Introduction We present a case study of a patient with a post-surgical wound localised to the fronto-parietal region with exposure of a plastic plate and encephalic mass, secondary to deep tissue infection after a meningioma resection.

Wound cultures were found to be positive for Klebsiella pneumoniae and Enterococcus sp. Large volumes of exudate made management of the wound difficult and the wound required treatment three times per day. Closure of the wound by third intention was impossible at this point. The patient was suffering from septic shock secondary to neurological infection.

Material and Methods The protocol consisted of cleansing the wound with sterile water, then dressing it with a silver-coated antimicrobial barrier dressing*, covering the entire wound. A calcium alginate dressing# was applied as a secondary dressing to assist with exudate control. The silver-coated antimicrobial barrier dressings* were changed every three days. The wound was cleansed with sterile water.

Results After three dressing changes (ten days), the wound culture was negative and exudate considerably reduced. Wound closure by neurosurgeons was possible after 15 days.

Discussion Post-surgical infection is a complication that can compromise the life of the patient. After being managed by conventional methods (cleansing with antiseptics and gauze dressing) the wound showed clear signs of failure in infection management and exudate reduction was becoming a mandatory issue for saving the life of the patient. The use of a silver-coated antimicrobial barrier dressing* combined with a calcium alginate dressing# in this case appeared to be the solution to manage the infection: after six days with this protocol, improvement was observed, control of the infection was corroborated with a negative swab after 10 days and the reduction in exudate made closure of the wound possible.

*Acticoat – Smith & Nephew Inc., Largo, Fl. #Algisite M – Smith & Nephew Inc., Largo, Fl.