for the patient, aiming the role of the nurse in the chronic wound healing process using these methods. The end of the theoretical part of the thesis is devoted to the nutritional support and the systemic enzymotherapy, which ensures a sufficient energy intake to the organism and both all the macronutrients and micronutrients necessary for building the body tissues. The empirical part of the thesis is in the form of a qualitative research focused on the documentation of the role of the nurse in the care of the patients with a single type of the chronic wound ? more precisely the patient after laparotomy with an extensive resection of the digestive system and a subsequent secondarily healed chronic wound. The method of using case studies was used to accomplish this goal. The record of the chosen group of the patients and the process of the systemic therapy with the support of the cardiovascular, ventilatory and nutritional functions regarding the surgical performance is acquisited and it is completed with the description of the local therapy of the chronic wound, with the description of the role of the nurse in the healing process and with the enclosed photo documentation. Casuistries describe the regression, the stagnation or the progress of the wound healing process; they map the role and the participation rate of the nurse in this process and the use of alternative equipment in this process and the art of improvisation. The summary of the results brings up the conclusion that the scientific and technological progress opens up new possibilities to the patient with the chronic wound and introduces modern technological procedures into the chronic wound therapy though there is a group of patients after laparotomy surgeries with the conducted extensive resection of the digestive system and with the subsequent anastomosis dehiscence, which is contraindicated for the use of these methods. These patients are left to depend on the holistically provided care of a multidisciplinary team with irreplaceable role of the nurse. Biopsychosocial needs of the patient puts great demands on the nurse regarding both the personal and the professional side. The reasoning at the end weighs up and suggests the possibilities of the participation of the nurse in the preoperative preparation of the patient for the planned resection of the digestive system mainly in the form of the education in the support of the nutritive functions and the systemic enzymotherapy.
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The nursing care for the patients with "diabetic leg" after using SONOCA 180 in combination with the damp healing technic
VÍTÁMVÁSOVÁ, Kateřina
Abstract The Bachelor Thesis ?Treatment for ?diabetic foot? after application of SONOCA 180 apparatus in combination with wet healing technique? is divided into a theoretical and a practical part. The theoretical part analyses the development of wound healing from history to present. It also describes diabetes mellitus disease, its classification and complications. The issue of diabetic foot syndrome we are dealing with in the Thesis is related to diabetes mellitus. The disease may be treated traditionally or applying modern methods, which include the ultrasound apparatus SONOCA 180 and wet healing of wounds. This ultrasound technique combined with wet healing of wounds is the main topic of our thesis. The practical part involved a qualitative research method ? semi-controlled interview and case studies of patients with diabetic angiopathy, who were treated by the SONOCA 180 apparatus combined with wet healing of wounds. We applied the method to a patient with diabetic angiopathy, who had been treated traditionally. We first prepared the case studies and then we talked to them about selected topics. We prepared 14 questions that directed our interviews. Patients hospitalized at the surgery ward or visiting the surgery outpatient room of České Budějovice Hospital were the respondents; we spoke to 4 patients A semi-controlled interview was conducted with 5 nurses of the surgery ward of České Budějovice Hospital. The interview consisted of 10 questions and dealt with the topics of diabetic foot syndrome treatment, SONOCA 180 ultrasound method combined with wet healing of wounds. The aim of the work was to discover the effect of SONOCA 180 application in combination with wet healing on treatment of wounds. The second goal was to find out the differences in healing after standard treatment and after application of this technique and to find out the opinion of patients on the technique. The research among the respondents showed that SONOCA 180 greatly contributes to healing of wounds, but it has individual effect on each patient. SONOCA 180 provided quicker healing of wounds than the traditional method, but the treatment as a whole also depends on the patient?s health condition, the appearance of the treated defect and the phase of healing. Our Thesis might serve in practice as a guide for closer familiarization with the SONOCA 180 apparatus in combination with wet healing of wounds and thus provide the clients with the diabetic foot syndrome with more information on this method, and medical staff with wider knowledge of this new technique. This is why a brochure (Annex 15) was prepared to inform patients and medical staff on the SONOCA 180 apparatus and wet healing of wounds.
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Use of modern methods in treatment of chronic wounds
LEPIČOVÁ, Zuzana
Healing and treatment for chronic wounds are big problems and they affect overall states and fate of patients who are immobile after heavy injuries in consequence of some diseases or because of penetrating wounds. Prevention and treatment flowing from profound knowledge of anatomy, skin physiology, pathology and patho-physiology of defects origins and of healing process is currently taking a big step forward in treatment for refractory wounds. The thesis is divided into two parts. The theoretical part deals with skin anatomy and physiology, pathology and patho-physiology of origins of defects, healing processes and proper treatments of wounds, especially chronic wounds such as ``diabetic foot syndrome{\crqq}, venous and arterial ulcerations and decubital ulcers. Preventative measures against decubital ulcers are described. Documentation of refractory wounds, 3 phases of healing and continuum of healing are described in detail. Re-bandages, the local wound care, are the most significant factor of treatment. Re-bandages follow standard procedures, which involve make-ready of patients, preparations of wounds for re-bandages, preparations of instruments and make-ready of attending staff. Good re-bandage assistance is crucial. Modern treatment methods include various new types of wound cleanup (from the mechanical one, chemical one and autolysis to the enzymatic one, with the use of larva therapy, for example) as well as the usage of very effective ``moist healing{\crqq} methods. Various contact - not adhesive bandages, foams, alginates, hydro gels, antiseptic bandages, dressings with active Carbon, hydrocolloids, hydro adherent dressings, hydro fibres, bandages with active AG ions, chitosin, dressings with hyaluronic acid, collagen bandages, dressings with iodine, mupirocin, or honey. The practical part is dedicated to qualitative research, in a way of non standardised interview. There were two thesis objectives: To map the usage of modern treatments for refractory wounds and to enlighten general nurses in this field. 15 nurses, who deal with chronic wounds, from various emergency wards and hospital wards took part in the interviews. Information was collected from February 2010 to April 2010 and it was elaborated into 15 casuistries. The result of analysed answers was digested into a table. In the Discussion I analysed the particular answers and set 3 hypotheses for each domain. Domain 1: H1: Modern treatments for healing of wounds are not systematically used at most units. H2: Monolithic systems for usage and indication of modern methods do not exist at most units. H3: Statistics of chronic wounds existence is not kept at many units. Domain 2: H1: Trainings are organised by medical facilities in collaboration with distributing companies but their capacities do not satisfy the interest of applicants. H2: Most nurses declare good knowledge of chronic wound healing phases and of continuum of healing. H3: Neither managers of medical facilities nor health insurance companies have sufficient knowledge regarding the ``cost {--} benefit{\crqq} of chronic wound treatments. The Conclusion summarise the whole thesis. The importance of follow up treatment and rehabilitation for subsequent fate of afflicted patients and their families is underlined in this part.
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