p ISSN 2723-6927-e ISSN 2723-4339
Comparison of
Conventional and Modern Wound Care in Post-Section Wounds at Cut Mutia
Hospital, North Aceh Regency in 2023
Yusnidaryani1, Said Taufiq2, Marlina3,
M. Jamil Fauzi4
1,2,3,4Health Polytechnic Ministry of Health, Aceh,
Indonesia
Email: [email protected]
ABSTRACT
The World Health Organization (WHO) sets the average cesarean sections
(CS) standard at 5-15% per 1000 births. However, cesarean section rates in
private hospitals exceed 30%, compared to 11% in government hospitals. This
study investigates the prevalence and complications of surgical wound
infections post-cesarean section and the effectiveness of modern wound dressing
techniques in reducing these infections. Data analysis reveals cesarean wound
infections occur during hospitalization (27%), re-admission (1%), and
post-discharge (71%). Surgical wound infections (SWI) significantly increase
morbidity, treatment duration, and healthcare costs, with a direct death rate
ranging from 3% to 75% globally. The study evaluated modern wound dressings
adhering to "moist wound healing" principles, such as hydrocolloids,
alginate, and foam, which maintain a moist environment to enhance epithelial
cell proliferation, accelerate wound healing, and reduce scarring. Findings
indicate that moist wound dressings significantly improve healing outcomes,
promoting epithelialization and collagen synthesis, with techniques showing a
30-50% increase in epithelialization and a 2-5 times faster
re-epithelialization rate. These results highlight the need for adopting
advanced wound care techniques to reduce surgical wound infections and improve
patient recovery post-cesarean section. The study implies that healthcare
providers should integrate modern wound care practices to enhance maternal
health outcomes globally.
Keywords: cesarean section, conventional wound care, modern
wound care
INTRODUCTION
WHO sets the
average standard for cesarean section in a country is around 5-15% per 1000
births
Odada et al.
The rapid
development of wound care today is the use of dressings or dressings
based on measuring the level of existing cost capabilities, of course, adjusted
to the principle of wound care, which is to maintain the physiology of moisture
in the wound environment so that it can trigger the tissue repair process
The use of
bandages focuses on dressings that are moist so that they are effective for
healing wounds. The dressing does not inhibit the flow of oxygen, nitrogen, and
other airborne substances
Research results of Tian et al.
What makes this
study distinct is its detailed examination of the clinical benefits of
moisture-retaining bandages, which has not been comprehensively explored in
previous research. The study provides quantitative data on the improvements in
epithelialization and collagen synthesis, as well as the reduction in fluid
loss, demonstrating clear advantages over traditional dry wound healing
methods. The aim of this study is to investigate the efficacy of
moisture-retaining bandages in wound healing, specifically focusing on their
ability to enhance epithelial cell proliferation and migration, increase
collagen synthesis, and speed up re-epithelialization while reducing scarring
and fluid loss. The study seeks to establish the clinical advantages of this
method and its potential to improve wound care practices.
RESEARCH METHODS
This research design uses a quasi-experiment posttest-only design conducted on October
20-30, 2023, at the Cut Mutia General Hospital, North Aceh Regency. The study
population was postoperative mothers of cesarean section who were treated in
the puerperium. The study sample
amounted to 18 people, divided into an intervention group of 9 people and a
control group of 9 people.
This study was
conducted intervention using wound care with modern dressings (tribe ointment)
and conventional wound care using 10% povidone-iodine as a control group. Wound
care is performed by nurses who have a modern wound dressing training
certificate (CBWT or CWCC certified). On day four, after wound treatment, then
the wound is observed by researchers accompanied by nurses using observation
sheets/checklists consisting of tumor statements, rubor, calor, dolor, and
functionless.
RESULTS AND
DISCUSSION
Research
Results
The respondents in this study were 18 participants, including nine
post-cesarean section clients who used conventional wound care and 9
participants using modern wound care. The characteristics of respondents are
described as follows:
Table 1. Characteristics of Research Respondents
|
Characteristic |
Intervention
Group |
Control Group |
||||
|
n |
Mean (SD) |
% |
N |
Mean (SD) |
% |
|
|
Paritas |
9 |
29,6 (3,5) |
100 |
9 |
31,1 (3,4) |
100 |
|
1-5 |
4 |
|
44,4 |
4 |
|
44,4 |
|
>5 |
5 |
|
55,6 |
5 |
|
55,6 |
The participants in the study from both
groups each dominated labor more than five times. The largest mean value was
the control group of 31.1. Furthermore, the wound healing values of both treatment and control
groups can be seen in the following table:
Table 2. Distribution of Wound Healing Values in Modern
and Conventional Wound Care Groups
|
Variable |
n |
Min-Max |
Median |
|
The value of wound healing in modern wound care |
9 |
1-2 |
1,00 |
|
The value of wound healing in conventional wound care |
9 |
2-4 |
3,00 |
The results of wound healing in
the modern wound care group are faster, which is between 1-2 days, compared to
conventional methods, between 2-4 days. The results of the analysis for comparison of modern
and conventional wound care results can be seen in the following table:
Table 3. Comparison
of Types of Wound Care Against Wound Healing in Modern and Conventional Wound
Care Groups
|
Group |
N |
Mean rank |
D |
P-Value |
|
Intervention
groups with Modern wound care |
9 |
5,50 |
,500 |
0,001 |
|
Control group
with conventional wound care |
9 |
13,50 |
,782 |
The results of the analysis using the Mann-Whitney test obtained a p-value
= 0.001 where p < 0.05, meaning that there is a significant difference
between conventional wound care and
modern dressings (tribe ointment).
Discussion
The results of the postoperative wound
healing study of cesarean section in the conventional wound care group on the
4th day after surgery experienced impaired wound healing with an average value
of 2.89. The wound healing value in the modern wound care group and standard
care in post-cesarean section patients was better than that of conventional
wound care, with an average wound healing value of 1.33. The value is not good
to say that wound care is good, but when compared to conventional wound care,
modern wound care is better. This
is in line with the literature that says modern wound care can maintain moist
conditions, control the incidence of infection, accelerate wound healing,
absorb excessive wound fluid, remove dead tissue, and be comfortable to use,
sterile, and cost-effective (Arisanty, 2018).
Acute wounds (postoperative wounds) can heal or
close according to physiological wound healing time (Arisanty, 2018). Wounds
can heal if they go through an inflammatory reaction (inflammatory phase), the
main purpose of which is to recombine parts of the wound and restore its function
(Sabiston, 2018). The inflammatory phase is the body's reaction to the wound
that begins after a few minutes and lasts for three days after the injury. The
wound repair process consists of hemostasis (controlling bleeding), sending
blood and cells to the injured area (inflammation), and forming epithelial
cells at the site of injury (epithelialization). During the hemostasis process,
the injured blood vessels will be
constricted, and platelets will gather to stop bleeding. The blood clot will
form a fibrin matrix, which will later become a skeleton for cell repair.
Damaged tissue and mast cells secrete histamine, which causes vasodilation of
surrounding capillaries and secretes serum and white blood cells into the
damaged tissue. This will cause redness, edema, warmth, and local pain.
Leukocytes will reach the wound within a few hours. The main leukocytes that
act on wounds are neutrophils that feed on bacteria and small debris.
Neutrophils will die within a few days and will leave behind enzyme exudates
that will attack bacteria or help tissue repair.
The results of
this study showed significant differences in the wound healing process using
modern and conventional wound care. This is because epidermal migration in
superficial wounds is faster in moist than dry settings. This modern dressing serves to protect the wound from germ
contamination and prevent germs from entering. This dressing provides a
balanced, moist condition, that is, if the dry wound can be hydrated, and if
wet, the fluid can be absorbed. Besides, it can help facilitate blood flow and
vasodilation of blood vessels so that oxygenation and blood flow to the wound
can be facilitated properly. This dressing is very comfortable and cost-effective for patients
The results of this study are in accordance with research conducted by
Chuang
In addition, Kielo-Viljamaa et
al.
The average value of wound healing after modern wound care is 5.50,
while the average value of wound healing after conventional wound care is
13.50. There are significant differences in the wound healing process using
conventional and modern wound care in postoperative cesarean section patients
at Cut Mutia General Hospital.
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Copyright Holder: Yusnidaryani, Said
Taufiq, Marlina, M. Jamil Fauzi (2024) |
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