CLINICAL PROBLEM: Family members brought 53 year-old female patient to hospital emergency department for redness and pain on left upper back of one week duration with nausea, vomiting and increased lethargy. History of poorly controlled diabetes, hypertension, obesity, and chronic renal failure.

MANAGEMENT: After receiving surgical debridement in the ER, she was admitted for IV antibiotics and wound care. Patient continued to experience pain and redness, persistent fever and lethargy with worsening leukocytosis. Second surgical debridement revealed pus pockets surrounding the wound. Cultures grew Methicillin-sensitive staphylococcal aureus and staphylococcus aureus bacteremia. Based upon the painful nature the wound and wound culture results, the team selected PVA impregnated with Methylene Blue and Gentian violet followed by secondary dressing. This absorbed exudate and continued debriding of the wound. Dressings were changed every three days.

PATIENT OUTCOME: In 24 days wound was clean and granulating with a moist wound environment. Patient was discharged home with patient and family teaching for continued wound care.

CONCLUSION: Despite co-morbidities, wound care team was able to effectively manage deep abscess on patient left upper back, decrease pain and tenderness during dressing changes and improve patient comfort between dressing changes.