Problem: Five patients with differing wounds suffered issues with exudates, maceration and pain.
Patient A was admitted 5/07 with thoracic surgical wound. Exudates increased with activity, as did frequency of dressing changes and patient’s complaints of pain.
Patient B was admitted 11/07 after multiple surgeries following near complete traumatic amputation of right leg. Patient had dressing change-related pain, fragile newly-epithelialized skin and edema-related exudates.
Patient C was admitted 10/08 with left lower extremity ulcer complicated by generalized edema and cellulitis. Had significant exudates, fragile peri-wound skin and dressing change-related pain.
Patient D was admitted 10/08 post-surgical repair of right ankle. The wound drained copious serosanguinous fluid. Peri-wound skin was compromised by maceration, erythema and ecchymosis.
Patient E was admitted 11/08 with non-healing surgical wounds to back. Wounds were highly exudative with macerated and fragile peri-wound skin. The patient had dressing change-related pain.
Past Management: Patient A was managed with a dry dressing.
Patient B had multiple treatments, including negative pressure wound therapy and silver hydrofiber*.
Patient C was managed with silver hydrofiber* and gauze overwhelmed by edema-related exudates volume.
Patient D was managed with 2% Chlorhexidine Gluconate 70% Isopropyl Alcohol*** pad over incision line with a gauze secondary dressing.
Patient E was managed with silver hydrofiber * often adhering to the wound.
Current Approach: All patients had SSETD** initiated as primary or secondary dressing.
Patient Outcomes: All patients had improvements in peri-wound skin condition. Patient B requested the “soft gentle dressing” when discharged. Patient D’s maceration resolved within twenty-four hours of SSFPWCL ** use. All patients reported decreases in pain. The nurses caring for patients A and C reported decreased use of pain medication and need for dressing changes.
Conclusion: SSETD ** is an excellent option for managing wound exudates while maintaining/improving peri-wound skin condition and managing pain.
*Aquacel Ag, ConvaTec
**Mepilex Transfer, Molnlycke