Evaluation of a treatment regimen for complex wounds.

Abstract

Advanced wound treatment relies on the knowledge of the healing process, as well as the factors that are adverse to it.
Technological progress has promoted the development of sophisticated products that play a fundamental role in the recovery of tissues damaged by different causes.
The dry gauze dressing used for a long time, has shown disadvantages such as wound dehydration and prolonged inflammation. The application of dressings that maintain a moist environment is then promoted, allowing the migration of epidermal cells and shortening the healing time.
Previous work in our environment has shown that:
There is no established protocol for the treatment of lesions, depending on the stage and their evolution.
The personnel who currently treat them do not know the fundamentals of the indications of the different antiseptics and products, as well as the advances in relation to them, which optimize the quality of care and reduce treatment times and therefore costs.
In other countries these difficulties have been solved through the unification of criteria, embodied in guidelines, which in some cases are issued by the Ministries of Health and have national application (3).
The objective of the study is to evaluate the results of the application of the wound treatment protocol defined for the HCFFAA.
The goal is to improve the quality of care, applying practices of proven efficacy, which ensure the achievement of therapeutic objectives in less time and at lower costs, improving the user's quality of life.
Methodology: this is a descriptive study that involves the follow-up of a group of patients to whom the wound treatment protocol approved in the Institution is applied in order to evaluate its efficiency. The patients are referred by the treating physician and are treated on an outpatient basis, thus reducing hospital stay.
Results: out of a total of 83 users attended between July 2001-July 2003, we highlight that in 74 users (89%) the following was achieved: control of the unpleasant odor emanating from the lesion, thus improving comfort. In the 9 cases where this control was difficult, these were users with extensive venous ulcers; pain control was achieved in 81 patients (97.5%). The other 2 corresponded to arterial ulcers; exudate control was achieved in 79 patients (95%).
Activated charcoal was applied in 51 cases and 28 required alginate dressings.
Only 4 patients had to wait until the granulation stage to see the exudation controlled and all of them corresponded to venous ulcers.
Conclusions: the criteria for treatment of complex wounds were standardized with the medical team, increasing the number of users referred to the program. The products used require a minimum contact time of 72 hours, which can reach up to seven days, which represents a benefit for the users and for the institution, allowing an early discharge, with a reduction in hospitalization costs. Although these costs have not been quantified so far, some international studies show a decrease of 50 to 75% of total expenses, including in their analysis model all variables and not only the direct cost (10, 11).