Abstract: Amorphous silver antimicrobial wound gel provides a sustained, effective barrier against microbes that delay healing in both partial and full thickness wounds. In large, open surgical wounds, silver antimicrobial wound gel reduces infection risk due to it's effectiveness in inhibiting microbial growth.

A 55-year old male presents with a large open surgical wound post hidradenitis suppurativa surgery to the bilateral groin and scrotum. PMH includes diabetes, hypertension, chronic renal insufficiency, congestive heart failure and obesity. Initial measurement on 01/20/06 was 14.0 x 50.0 x 5.0cm with very foul odor, extreme pain, copious exudate requiring three times daily gauze dressing changes. Goal was to promote healing and decrease infection risk by controlling bioburden, managing exudate and decreasing frequency of dressing changes.

Silver antimicrobial wound gel with twice daily changes was started with highly absorbent cover dressings. After 1 week, ulcer measured 10.5 x 47.0 x 5.0, was odor free, had a clean wound bed with epithelial migration and significant decrease in exudate load. Frequency was decreased to daily after 3 weeks. Six weeks into treatment three distinctive open areas remained that measured 5.0 x 0.5 x 0.1 (to the left proximal margin) and 3.0 x 0.3 x 0.1 (to the right proximal margin) and 3.0 x 1.5 x 0.1 to the scrotal area. After four months, the right groin and scrotal wounds had closed and remaining wound measured 2.6 x 0.5 x 0.1 to the left groin with scant exudate and no pain complaints.

Conclusion: - The use of the silver antimicrobial wound gel for hidradenitis suppurativa led to the successful healing of this patient's large open surgical wound without sustaining any infection. By eradicating wound odor and fostering faster healing, the patient was able to maintain his daily activities without loss of dignity or self-isolation.