Essay Sample on Mechanical Debridement

Introduction

Repeating mechanical debridement until a partial thickness burn wound is surgically excised or epithelialized is critical for the healing process. Sharp et al. (2014) surveyed nurses opinions to determine the preferences in burn treatment between silver sulfadiazine (SSD) and collagenase (CO). The research that was conducted in three months required thirteen nurses to rate the removal or application of the products and describe their experiences in treating partial thickness burns. 83% of the nurses preferred CO while 17% had no preference among the two. Silver sulfadiazine (SSD) was rejected due to its pseudoeschar, messiness, difficulty in application and need for more dresses. The expensive nature of collagenase (CO) and the need for applying antimicrobial agent were identified as significant weaknesses. However, collagenase cleanliness and minimal dressing, and lack of pseudoeschar were the primary reasons for preference.

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The article by Sharp et al. (2014) is at least five years old which increases the chances of developing trends in the use of silver sulfadiazine (SSD) and collagenase (CO) being overlooked. This research also fails to elaborate on the role of shared decision making (SDM) model between patients and nurses, and nurses and nurses. The role played by SDM in influencing the choices of nurses during the treatment of partial thickness bums ought to be included in the research. Additionally, client contributions to the treatment model due to the regard of issues such as the high-cost nature of collagenase (CO) deterrent is also not taken into consideration. The research is also bias. There is also a limited reference to the previous studies or historical data depicting the variations in nurse's experiences and use of collagenase and SSD.

Additionally, the sampling frame and foundation often research is not supported by empirical or theoretical background regarding nurses choices in treatment preferences. For example, evidence-based model of decision making is based on a combination of knowledge emanating from patient preferences, clinical nurse expertise, and research evidence. Such a model may significantly influence the decisions made between the use of collagenase (CO) and sulfadiazine (SSD) for debridement. Considering the size of the sample, there is a need for further research to portray the results that are closer to clinical preferences between silver sulfadiazine (SSD) and collagenase (CO).

Impact on Nursing Practice

Partial thickness burns are severe regardless of the area of the body or size; they should be therefore evaluated and treated with the best care possible. This article is informative in both short and long term management of burns. Treatment of burns is a crucial nursing task requiring assessment as the wounds are erythematous, swollen, and painful as they heal. There is also a greater chance of contracting infections from bacteria's such as Streptococcus pyogenes, Staphylococcus aureus, and Pseudomonas aeruginosa if antibiotics are not adequately administered (such as the case of collagenase). Therefore, the article presents data on preference between the two agents based on their propensity to improve wound clearance and association with bacterial pathogens.

In their survey, Sharp et al. also presents the challenges associated with topical treatment such as pseudoeschar, the frequency of dressings, difficult application on burns, messiness, need for antimicrobial agent and cost. Without the consideration of such inadequacies in clinical practice, the patient's chances of acquiring effective treatment are reduced. Therefore, collagenase (CO) is identified as the best treatment to ensure patients are relieved of the burden of pain, discomfort, and more extended hospital stay.

Reference

Sharp, N. E., Aguayo, P., Marx, D. J., Polak, E. E., Rash, D. E., Peter, S. D., ... & Juang, D. (2014). Nursing preference of topical silver sulfadiazine versus collagenase ointment for treatment of partial-thickness burns in children: survey follow-up of a prospective randomized trial. Journal of Trauma Nursing, 21(5), 253-257.