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156

Activation of a stalled traumatic finger wound with silver polymeric membrane dressings

Linda Benskin, RN, BSN, Ghana_SRN, Church of Christ Mission Clinic, volunteer nurse, 11304 Prairie Dog Trail, Austin, TX 78750-1322

A healthy eighteen-year-old female from Ghana, West Africa, presented with an acute cooking-accident crush wound to the right fourth finger which prevented her from working. Relative humidity during treatment was often below 10% and always below 30%, creating a challenge to maintaining a moist wound-healing environment. After eight days of treatment with triple antibiotic ointment (TAO) and gauze, healing stalled, leaving the painful 0.5cm x 1.5cm wound edematous and avascular with periwound maceration. Wound management was changed to silver polymeric membrane dressings, without use of TAO, to activate the stalled wound and decrease inflammation. Silver polymeric membrane dressings have demonstrated the ability to provide antimicrobial benefits in low humidity environments because of residual moisture in the dressing and natural hydrophilic action of the dressing. Use of the dressing has been shown to reduce the risk of periwound maceration. The dressing's uncomplicated design and protocol facilitates teaching its use to unskilled caregivers. It has been used successfully to decrease the chronic inflammatory reaction which is known to interfere with healing. A silver polymeric membrane dressing was applied and changed every other day. This product contains a wound-friendly surfactant, which provides continuous built-in cleansing action, often eliminating the need for woundbed cleansing during dressing changes. After eight days of treatment with silver polymeric membrane dressings, the patient was able to continue the treatment without assistance. Inflammation immediately decreased and vascularization increased, as evidenced by minimal bleeding at dressing changes and granulation of the woundbed. Patient returned to work, fully healed, 20 days after initiation of management with the silver polymeric membrane dressing. Silver polymeric membrane dressings successfully activated the stalled wound and were used until closure. The easy-to-use dressings kept the woundbed appropriately moist and clean, allowing the patient to do dressing changes herself.


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