J Korean Acad Nurs.  2011 Dec;41(6):768-779. 10.4040/jkan.2011.41.6.768.

Adaptation of Evidence-based Surgical Wound Care Algorithm

• Han JY
• Choi-Kwon

• KMID: 1120109
• DOI: http://doi.org/10.4040/jkan.2011.41.6.768

Abstract

PURPOSE
This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit.
METHODS
This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75.
RESULTS
A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were > or =.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations.
CONCLUSION
The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

Keyword

Critical illness; Surgery; Wounds and injuries; Evidence-based nursing; Practice guideline

MeSH Terms

*Algorithms
Critical Illness/nursing
*Evidence-Based Nursing
Humans
Intensive Care Units
Practice Guidelines as Topic
Wounds and Injuries/*therapy

Figure

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  Figure 1 The surgical wound care algorithm framework. BMI=Body mass index; WBC=White blood cell; CRP=C-reactive protein; APACHE score=Initial Acute Physiologic and Chronic Health Evaluation that stands for critical ill status of critical patients.

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  Figure 2 (A) Evidence-based surgical wound care algorithm. GS=General surgery; INF=Infection part; DER=Dermatology; PS=Plastic surgery; WOCN=Wound, ostomy, continence nurse; MBP=Mean blood pressure; BP=Blood pressure; Hb=Hemoglobin; DM=Diabetes mellitus; HTN=Hypertension; BST=Blood sugar test; NPWT=Negative pressure wound therapy; HBOT=Hyperbaric oxygen therapy; E-stim=Electro stimulation; WBC=White blood cell; CRP=C-reactive protein; APACHE=Acute physiologic and chronic health evaluation. (B) Evidence-based surgical wound care algorithm. MD=Medical doctor; Cx=Culture. (C) Evidence-based surgical wound care algorithm. MNA-SF=Mini nutritional assessment short form; PPN=Peripheral parenternal nutrition; TPN=Total parenternal nutrition.

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