Class B Kel 1 Project Field Community Service "Wound Care"

FIKES UPNVJ - On Tuesday, September 19 2023, the "Wound Care Community Service Field Project" activity began. This event was organized by students from the 5th Semester Undergraduate Nursing Study Program who are active students of the 2021 Undergraduate Nursing Study Program. This activity took place at the home of our patient named Mrs. K on Jl Pt. Mandar Cahayasari District. Ciracas, East Jakarta City, Special Capital Region of Jakarta.

The first meeting was held at 17.00 WIB on Jl Pt. Mandar Cahayasari District. Ciracas, East Jakarta City, Special Capital Region of Jakarta with the assistance of our supervisor, namely Ns. Santi Herlina, M.Kep., Sp.Kep.MB. The aim of holding this event is to treat patients with decubitus wounds (pressure wounds) in the hope that the wounds will get better and heal after treatment by our group.

The first meeting started with the group and Ns. Santi washes his hands first, wears PPE (mask and gloves), and positions the patient and provides treatment for the patient's lower part. First, the group members began to clean the patient's wound with wound soap and NaCl liquid. After cleaning, the wound was examined and there were 3 pressure wounds on Mrs. K. After the group members finished cleaning and washing the wounds on the back, we took turns washing and choosing appropriate dressings for several other pressure wound points. The dressing we use for primary dressing is metcovazin ointment because the patient's wound is dry, then for secondary dressing we use gauze, and after that we apply a transparent dressing/hypafix for tertiary dressing.

The second meeting began with group members removing the wound dressing, then cleaning the wound and assessing the progress of wound healing.

Wound 1: The wound on the right back has already formed granulation tissue, the wound boundaries are clear and there is no necrosis.

Wound 2: The wound on the buttocks (close to the anus) has improved, granulation is present and the black tissue has softened but the tissue cannot be removed yet. On the second day, the wound dressing was removed because it was exposed to feces.

Wound 3: Wound on the right buttock (initially 3 wound points) 2 wound points have epithelialized, there is a little necrosis, there are already granulations, the red color has decreased but new wounds have appeared due to scratching by the patient. The patient felt itchy so he scratched it until it bled. At the time of the visit the dressing was open due to scratching by the patient.

After assessment, the group bandaged the wound occlusively again with metcovazin ointment as well as gauze and transparent dressing/hypafix.

Then at the third meeting, group members cleaned the wound again by first removing the bandage, then washing it with wound soap and rinsing with NaCl. There was a bandage that came off because the patient scratched the wound and traces of blood were also visible on the wound. After that, carry out an assessment of the patient's wounds.

Wound 1: The wound on the right back has increased granulation (approximately 75%), the wound borders clearly merge with the wound, the skin around the wound is dry, pale in color.

Wound 2: Wound on the buttocks (close to the anus), the bandage is open because it was removed and scratched by the patient, 50% granulation tissue, no necrotic tissue, the skin around the wound is red, a new wound has formed (previously it was only black).

Wound 3: Wound on the right buttock, approximately 80% granulation, the skin around the wound is pink, the bandage is open because it was removed and scratched by the patient, there is blood from the patient's scratching, the patient's wound is getting wider.

After assessment, the group bandaged the wound occlusively again with metcovazin ointment as well as gauze and transparent dressing/hypafix.

At the fourth meeting, the group also started cleaning the wound by first removing the bandage and washing the wound with wound soap and then rinsing with NaCl. There was improvement in the tissue around the patient's wounds, but there were several wounds whose bandages were open due to scratching by the patient. Then, the group assesses the patient's wounds.

Wound 1: Wound on the right back, 75% granulation tissue, the wound borders clearly merge with the wound, the skin around the wound is dry pink, there is blood because the bandage is sticky when opened.

Wound 2: Wound on the buttocks (close to the anus), bandage open because it is wet, still scratching frequently, 75% granulation, no necrotic tissue, skin around the wound pink.

Wound 3: Wound on the right buttock, granulation is 95%, the skin around the wound is pink, the bandage is open because it was wet when replaced with Pampers, the wound is still frequently scratched, there is no blood from the patient's scratching, the patient's wound has shrunk.

After assessment, the group bandaged the wound occlusively again with metcovazin ointment as well as gauze and transparent dressing/hypafix.

At the fifth meeting, the group also started cleaning the wound by first removing the bandage and washing the wound with wound soap and then rinsing with NaCl. There is tissue repair around the wound