Clinical trial, effectiveness cutisorb ultra as the superabsorben dressing in pressure

ulcer category IV

Saldy Yusuf, S.Kep.Ns.ETN., Sukmawati, S.Kep., Sulaiman, AMK., Awaluddin, AMK

RSUP. Dr. WAHIDIN SUDIROHUSODO, MAKASSAR INDONESIA8 September s.d. 14 Oktober 2011

• The incidence of pressure ulcer in Indonesia is 33.3 % and it’s higher among ASEAN countries which incidence average between 2.1 %-31.3% (Suriadi. et al 2008)

• One of the most challenging aspect in pressure ulcer care is exudate management.

• As the pressure ulcer exacerbate, the production of exudate also increasing leading disturbance quality of care and quality of life.

BACKGROUND

• Wound dressings are a central component of pressure ulcer care (EPUAP, 2009)

• In local wound management, dressings are the main option for managing exudate (WUWHS, 2007).

• There are several criteria for exudate management; remove excess exudate from the wound site and surrounding skin while maintaining high humidity at the wound bed (Bale, 1997), easy to remove and cost effective (White and Cutting, 2006).

BACKGROUND

• In this trial we evaluate Cutisorb Ultra as the super absorben in wound healing process in pressure ulcer category IV.

OBJECTIVE

• Two patients divided into experiment group (Cutisorb Ultra) and conventional group (Gauze dressing).

• Both group using gauze impregnated honey as the primary dressing.

• Experiment group using Cutisorb Ultra as the secondary dressing.

• Control group using gauze as the secondary dressing.

METHODS

• Concern to beneficiency effet for subjects we use gauze honey as the primary dressing for both group.

• Indonesian honey has ability to decrease wound size, increasing the number of neutrophils, promotes epithelialization,syntesis of collagen and formation of granulation tissue (Haryanto, et al 2010)

• We evaluate healing process by using DESIGN tool. It was found to have both high inter-rater reliability and high validity.

METHODS

Cutisorb Ultra has five layers:

1. Soft, non-woven contact layerprevents the dressing from sticking to the wound2.

Distribution layerensures that the absorbed exudate fl ows evenly into the core3.

Absorbent corebinds a high volume of exudate with superabsorbent particles4.

Adhesive layerfixes the superabsorbent particles in place5.

Protective backingthe outer side prevents strikethrough onto clothing and bedding

METHODS: PROPERTIES OF CUTISORB ULTRA

R E S U L T S

Tabel 1: BRADEN SCALE

CUTISORB ULTRA CONVENSIONALSensory Perception 3 3

Moisture 3 3Activity 1 1Mobility 1 1Nutrition 2 2

Friction & Shear 1 1TOTAL 11 11

RESULTS

RESULTSDESIGN TOOL CUTISORB ULTRA CONVENSIONAL

Depth 4 4

Exudate 3 3

Size 12 15

Infection/Inflammation 3 3

Granulation 4 4

Necrotic 3 3

Pocket 12 9TOTAL D4-e1S12i0g1p0: 37 D4-e3S15i0g2n0p6: 37

STATUS AWAL LUKA

CONVENSIONAL DRESSINGCUTISORB ULTRA

DESIGN R D4-e1S12i0g1p0: 37

INITIAL WOUND STATUS

DESIGN R D4-e3S15i0g2n0p6: 37

1 2 3 4 5 6 7 8 9 10 110

5

10

15

20

25

30

35

40

COMPARASION OF WOUND HEALING PROCESS BETWEEN CUTISORB ULTRA AND CONTROL GROUP

cutisorb ultra gauze dressing

Frequency of Dressing

DES

IGN

R T

OO

L SC

ORE

COMPARASION OF WOUND HEALING PROCESS at 11th DAYS

CUTISORB ULTRA KONVENSIONAL DRESSING

DESIGN R D4-e1S12i0g1p0: 17 DESIGN R D4-e3S15i0g2n3p6: 29

Graphic 2

Rp- Rp500,000

Rp1,000,000 Rp1,500,000 Rp2,000,000 Rp2,500,000 Rp3,000,000 Rp3,500,000 Rp4,000,000 Rp4,500,000 Rp5,000,000

Rp2,924,448

Rp4,497,768

COMPARASION OF TOTAL COST BETWEEN CUTISORN ULTRA AND CONVENTIONAL DRESSING

CUTISORB ULTRA KONVENSIONAL DRESSING

Rp. 2.924.448 = 27.847 yenRp. 4.497.768 = 42.835 yen

Graphic 3

0

1

2

3

3 DAYS

1 DAY

COMPARASION OF INTERVAL DRESSING CHANGES BETWEEN CUTISORB ULTRA AND CONVENTIONAL DRESSING

CUTISORB ULTRA KONVENSIONAL DRESSING

INTE

RVAL

PER

GAN

TIAN

(HAR

I)

Grafik 4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

79.3 gr

40.3 gr

COMPARASION ABSORBTION ABILITY BETWEEN CUTISORB ULTRA AND CONVENTIONAL DRESSING

CUTISORB ULTRA KONVENSIONAL DRESSING

DRE

SSIN

G W

EIG

HT

(gra

m)

Using CUTISORB ULTRA as the secondary dressing in pressure ulcer category IV increase wound healing process 47. 8 %, reduce total

care cost 65 %, increase intercal dressing time 300 %. effective absorb exudate 50 % Compare

to conventional dressing.

CONCLUSION

• Suriadi, Sanada H, Junko S, Thigpen B, Subuh M.(2008). Development of a new risk assessment scale for predicting pressure ulcers in an intensive care unit. Journal British Association of Critical Care Nurse, 13, 34-43.

• European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Treatment of pressure ulcers: Quick Reference Guide. Washington DC: National Pressure Ulcer Advisory Panel; 2009.

• World Union of Wound Healing Societies (WUWHS). Principles of best practice: Wound exudate and the role of dressings. A consensus document. London: MEP Ltd, 2007.

• Adderley, Una. Wound exudate: What it is and how to manage. Wound Essentials. 2008(3).

• Sanada H, Moriguchi T, Miyachi Y, Ohura T, Nakajo T, Tokunaga K, Fukui M, Sugama J, Kitagawa. Reliability and validity of DESIGN, a tool that classifies pressure ulcer severity and monitors healing. J Wound Care. 2004 Jan;13(1):13-8.

• Haryanto, Nakatani T, Sugama J. Effectiveness of indonesian honey toward acceleration of cutaneous wound healing: an experimental study in mice. Master thesis. Kanazawa university, Japan. 2010

REFERENCES

TERIMA KASIH

saldy yusuf

www.saldyusuf.blogspot.com

saldy_yusuf@yahoo.co.id

THANK YOU