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Wound Dressing Techniques and Costs at a County Hospital

Pamela Amatta Odhiambo, Kennedy Omondi, Ng’wena Magak

School of Medicine, Maseno University

Correspondence to: Pamela Amatta Odhiambo, PO Box 3838–40100 Kisumu, Kenya; email: amatta19@gmail.com

Abstract

Background: Wound management is one of the commonest procedures conducted in surgical departments across health facilities in Kenya. Objective: This study aimed at exploring wound dressing techniques used at Migori County Referral Hospital (MCRH) and the cost of treatment to patients. Methods: Convenience sampling was used to select inpatients presenting with wounds undergoing treatment at the time of recruitment. Five patients (2 male and 3 female) were enrolled after obtaining informed consents. Wounds were examined during cleaning and dressing and healing process follow-ups made. Selection of wound dressing technique was done by the primary clinicians with no bias from the research team. Results: One patient’s wound was an open fracture resulting from a road traffic accident; three patients had pyomyositis following thorn pricks; and the last patient’s was sustained following a blast injury. Wound management methods employed at MCRH included cleaning

with vinegar, irrigation with normal saline, dressing with honey, and improvised negative pressure wound therapy. Total cost incurred was affordable to patients, and ranged between Kenya shillings 100–360 (USD 1–3.60) weekly. Conclusion: Wound management techniques at MCRH were effective and affordable. Additional studies with a larger sample size are recommended.

Key words: Wound dressing, costs, NPWT, vinegar cleaning, honey dressing

Ann Afr Surg. 2019; 16(1):33–37

DOI: http://dx.doi.org/10.4314/aas.v16i1.8

Conflicts of Interest: None

Funding: None

@2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction

Wound care is one of the most common procedures conducted in surgical departments across health facilities in Kenya. Migori County Referral Hospital (MCRH) is a level four facility serving a population of 917,190 residents (1). With advances in healthcare delivery coupled with rapidly evolving antibiotic resistance by most microorganisms, wound care is rapidly developing (2). Different methods are used in wound care in different areas of the world, depending on wound type and expertise availability (3). Negative pressure wound therapy (NPWT) has been successfully used in several parts of the world since its invention (4). However, resource-limited facilities cannot implement the exact technique of NPWT and have had to improvise, without compromising the outcome (5). The aim of the study was to describe the types of wound dressing techniques used at MCRH. The cost associated with dressing was also determined for each technique.

 

Methods

This is a case series of consenting patients treated for acute wounds in the surgical wards of MRCH for 6 weeks. Patients with pre-existing diabetes mellitus or peripheral vascular disease were excluded. History, biodata and examination findings were documented. The techniques applied for wound dressing were observed and documented progressively until the patients were discharged from hospital. Estimates of daily and cumulative cost of the dressing materials were generated. Quantitative data are presented as tables while the techniques are described qualitatively. Ethical clearance and permission to conduct the study were obtained from the medical superintendent’s office.

Results