The WOCN Society 40th Annual Conference (June 21-25th, 2008)


2258

The Use of Bismuth Subgallate/Borneol (Suile™) in Partial Thickness Wounds in a Long Term Setting

Jennifer K. Agosti, RN, CWCA, FACCWS, CFCN, DAPWCA, Nurse Sharks, Inc. ; Nursing Consulting Services, President, 661 Byrnedale Road, Weedville, PA 15868, Barbara Bartley, RN, Jefferson Manor Healthcare, Wound Nurse, 46 South Pickering Street, Brookville, PA 15825, Thomas Serena, MD, FACS, New Bridge Medical Research/Penn North Centers for Advanced Wound Care, Medical Director, 552 Quaker Hill Rd, Warren, PA 16365, and Alice B. Levy, RN, COWCN, Nurse Sharks, Inc., Consultant, 661 Byrnedale Road, Weedville, PA 15968.

Patients confined to skilled nursing facilities frequently suffer partial thickness wounds such as skin tears, perineal excoriations and stage II pressure ulcerations. These wounds can lead to significant morbidity and cause discomfort. A topical treatment that facilitates skin healing and regulates skin quality is a fundamental goal in attaining partial thickness wound closure. Bismuth subgallate/Borneol (Suile™) is a novel agent with FDA permission for the treatment of partial thickness wounds. A recent randomized clinical trial has shown it to be effective in acute wounds.1 Three cases are presented demonstrating the efficacy of Suile™ in the treatment of partial thickness wounds in a single skilled nursing facility.

A 92 year old gentleman developed several stage II pressure ulcerations resulting from shear forces. Topical treatment with Calmoseptine™ (Calmoseptine Inc. Huntington Beach, CA) daily resulted in no improvement. Suile™ was then applied daily. The wounds healed completely in 12 days. A 41 year old male with partial thickness perineal excoriations of the inner buttocks and rectal area were not improving with Zinc Oxide applied twice daily. Suile™ was administered daily to the affected areas. All of the wounds were resolved in 11 days. Finally a 74 year old female with multiple self inflicted excoriations of the abdominal wall continued to experience skin breakdown with Calmoseptine™. Suile™ treatment resulted in rapid improvement with resolution of the open areas in seven days.

Suile™ acts through several mechanisms: local vasodilatation through the action of Gallic acid, a by product of subgallate; reduced inflammation resulting from Borneol; and skin protection by the petroleum base.

This series of cases suggests that Suile™ may be a valuable tool in the treatment of partial thickness wounds particularly in the long term care setting.

1 Serena et. al. Bismuth Subgallate/Borneol (Suile) Is Superior to Bacitracin. Adv Skin Wound Care. 2007 Sep ;20 (9):485-492 


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