Is saline irrigation an effective alternative for cleansing pressure sores of elderly in old aged home : a pilot study

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Is saline irrigation an effective alternative for cleansing pressure sores of elderly in old aged home : a pilot study

 

Author: Ho, Yuet-ming
Title: Is saline irrigation an effective alternative for cleansing pressure sores of elderly in old aged home : a pilot study
Degree: M.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations.
Bedsores -- Treatment.
Wound healing.
Older people -- Nursing home care -- China -- Hong Kong.
Department: School of Nursing
Pages: viii, 73 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2232396
URI: http://theses.lib.polyu.edu.hk/handle/200/3528
Abstract: Wound cleansing is an essential component of wound management used to facilitate the wound healing process (Barr, 1997, as cited in Hoffman & Schafer, 2000). Several methods are available for healthcare professionals to perform wound cleansing. Traditionally, nurses clean wounds by swabbing that involves the use of cotton wools, forceps or gloves. However, Williams (1999) claims that the modern concept of wound cleansing by irrigation has now always been a priority in wound management. Since wound cleansing is a crucial part of the wound healing process, the technical method to be adopted becomes an important facet of nursing. This study aimed to examine the effectiveness of cleansing pressure sores by irrigation using saline vis-a-vis the conventional practice by swabbing. Three subvented and one private old aged homes had joined the study. Elderly with stage II or stage III pressure sores were invited to participate a 6-week wound cleansing programme. The wound was followed up for 6 weeks or until it was healed, whichever was earlier. During this follow-up period, any recruited subject infringing the exclusive criteria would be laid off. At the end, twelve subjects, six for the irrigation group and the other six for the swabbing group, finished the study. The chi square analysis indicated that statistically there was no significant difference of the baseline wound characteristics between the two groups (p = 0.53). Also, the Mann Whitney U-test detected no significant difference of the initial wound size between the two groups (p = 0.63). Among other things, the study looked into various areas including (i) any correlation between wound healing and method of cleansing; (ii) the time effect on wound healing; and (iii) any correlation between method of cleansing and infection. Sixty-seven percent of the wounds (n = 8, 4 by irrigation and 4 by swabbing) were completely healed after the intervention period. Another 25% of the wounds (n = 3, 1 by irrigation and 2 by swabbing) experienced a wound size reduction by a range from 40% to 73.7%. For the remaining wound which was in the irrigation group, it accrued a wound size reduction by 60% during the first 3 weeks of intervention but afterwards progressively resumed its original size. Repeated measure ANOVA was conducted to assess the effect of time and cleansing method difference on wound healing. The results indicated that wound healing was neither significantly affected by the different method of cleansing (p = 0.45) nor the time span (p = 0.08). Despite micro-organisms were cultured, no signs and symptoms associated with infection of the wound were observed from the two groups during the study. As such, no result could be deduced regarding the effect of different method of cleansing on rate of infection. For this study, only a small sample size could be recruited due to various constraints. One might cast doubt on whether the subjects were typical of the population in relation to their response to the method of cleansing, and thus the reference value of the study results. Admittedly, the small sample size posed much constraint on statistical interpretation. Nevertheless, this study has revealed the practical difficulties and provided clues to overcome them. It is hoped that these experience and advices will be of good reference value for future studies of related topics.

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