Impact of Aloe Vera gel on Pressure Ulcers: An interventional study

Pressure ulcers are agonizing and hard to treat. Forestalling pressure ulcers is essential in keeping up solace and treating them is rapidly fundamental. Aloe vera is a trademark source which can be of huge points of interest it isn’t simply functional and besides viably open, yet the examination is done to notice the abatement in the recuperating time with the usage of aloe vera gel. The present study aims to assess the impact of aloe vera gel on pressure ulcers. A quantitative approach with one group pre-test-posttest research design was used to conduct the study in Thiruvallur District Head Quarter Government Hospital. 60 samples were chosen by using a convenient sampling technique. Semi-structured questionnaire was used to assemble the in sequence regarding demographic variables. The pre-assessment of the pressure ulcer was measured using PUSH Scale using the ruler and the trace paper. The wound assessment consists of wound size, exudates amount and tissue type. Routine wound dressing procedure was done using aloe vera gel and the post assessment was done on 1, 5 and 10 day. The study results show signi icant improvement in the level of wound healing after the intervention at the level of p<0.001. This demonstrates that utilization of aloe vera gel is the savvy and simple technique to improve twisted recuperating of pressure ulcers.


INTRODUCTION
Pressure ulcers are excruciating and hard to treat. Forestalling pressure ulcers is fundamental in keeping up solace and treating them is rapidly basic. (Ghanee and Gavami, 2010) The headway of weight ulcer is a standout amongst other preventive complexities for the subjects who are kept to the couch for a signi icant while. A lone carelessness in consideration can incite constant or reiterated ulceration which achieve hospitalization, loss of liberty and absolute aggravation of any social change. (Jiang et al., 2014) Skin treatment of Pressure ulcers is to arrange in which the best quantity of progress in management have happened. Munro began that as elongated as the ulcer is kept desiccated and liberated from de ilement it can mend well. (Soozani et al., 2012) Aloe vera is a trademark source which can be of titanic preferences it isn't simply reasonable and moreover successfully open, yet the examination is done to notice the abatement in the mending time with the usage of aloe vera gel. It has a strong relationship with the characteristic prescription. It is gotten by breaking or cutting a leaf, which contains supplements, nutrients, enemies of oxidants and has wound mending and immunomodulating impacts. (Simon et al., 2010) Pressure ulcers are brought about by supported weight being put on a speci ic piece of the body. (Repić and Ivanović, 2014) While pressure is the primary causative factor, numerous other, for example, shear, grating denervation, helpless nourishment, age and smoking can likewise accord. Examines have proposed that, at some random time, 3-10% of hospitalized people have pressure ulcers and 2.7% grow novel bed ulcers. (Aydin and Karadag, 2010) Among a picked people, the recurrence rate for the progression of another pressure ulcers has been shown to be signi icantly higher, with an extent of 7-30%. (Hekmatpou et al., 2018) Overall, subjects with pressure ulcers are critical customers of clinical resources. They need half all the more nursing time, remain hospitalized for altogether longer periods, and acquire higher clinic charges. (Aqsa et al., 2019) Predominance luctuates in Europe somewhere in the range of 3 and 28%, and the areas with the most elevated frequencies administrations and serious consideration medicine. (Yin et al., 1999) The assessment construed that a plan of request of bed ulcers in their type of classes and the differential determination with wounds, mugginess diminishes the misclassi ication of bed ulcer. (Zagórska-Dziok et al., 2017) The purpose of the study [1] To assess the level of wound healing among patients with pressure ulcers.
[2] To assess the effectiveness of aloe vera gel in wound healing among patients with pressure ulcers.
[3] To associate the level of wound healing with selected demographic variables.

MATERIALS AND METHODS
A quantitative research with one group pre-test post-test research design was choosen to conduct the study in Thiruvallur District Head Quarter Government Hospital. 60 samples were elected by means of a convenience sampling technique. The criteria for sample selection were clients who are having pressure ulcers, clients who were willing to Participate, prolonged bed ridden patients who has pressure ulcers, clients who can read, write and understand Tamil/ English. The exclusion criteria for the samples were clients who are suffering from chronic illness, clients who had more than 4 comorbidities, clients who do not have pressure ulcers and clients who are not willing to Participate and clients who were mentally challenged. The data collection period was done with prior permission from head of the Department of Thiruvallur District Head Quarter Government Hospital.
The intention of the examination was detailed to the samples and written informed approval was got from them. Semi-structured questionnaire was used to collect information regarding demographic variables and variables related to personal hygiene. The pre-assessment of the wound was done using PUSH Scale using the ruler and the trace paper. The wound assessment consists of wound size, exudates amount and tissue type. Routine wound dressing practice was done using aloe vera gel and the post assessment was done on 1 st , 5 th and 10 th day. The data were analyzed using descriptive and inferential statistics.

Level of wound healing among patients with pressure ulcers
The major conclusion of the investigation states that the mean score of wound curing on Day 1 was 10.13±1.66 with minimum score of 6.0 and maximum score of 14.0. The mean score on Day 5 was 7.25±1.94 with minimum score of 4.0 and maximum score of 13.0. The mean score on Day 10 was 4.0±1.92 with minimum score of 1.0 and maximum score of 9.0 ( Table 1).
Mean incidence in intense consideration location was 17.6%, (1.4-49%); in extensive remain was 6.63% (3.1-8.4). Outcome were reliably most noteworthy in intense consideration and hospice settings, and lowest under the watchful eye of the more established individual setting.

Effectiveness of aloe vera gel on wound healing among patients with pressure ulcers
The ef icacy of the aloe vera gel in wound healing is depicted by paired 't' test value of t = 28.520 between Day 1 and Day 5, t = 23.237 between Day 5 and Day 10 and t = 39.139 between Day 1 and Day 10 shows that there was signi icant improving in the level of wound healing which was established to be statistically signi icant at p<0.001 level. This clearly infers that administration of Aloe Vera Gel on wound curing was found to be effective in wound healing among patients with pressure ulcer. (Table 2) The study portrays that none of the demographic variables and personal hygiene variables had shown statistically signi icant association with level of wound healing among patients with pressure ulcer.
The examination is upheld by Khorasani et al. (2011) Who researched the outcome of Aloe Vera Cream on Split-thickness Skin Graft Donor Site Management. This examination indicated a fundamentally more limited injury care time for skin join benefactor destinations in clients who were cured with aloe vera and fake treatment creams. The sodden support impact of these creams may add to wound curing.

CONCLUSIONS
Application of aloe vera gel is the cost effective and easy method to improve wound healing of pressure ulcers. Aloe vera gel additionally helps in forestalling further disease of the injury with its enemy of microbial activity. Use of aloe vera gel advances fast mending of the pressure ulcers.