CLINICAL PRESENTATION:
48 year old lady, victim of an automobile accident, incurred nerve damage, eye damage, digit loss, and multiple fractures that received hardware.  Upon her first post discharge visit a dehisced surgical incision of the left knee was observed with exposed bone, hardware and thick tenacious purulence within the wound.  Patient grew MRSA in the wound.  Measurement of the knee wound was 6.1 x 2.8 x 2.9 deep.  Patient was admitted to long term care facility for IV antibiotics and wound care. 

 METHODOLOGY:
The goal is to clean the wound of the acute infection, prevent systemic infection, maintain an infection free wound environment, and provide pain free dressing changes.  PVA was placed in and over the wound of exposed hardware and bone then covered with negative pressure gauze dressing.  PVA is polyvinyl alcohol sponge preferentially bound to Gentian Violet and Methylene Blue.  Product provided self debridement of purulence and necrotic tissue and comfortable dressing changes for the resident. 

RESULTS:
The wound cleaned and granulated by using polyvinyl alcohol sponge with Gentian Violet and Methyl Blue and NPWT.  The wound was infection free. Culture was negative.  This prepared the resident for surgical flap over exposed bone and hardware.  Wound measurement at time of flap surgery was 4.5 x 1.5 x 2 deep. 

 CONCLUSION:

 The use of PVA in conjunction with negative pressure wound therapy significantly debrided the infected surgical wound without surgical intervention and prepared resident for surgical flap closure of the wound leading to discharge home from long term care facility.