Objectives: µ Determine the efficacy of silver antimicrobial gel (SAG) as primary dressing as a standard protocol on non-healing surgical wounds. µ Establish whether protocol reduces nursing visits in home health setting.

Case Studies:

Patient 1: Patient 65 year-old female with non-healing right buttock surgical wound 11/04. History of COPD, neuropathy, hypothyroidism. Daily visits by SN. Wound measured 0.7x0.7x1.0 1/7/05. Wound care ordered MWF SAG with ¼” gauze and ABD dressing. Patient discharged 3/1/05 healed. (Figures 1&2)

Patient 2: Patient 77 year-old female with non-healing LLE surgical wound. History of diabetes, cellulitis, osteoporosis, asthma, anemia, HTN, CAD with CABGx3. Daily visits by SN. Wound 50.0x1.5xeschar 6/23/04. Wound infected. Daily care ordered: SAG, alginate with 4x4 gauze cover. Debrided 7/7/04. Wound 15.0x1.3x0.05 7/23/04. Wound debrided, visits reduced to QOD. Patient received biweekly debridements. HH visits reduced to MWF 8/13/04, then M/Th 8/20/04. Patient discharged 9/23/04. (Figures 3&4)

Patient 3: Patient 61 year-old male with non-healing surgical wound to abdomen. Surgery 2/5/04. History of Fragile X syndrome and mental retardation, large bowel obstruction. Daily visits by SN. Wound measured 8.0x2.5x0.5 3/26/04 post-debridement. Daily care ordered: SAG, alginate with 4x4, ABD gauze cover. Wound 7.5x2.8x0.5 4/2/04. Wound debrided , visits reduced to QOD. Visits reduced to MWF 4/23/04. Wound debrided as needed during remaining course of treatment. Patient discharged 6/25/04. (Figures 5&6)

Patient 4: Patient 49-year-old male with dehisced surgical wound to left ankle post-I&Dx3. History of chronic foot pain, sarcoid deformities. Daily visits by SN. Wound 1.0x0.2x0.2 12/15/04. MWF care ordered: close with surgical tape

Conclusion: Use of SAG, with sharp debridements performed as needed, facilitated closure of non-healing surgical wounds without complication or infection and contributed to reduced nursing visits by HH.

Support of Medline Industries for this project is gratefully acknowledged.