Network Transformation in Elderly Pressure Ulcers: From Necrosis to Granulation Through the Time Approach

Indah Susanti, Amelia Andini, Wulan Mei Mustika Dewi, Rantiningsih Sumarni, Asmat Burhan

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ABSTRACT

 

Pressure ulcers are prevalent in older patients who are immobile and can substantially impact their quality of life and add to the burden on the health care system. Factors that can slow wound healing are infections, necrotic tissue, moisture, and blood supply. The TIME model, which stands for tissue management, control infection or inflammation, moisture balance, and epithelial edge advancement, can be used to improve the healing of chronic wounds. This study aims to evaluate the effectiveness of the TIME approach in accelerating the healing of stage III pressure ulcers in elderly patients. This case included an older woman, 70 years of age, with a sacral (Stage 3) pressure ulcer. Treatment consisted of sharp debridement, irrigation (0.9% saline), and dressings of Cutimed Sorbact, cadexomer iodine (0.9%), then polyurethane foam over four treatment sessions. High-protein nutrition and scheduling, turning every three hours, complemented the treatment. Progress was monitored using the Bates-Jensen Wound Assessment Tool (BWAT). After four treatment sessions, necrotic tissue had decreased from 75% to 10% and granulation tissue had increased up to 90%. Clinical signs of infection improved. The initial BWAT score of 49 (indicating degeneration of the wound) was closer to partial regeneration by the final session. in facilitating wound healing in a high-risk patient. More studies are needed with a comparative study design and larger populations to verify this and enable wider clinical adoption.

 

Keywords: Debridement, Geriatric Nursing, Pressure Injury, Wound Healing.

 

 

ABSTRAK

 

Ulkus tekan sering terjadi pada pasien lansia yang mengalami kesulitan bergerak, dan hal ini dapat memperburuk kualitas hidup mereka serta menambah beban pada sistem layanan kesehatan. Proses penyembuhan luka dapat terhambat oleh berbagai faktor, termasuk infeksi, jaringan mati, kelembapan yang berlebihan, serta masalah aliran darah. Pendekatan TIME, yang mencakup manajemen jaringan, pengendalian infeksi atau peradangan, keseimbangan kelembapan, serta stimulasi tepi epitel, telah diterapkan untuk mempercepat proses penyembuhan luka kronis.Penelitian ini bertujuan untuk menilai efektivitas metode TIME dalam mempercepat penyembuhan ulkus tekan tahap III pada pasien lansia. Laporan kasus ini membahas seorang pasien wanita berusia 70 tahun yang mengalami ulkus dekubitus di area sakrum. Intervensi dilaksanakan dalam empat sesi, yang mencakup debridemen tajam, irigasi dengan NaCl 0,9%, serta penggunaan balutan Cutimed Sorbact, cadexomer iodine, dan foam poliuretan. Dukungan nutrisi yang kaya protein dan tindakan mobilisasi tersedia setiap tiga jam. Untuk evaluasi, digunakan alat penilaian luka Bates-Jensen (BWAT). Setelah melakukan empat intervensi, area nekrotik mengalami penurunan dari 75% menjadi 10%. Selain itu, jaringan granulasi meningkat mencapai 90%, dan gejala infeksi menunjukkan perbaikan. Skor BWAT awal sebesar 49 menunjukkan adanya kerusakan degeneratif, yang kemudian menunjukkan pergeseran menuju fase regenerasi parsial. Pendekatan TIME yang diterapkan dengan sistematis dan secara individu terbukti dapat mempercepat proses penyembuhan ulkus tekan pada pasien yang memiliki risiko tinggi. Penting untuk melakukan studi tambahan dengan desain komparatif dan melibatkan populasi yang lebih besar guna memperkuat temuan ini.

 

Kata Kunci: Debridemen, Keperawatan Geriatri, Cedera Tekanan, Penyembuhan Luka.


Kata Kunci


debridemen, keperawatan geriatri, cedera tekanan, penyembuhan luka

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Referensi


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DOI: https://doi.org/10.33024/mnj.v8i2.24305

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