HLT54115 Nursing : Therapy and Mechanical Method
Patient currently using mechanical method (wet to dry dressing) on venous leg ulcer but she found it is not good her. Now she is asking nurse to use maggot debridement therapy on her leg ulcer. We need to present our findings in a way that allows patient to make informed decisions about her care.
In patients with venous leg ulcer, which method is more effective at healing leg ulcer?
Two methods are:
- Maggot debridement therapy
- Mechanical method (wet to dry dressing)
Answer:
Introduction
The leg ulcer is quite disturbing and very painful. Usually, it significantly reduces the quality of life for a patient. In most instances the ulcer gets difficult to treat, but, the fruitful treatment of the leg ulcer would depend solely on the diagnosis accuracy and efficient handling of the cause (Vivas, Lev-Tov, & KIrsner, 2016). In this essay assignment, I would discuss two methods for the leg ulcer care and recommend the most effective method.
Similarities between Maggot Debridement Therapy and Mechanical Method
Both of the two approaches gets applied
with the objective of removing the necrotic, the damaged and the tissue which got infected. The debridement methods are both employed with the aim of improving the rate of healing of the uninfected and undamaged tissue. In the two approaches, a gauze bandage gets put into use though differently (Gethin, Cowman, & Kolbach, 2015). The two methods get applied on the chronic wound to make it acute wound so as to hasten the therapeutic process by removing the dead tissue and infection removal. The two methods promote tissue proliferation and their maturation and create a wound environment that is moist for fast healing. In the process of applying either of the two approaches, the excessive inflammatory responses get controlled, and there is stimulation of the release of the cytokines and growth factors by the platelets since the action of the two methods results to bleeding.
Differences between Maggot Debridement Therapy and Mechanical Method
The maggot debridement therapy remains cost effective as compared to the mechanical method. The maggot debridement therapy minimizes on the hospital admission frequencies for surgical debridement and also, reduces the amount of clinical follow-up visits (Marston & F, 2016). On the other hand, research has shown that in the mechanical method, the labor plus the material costs involved in the many dressings renders the method very expensive. For the maggot debridement, young maggots are applied to feed on the necrotic whereas, in the mechanical process, the necrotic tissues are trapped in a gauze bandage and then get pulled manually upon accumulation of the dressing material. In the maggot debridement method, airborne contamination gets controlled since the larvae feed on the bacteria on the wound bed unlike in the case of the mechanical method where the bacteria get released into the immediate environment during the gauze removal.
Key Point about the Two Methods.
In both of the two approaches, research has just revealed that pain is a major drawback. Studies show that a greater proportion of the patients undergoing maggot debridement therapy have complained of feeling a lot of pain in the process of treatment and end up requesting the application of analgesics before the MDT. Further patients under severe conditions have sought application of the opioids or the peripheral nerve blockers before the treatment procedure sets (Sun, et al., 2014). In the mechanical method, patients who got dressed in the gauze do experience much pain during the process of changing the dressings as they get removed forcefully. For instance, out of the ten studies on the gauze dressing, eight studies confirmed that patients with the gauze dressing experienced so much pain during the gauze dress removal process.
Recommendation
It would be quite wise for the patient to choose the maggot debridement therapy as the efficient method for the care of her leg. The patient should choose the method since it is very cost effective such that she would have to visit the clinic regularly for follow-ups and it minimizes the debridement surgery costs (Neumann, et al., 2016). Further, the maggots help to feed on the bacteria on the wound bed, thus, infection control. Finally, the larvae would make the method more appropriate as they would remove all the necrotic tissues creating room for the proliferation and maturation of new tissues hastening the healing process.
Reflection on Turnitin Report
In this assignment, I have attained a 0% score in plagiarism because I have just produced an original work which has never been submitted before by any other student. I have also read the articles authored by different writers, in which I have acquired knowledge that enabled me to do my assignment. After reading the articles, I have written the ideas obtained using my words, since it is wrong to copy and paste the author’s words. I have done the intext citation and referencing so as to advocate and acknowledge the authors’ work for all the sources I used in the production of the assignment. Furthermore, I do not typically rely on the published sources only, but I do also, brainstorm to get my new ideas in addition to the sources used in the assignment preparation. Finally, I have adhered strictly to the academic integrity by producing an original assignment and acknowledging all the scholarly sources I used.
References
Davies, C. E., Woolfrey, G., Hogg, N., Dyer, J., Cooper, A., Waldron, J., ... & Poskitt, K. R. (2015). Maggots as a wound debridement agent for chronic venous leg ulcers under graduated compression bandages: a randomised controlled trial. Phlebology, 30(10), 693-699.
Gethin, G., Cowman, S., & Kolbach, D. N. (2015). Debridement for venous leg ulcers. The Cochrane Library.
Marston, W. A., & O’Donnell Jr, T. F. (2016, December). Local treatment of venous ulcers. In Handbook of Venous and Lymphatic Disorders: Guidelines of the American Venous Forum (pp. 585-595). CRC Press.
Neumann, M., Cornu-Thénard, A., Jünger, M., Mosti, G., Munte, K., Partsch, H., ... & Streit, M. (2016). Evidence based (S3) guidelines for diagnostics and treatment of venous leg ulcers. Im Internet: https://www. euroderm. org/edf/index. php/edf-guidelines/category/5-guidelines-miscellaneous.
Sun, X., Jiang, K., Chen, J., Wu, L., Lu, H., Wang, A., & Wang, J. (2014). A systematic review of maggot debridement therapy for chronically infected wounds and ulcers. International journal of infectious diseases, 25, 32-37.
Vivas, A., Lev-Tov, H., & Kirsner, R. S. (2016). Venous Leg Ulcers. Annals of Internal Medicine, 165(3), ITC17-ITC32.
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