Class B Ex 2 "Wound Care Field Project" Wound Care Mr. R With Diabetes Mellitus

FIKES UPNVJ - On Tuesday, September 19 2023, the "Wound Care Field Project" activity was carried out. This activity was organized by students of the Undergraduate Nursing Study Program (Semester 5) who are active students of the 2021 Undergraduate Nursing Study Program. This activity was carried out by treating wounds on one patient by a group of 14 students.

This activity was carried out every 3 days for 6 meetings, namely 19, 21, 23, 25, 27 and 29 September at the patient's home whose address was Ciputat, South Tangerang. The patient being treated suffered from diabetes mellitus and had a wound on his right leg. Students who carry out wound care are also accompanied by Ns. Fiora Ladesvita, M. Kep., Sp. Kep. MB as the group supervisor. The aim of this field project is to increase knowledge and skills about caring for wounds properly.

Before carrying out wound care, the group divides tasks, namely there is a team to check the patient's blood sugar levels, carry out washing, debridement and dressing the wound, as well as assessing the wound. This activity begins with an introduction and building a relationship of mutual trust with the patient. Checking Mr.'s blood sugar levels. R is done to see if Whether the patient's blood sugar is still controlled or not is because if the patient's blood sugar level is too high it will affect the wound healing process. After that, the group began wound care by removing the patient's bandage and washing the wound using NaCl, then assessing the wound.

Wound assessment starts with examining the wound, measuring the length and width of the wound to obtain the size of the wound, assessing whether there is dead (necrotic) tissue, assessing the depth of the wound, assessing the edges of the wound, assessing whether there is fluid (exudate), and assessing whether there is still bleeding.

After conducting a wound assessment, students then begin to remove necrotic tissue which can inhibit the process of forming new tissue and hinder wound healing. On the first day there was a lot of necrotic tissue, namely slough and a little black tissue. This process is carried out by mechanical and autolysis. Most of this necrotic tissue is hard and difficult to remove, so the tissue is compressed with gauze soaked in NaCl first. Hard tissue is not forced to be removed by mechanical debridement, but is carried out by autolysis debridement. Mechanical debridement is carried out using tweezers and anatomical scissors that have been previously sterilized and this process uses sterile gloves. For autolysis debridement, after all the soft necrotic tissue has been mechanically removed, the tissue that is still hard and dry will be smeared with hydrogel and green metcovazin. Then, calcium alginate will be placed on the bleeding wound to prevent the bleeding from getting worse.

Next, the wound will be dressed with an occlusive dressing concept (covering it completely). This occlusive dressing aims to make the dressing air and water tight so that the wound and surrounding area remains moist and does not become infected. After that, the dry skin around the wound is smeared with coconut oil or baby oil to make it moist. And for further treatment, the treatment process is carried out in the same way, starting from checking the patient's blood sugar, washing, assessment, debridement, and dressing the wound. And there is an addition to the wound dressing, namely applying foam to the part of the wound where exudate often comes out so that the exudate does not seep out. Apart from that, this foam is also used with the aim of suppressing hypergranulation that has occurred in the patient's wounds. And for tissue that is already red, metcovazin red will be given to help the epithelialization process.

Before the end of the "Wound Care Field Project" group members provided education regarding good and appropriate wound care to the patient's family. The education is about how to wash wounds, remove dead (necrotic) tissue, and choose the right dressing. And education about maintaining a healthy diet to help the wound healing process because the patient suffers from diabetes mellitus.

The closing of activities or the end of the "Wound Care Field Project" for Undergraduate Nursing Study Program Students (Semester 5 2021) is officially completed and followed by documentation. Then say goodbye to the patient and family. (APS/ATZM/DWD/DMY/SFS)