title: [Nursing Experience With Providing Wound Care for a Newborn With Epidermolysis Bullosa].
abstract: Epidermolysis bullosa (EB) is a rare hereditary, chromosomal disease of the skin. Life-threatening septicemia may result if appropriate care is not provided to alleviate the extensive skin irritation that is the main symptom of this disease. This case report describes the experience of the author in nursing a wound area on a newborn that was suspected of being caused by EB. This wound area comprised blisters and peeling skin that covered 30% of the entire skin area of the infant. A holistic assessment conducted from December 1st, 2013 to January 7th, 2014 revealed that this large of an area of damage to the skin and mucosa considerably complicated the task of wound care and caused severe pain to the infant. In response to the special needs of this case, our medical team conducted a literature review of wound care for this rare disease. Based on the suggestions of previous empirical studies, nursing measures for the skin, mucosa, and wounds of the newborn were then administered through inter-team cooperation. These actions effectively reduced the pain, controlled the infection, and accelerated wound healing. In addition, progressive contact was used to guide the primary caregivers of the newborn, which alleviated their physical and psychological stresses effectively. The caregivers were educated systematically on wound care and guided to learn techniques for nursing and dressing wounds. Thus, these caregivers were better prepared to continue providing wound care at home. We suggest that healthcare professionals reference empirical studies when providing care to EB newborns during the acute-care period and provide wound care and supportive therapies to control the occurrence of complications using a multidisciplinary team-care model. In addition, social resources should be used effectively in nursing care plans to mitigate the effect of this rare disease on families.
authors.affiliation: BSN, RN, Wound Ostomy Continence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC.
authors.forename: Hsiao-Hui
authors.initials: HH
authors.lastname: Hsu
authors.affiliation: BSN, RN, Tuberculosis Case Manager, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC.
authors.forename: Xin-Yi
authors.initials: XY
authors.lastname: Zheng
authors.affiliation: MSN, RN, Wound Ostomy Continence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC. my_shu@tzuchi.com.tw.
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Hsu
mesh_terms: D004820:Epidermolysis Bullosa / Q000451:nursing*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D014945:Wound Healing
keywords: epidermolysis bullosa; newborn; wound care