Management of Ulcer Infected by Marsa - Essay Example

MANAGEMENT OF ULCER INFECTED BY MARSA Claribel Rivera MANAGEMENT OF LEG ULCER INFECTED BY MRSA INTRODUCTION Before talking about management and treatment of the disease it is necessary to define what leg ulcer and MRSA are and what can cause such terrible disease. It is a common knowledge that such disease can be chronicle and in some cases even incurable. It is pity that some people have to suffer from the leg ulcer infected by Methicillin-Resistant Staphylococcus Aureus (MRSA) for many years. And if the patient is cured nobody will guarantee that the disease won't return. Doctors say that the chances to become ill with ulcer once more are rather high. It is a matter of fact that leg ulcer is very serious disease, because it can leaf to such consequences as blood-poisoning. It is necessary to warn that leg ulcer infected by this virus leads also to limited functionality, mobility and constant disturbing pain. It is seen that this diseases is serious and it requires thorough treatment and management in order to cure and to prevent infection's spreading. Doctors advise to eat raw foods and steamed vegetables for several months in order to improve and to speed treatment process. But this diet has to be only additional method of management involving surgical operation or other methods. It was mentioned that people infected should eat also leafy vegetables of dark color to increase intake of vitamin K LEG ULCER INFECTED BY MRSA MRSA (Methicillin-Resistant Staphylococcus Aureus) is known to be a type of bacteria which appears and lives on skin, legs, in mouth or nose of approximately one third of completely healthy people. Commonly it is not harmful, but when it occasionally gets into person's body through wounds and breaks of skin it can cause such infections as ulcer, impetigo, abscesses, warts, etc. but what is more important to know is that MRSA is the cause of more serious diseases involving blood poisoning, heart-valve infection or infection in bones(Phillips 1991). Leg ulcer is a chronic condition caused either by MRSA infection or by incompetent work of venous system in legs or feet. Capillary pressures and permeability is affected in the result. Leg ulcers are open sores which usually develop on infected areas of skin in the lower extremities such as legs and feet (usually above ankle and below the knee area). When the tissues are infected by MRSA bacteria it becomes to erode and as the result the skin develops open sores. If the leg ulcers develop open sores and skin is broken the process of healing is very slow. General treatment includes: wound dressing changes, elevation, patient psychological education and external compression. In hard cases the surgery intervention is needed(Callam 1985). It is also necessary to define the possible reasons of ulcer developing. They are: Vascular diseases Trauma and physical circumstances Metabolic disease Possible symptoms infected by MRSA: leg ulcer as the result of infection develops usually inside the leg and below the ankle. It is known that ulcers are open wounds which can ooze sticky fluid and then wounds crust over. The common signs are pain, skin sensitivity and itching. Symptoms of developing ulcer are: Skin becomes purple on the infected area Skin becomes thick and dry Skin starts itching in infected area(Phillips 1991). But it is necessary to admit that ulcer infected by MRSA is too difficult to cure, because this type of bacteria becomes nowadays resistant to many types of antibiotics, for example to antibiotic methicillin. One possible way treatment is surgical treatment aimed at treating leg ulcer by means of skin grafting. But there are other surgical treatment approaches. For example, in a study (Phillips 1991) surgery intervention includes "superficial stripping and excision of varices, subfascial perforating vein interruption, excision and skin grafting, excision and free flap coverage". It is necessary to identify what the aim of treatment is. Firstly, it is necessary to suppress disease and for this purpose such drugs as corticosteroids can be used. Secondly, the MRSA infection has to be cured in order not to become ill with more serious disease. Patients who suffer from leg ulcer infested by MRSA have to be cured in special health services and agencies. Phillips (1991) strongly argued that "treatment is time consuming and prolonged, requiring health care professionals to focus on the wound or the limb that is affected by the leg ulcer in providing care". It is also needed at home to apply oil with vitamin E and to bandage the leg ulcer but not too tight. Patients should always keep leg ulcers clean not to spread infection and to prevent other bacteria from getting into wound. It is possible to use antibiotics, but as it was mentioned MRSA is resistant to them(Callam 1985). There are a lot of difficulties for people infected by MRSA: functional limitations, constant pains and emotional disturbance, nervous disorders and stresses. Leg ulcers require also self-management. But self-management requires proper knowledge, energy and functional capabilities in order to improve and to support the process of healing. Therefore patients suffering from leg or foot ulcers have to study necessary information about disease and to participate in self-management, because it can enhance healing(Chase 1997). Limitations of activity and mobility are apparent and profound, it is difficult to move and works and as it was mentioned pain is the most difficult aspect of leg ulcer. So it is a matter of fact that patients with MRSA infection have limited activity and mobility as the result of lengthy process of treatment and management. MRSA infection is transmitted by direct physical and by indirect physical contacts(Callam 1985). It is necessary to admit that patients in hospital are vulnerable, because MRSA virus can easily spread from one patient to other. It means that patients at hospitals risk more to be infected by MRSA and to become ill with ulcer. They can be infected by surgical wounds, intravenous line or catheter. But some patients carry infection on their skin and it cause no harm. Such persons are called "colonized" with MRSA. These patients are able to spread infection to other patients they contact with. Healthy people are not usually infected by MRSA. But the risks is increasing in if the person has chronic cancer, diabetes and other diseases, which significantly weaken the person's immune system; if the person is injured and post-operative; if the person has wounds and breaks in skin: surgical wounds, urinary catheters, burns, etc.; if the person has severe skin injures including leg ulcer; if the person frequently uses antibiotics. Ulcers infected by MRSA are diagnosed by wound swabs, urine samples and/or blood samples. If bacteria are found then they are identified and checked whether they resist antibiotics or not. It is known that "colonization" with MRSA in leg ulcer is detected by means of taking swabs from affected skin of person. And if the MRSA virus is detected the choice of management according to Chase (1997) depends on "what antibiotic resistance the particular strain of SA has". Treatment for patients colonized with MRSA virus doesn't require surgical operation, because the virus doesn't cause any harm. Doctors advise to apply special antibiotic cream to the skin where the MRSA is detected. This procedure is necessary to get rid of MRSA and it helps to reduce the possibility of bacteria spreading or getting into the patient's body. MRSA has to be cured, because it can cause infection or infect other patients. It is needed to wash skin with special disinfectants prescribed by doctors. TREATMENT OF PATIENTS INFECTED BY MRSA As it was mentioned MRSA is resistant to most of widely used antibiotics such as erythromycin, flucloxacillin and ciprofloxacin. But there are some antibiotics which are able to affect MRSA involving teicoplanin and vancomycin. Leg ulcers infected by MRSA usually treated by one of the drugs mentioned above. These drugs have to be administered either by injection or infusion. Therefore drugs are given in hospitals and other health services. It is necessary to note that there were some cases when MRSA had resisted even teicoplanin and vancomycin. New drugs are investigating and they will become available in future(Flett 1994). A new drug called linezolid was introduced. It is given to patients by intravenous infusion or in the form of tablets. It is important to know that antibiotics should be used only when there is no other possible ways and in case when doctor prescribes them. In most severe cases the surgical operation is needed. But this variant should not be the last, only in really hard cases. If it is possible to cure illness without surgical operation, it is much better to avoid it. Treatment of leg ulcer infected by MRSA It is a common knowledge that it is easier to prevent illness than to cure it. Doctors say that it is necessary to wash skin and clean bed regularly in order to avoid infection, especially if person is vulnerable to them. All clinical investigations must be taken only by professional who are skillful in leg ulcer management(Hamer 1994). CONCLUSION Leg ulcer infected by MRSA is a serious disease which can lead to serious consequences such as blood poisoning. MRSA can spread from one patient to another and patient even can have no idea that he is infected. Therefore it is necessary to visit doctors as often as possible in order to avoid serious diseases. References Callam, M. J., Ruckley, C. V., Harper, D. R., and Dale, J. T. 1985. "Chronic ulceration of the leg: Extent of the problem and provision of care". British Medical Journal, 290. Chase, S. K., Melloni, M., and Savage A. 1997. "A forever healing: The lived experience of venous ulcer disease. Journal of Vascular Nursing, 15. Chase, Susan K. 2000 Living with Chronic Venous Leg Ulcers: a Descriptive Study of Knowledge and Functional Health Status. Journal of Community Health Nursing, 17. Flett, R., Harcourt, B., and Alpass, F. 1994. "Psychosocial aspects of chronic lower leg ulceration in the elderly". Western Journal of Nursing Research, 16. Hamer, C., Cullum, N., and Roe, B. H. 1994. "Patients' perceptions of chronic leg ulcers". Journal of Wound, Ostomy, and Continence Nursing, 21. Phillips, T. J., and Dover, J. S. 1991. "Leg ulcers". Journal of the American Academy of Dermatology, 25. Vowden, K. 1998. Venous leg ulcers: Assessment. Professional Nurse, 13. Ware, J. E., Kosinski, M., and Keller, S. D. 1994. SF-36 physical and mental health summary scales: A user's manual Boston: New England Medical Center, The Health Institute. LINK LEARNING ACTIVITY 1, PLAN OF WORK /STUDY TIME: NOTES AND IMPLEMENTATION Plan of my work "Management ulcer infected by MRSA in surgical ward" was divided into four weeks. It means that the time needed to write the paper covered all these weeks. I think the work is more effective if to work only several hours per day, though it takes more days than to make the paper in several days. But such study is more thorough and accurate, because four weeks are enough to find necessary materials, to outline the direction and main points of the works, to write and to check the paper(Adair 1999). As I mentioned the plan of my work (time table) is divided into four intervals: 1. 1-7 May: finding materials, pointing out main definitions concerning the topic. I was busy with finding proper materials concerning the topic. I decided to take materials from medicine and scientific journals and books, because specialized issues have more necessary materials than general non-scientific newspapers. During first week I pointed out the main definitions of MRSA and leg ulcer and than chose the best suited for the paper. So the main tasks of this period were: to find necessary materials (1-4 May) and to find necessary definitions (5-7 May). I worked for several hours per day, especially in the evening after my classes. In my leisure time I preferred to relax and to collect my thoughts. 2. 8-14 May: researching causes and consequences of leg ulcer During this week my task was to continue collecting necessary material and figure out main causes and consequences of MRSA infection: 8-11 May (task: to point out main causes and symptoms of leg ulcer); 12-14 (research of possible consequence of MRSA infection). According to my plan I worked in the library in my leisure time for two-three hours. 3. 15-22 May: leg ulcer management, recommendations how to avoid MRSA infection. During the third week my tasks were clear and definite: to ascertain possible ways of treatment and management and to find recommendations necessary for ulcer prevention. During this week I worked at home, because I have found all necessary materials. 4. 23-31 May: summing up and drawing a conclusion. During last week of my research my task was to draw conclusions and to define the risks of MRSA infection. As far as I understood that conclusion is necessary I tried to point out main ideas of the research. According to my time table my leisure time was in the evening and I preferred to read materials concerning the topic. The most important task for me was to use time efficiently; therefore I preferred to work in the evening when nobody could disturb me. The most effective work for me takes two-three hours, not more. This time is enough to make necessary notes and not to become overburden. The implementation of my accurate plan led to successful finishing of my assignment. I followed strictly my plan and I wasn't late wit the term. Time table is very efficient and useful if you want to write the research paper. It is better to work two-three hours per day during the months than to sit three nights at once(Macan 1996). References Adair, John. 1999. Time Management and Personal Development. London: Thorogood. Macan, Therese. 1996. Time-Management Training: Effects on Time Behaviors, Attitudes, and Job Performance. Journal of Psychology, 130. LINK LEARNING ACTIVITY 2: LITERATURE SEARCH IN THE LIBRARY I'd like to admit that literature search in the library is very useful and efficient, because library is the endless source of information needed for researches and just for reading. Literature broadens our outlook and makes us more educated and widely-read. The topic of my research was "Management of leg ulcer infected by MRSA" and I set a task to search only for medical books and journal, because such topics are more frequently and widely discussed in specialized issues. It goes without saying that the range of books and journals varies greatly and it was rather difficult to find exact facts needed for my research. Different journal and magazine article present different points of view and I had to find such material which will coincide with my thoughts and ideas(Pirie 1991). I'd like to mention the articles written by Susan Chase "Living with Chronic Venous Leg Ulcers", M. Callam "Chronic ulceration of the leg: Extent of the problem and provision of care" and many others. These articles represent thorough and full studies of the topic being researched. It is a matter of fact that I chose article and books only concerning the topic. I found more than fifty proper sources regarding to my topic and it was difficult to choose which of them are to use in the paper. All sources are scientific and they highlight the very details of the problem. Actually literature search has its negative and positive moments. I'd like to start with positive points. As I mentioned above library and literature are essential parts of knowledge and education, because they provide readers with lots of information, details, evidences and facts. Literature search is necessary if you want to get clear idea of any topic you are interested in. literature search is also useful to see different point of view concerning the chosen topic. I'd even say that literature is a real treasure in our life. Therefore literature searches are really important to write researches(Pirie 1991). But there are negative moments of such search. It is a common knowledge that library keeps huge amount f information and it takes sometimes too much time to find necessary books and articles. There are also cases when the efforts to find necessary materials fail and all time is lost in vain. There can be the situation when you try to find the exact book and somebody takes it before you. The other negative point it is difficult to define whether materials are important or not. The main negative moment is that literature search takes too much time, although I understand that there are more positive points of search(Parker 1999). In conclusion I'd like to give some recommendations how to cope with these difficulties. Firstly it is rather useful to use library catalogues, especially on-line ones, because it is faster that to turn over pages. If you don't know where the necessary material is it would be useful to ask librarian for help. I don't think she/he will refuse to help. These two recommendations can make the literature search more pleasant and effective. References Pirie, David. 1991. How to Write Critical Essays. London: Routledge. Parker, Necia. 1995. "How to Sift Citations". College Teaching, 43, 3. Read More