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Case Study
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Addressing the ÒIÓ of TIME in patients with chronic leg ulceration Rod Oldfield, BS, DipHE, RN, Trafford General Hospital, Manchester, UK Chronic wounds present the practitioner with many challenges, making up a large proportion of their workload. The TIME Framework, (International Advisory Board on wound bed preparation, 2003) provides a useful tool to enable the practitioner to perform a holistic assessment, identifying any factors which can delay wound healing. In this case - Infection. I will outline the care received by two female patients with chronic leg ulceration managed with an absorbent silver coated antimicrobial barrier dressing*. Both patients have complex underlying medical pathologies and are MRSA positive. Problems are exasperated by poor compliance and long standing bilateral ulceration. Both patients quality of life is extremely poor.. .The objective of management was to provide a dressing regime, which would;..-Reduce / control infection levels and bacterial burden in the wounds.-Control / reduce levels of exudate to a more manageable level.-Reduce odour / pain levels.-Reduce number of dressing changes to improve quality of life.-Increase compliance in the first patient's case.-To stimulate wound healing. .Chronic wounds present the practitioner with many challenges and difficulties, not least because not all the processes involved are fully understood. Optimisation of the wound bed is essential to achieve better patient outcomes. Abnormalities, which impair wound healing, must be addressed, before healing will start. The utilisation of an absorbent silver-coated antimicrobial barrier dressing*, not only addressed the issue of infection within the TIME concept, but also the moisture aspects as well. The dressing produced significant improvements, in both patients' wounds, which had remained static for many months. More significantly, there was an improvement in the two patient's quality of life, with less pain and less frequent dressing changes. *ACTICOAT, Smith & Nephew Wound Management Inc., Largo, FL. |
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