THE USE OF IVT IN A WOUND CARE PRACTICE
Liezl Naude Wound Management Specialist BCur, MCur, Cert Wound Care (UFS), Cert Wound Care (Hertfordshire), IIWCC (SUN/Toronto)
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WOUND MANAGEMENT INNOVATION Established 2000 Holistic patient centred approach Multidisciplinary team Focussed on lower limb management Specialised diagnostic tests and screening methods IVT
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ELOQUENT LEARNING HEALTH Established 2005 Practical hands on training Evidence based practice Multidisciplinary team Short courses Symposiums Conferencing
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ELOQUENT WELLNESS
Early diagnostics
Optimising wellbeing and healing
Rehabilitation
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PATIENT PROFILE
Diabetes
Venous leg ulcers
Arterial insufficiency
Post op surgery
Lymphoedem a
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Epidemiology involved i.e. Diabetes, Cardiovascular disease
BASELINE TREATMENT PROTOCOL If improvement not as expected re-assess the patient
Medical history Current problem Patient Centred concerns
Evaluate weekly: Leg circumference Wound size Wound bed Pain Saturation levels
IVT and Wound management
IF ABPI LESS THAN 0.6 PATIENT IS FIRST REFERRED TO VASCULAR SURGEON BEFORE COMMENCING TREATMENT Program according to individual needs of the patient
Vascular status Leg Measurement
ABPI & palpable pulses Capillary refill Ankle, calf and thigh measurement Saturation %
Saturation rate
Wound Assessment Pain assessment
Photograph with ruler Longest width x longest length Pain scale 0-10
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CASE EXAMPLES L NAUDE WEYERGANS GERMANY 2015
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PATIENT WITH CHRONIC VENOUS HYPERTENSION WITH LYMPHATIC COMPONENT FOR 6 YEARS. Session 1 Oxygen R leg Thigh = 48, calf =39,5cm, Ankle = 28,5cm saturation % 88% L Leg Thigh =47, calf 48cm, ankle = 30.5cm - 92%
Session 5 Oxygen R leg Thigh = 45, calf =34,5cm, Ankle = 24cm saturation % 90% L Leg Thigh =45, calf 36.5cm, ankle = 26.5cm - 94%
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PATIENT WITH 7 YEAR HISTORY OF CHRONIC LYMPHOEDEMA AND ECZEMA SESSION 1
Session 1
SESSION 12
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PATIENT WITH CHRONIC ULCERATION AND OEDEMA 3 YEAR ULCER HISTORY Session 1 R leg, calf =46cm, Ankle = 23cm
L
Leg, calf 48cm, ankle = 25cm
Oxygen saturation % 86% - 90%
Session 12 R leg, calf =41cm, Ankle = 21cm
L
Leg calf 42cm, ankle = 21.5cm
Oxygen saturation % 92% - 96%
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DIABETES WITH LYMPHOEDEMA & MYCOSIS FUNGOIDIS 4 SEPTEMBER 2014
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DIABETES WITH LYMPHOEDEMA & MYCOSIS FUNGOIDIS DATE 17 SEPTEMBER 2014
DATE 17 OCTOBER 2014
DATE 17 NOVEMBER 2014
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TREATMENT PROTOCOL TREATMENT: 1. IVT which consists of 30minute sessions with exposure to negative pressure at -38mmHg - -50mmHg. 2. 3 times per week 3. LED light therapy with biofilm remover gel for 15 minutes 4. Wound dressing 5. Modified compression bandaging
CHALLENGES: Travel distance Infection Mycosis fungoides Radiotherapy
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ARTERIAL INSUFFICIENCY WITH LYMPHOEDEMA 25 JULY 2014
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ARTERIAL INSUFFICIENCY WITH LYMPHOEDEMA DATE 11 AUGUST 2014
DATE 29 SEPTEMBER 2014
DATE 22 DECEMBER 2014
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CHALLENGES: Travel distance Infection Lymphoedema Age Mobility
TREATMENT PROTOCOL TREATMENT:
1. IVT which consists of 30minute sessions with exposure to negative pressure at -38mmHg - -50mmHg. 2. 3 times per week 3. LED light therapy with biofilm remover gel for 15 minutes AFTER 10 DAYS AND 4 IVT SESSIONS
4. Wound dressing
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WOUNDHEALING <2 months
Improved circulation
Improved tissue regeneration in proliferation phase
IVT
Cleaning up the dirt
SUCKING FRESH BLOOD INTO THE LEGS, SQUEEZING VENOUS BLOOD & LYMPH OUT, PURIFYING THE TISSUE FROM THE INSIDE
Kick starting the normal inflammatory phase
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CONCLUSION
space with nothing in it
cleaning up the dirt providing a clear pathway for healing L NAUDE WEYERGANS GERMANY 2015
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liezl@eloquent.co.za www.eloquent.co.za
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