PURPOSE:  To create an effective wound healing environment by managing moderate  exudate and providing a barrier to bacteria. 

CLINICAL PROBLEM:  50-year-old male spilled hot soup broth on his left bare foot while transferring it from a crock pot to a storage container, sustaining second and third degree burns on the lateral aspect.  Initial treatment was daily pulsed lavage followed by silver sulfadiazine cream topical dressings.  There was a considerable amount of swelling in the foot, and dressing changes were very painful.  Control of bacteria was a primary concern due to poor hygiene as well as pet hair and dirt contamination in the home environment.  He was on pain medication and placed on oral antibiotic therapy at the time of injury.    

CURRENT CLINICAL APPROACH:   The wound measured 5 x 9.5 cm.  The wound was cleansed with a dermal wound cleanser[1] and an absorbent silver barrier dressing[2] was applied. He was placed in an open toed post-op shoe for ambulating when necessary, otherwise, was to be non-ambulatory with elevation above his heart level with ankle pumps. The dressing changes were decreased to every two to three days and it conformed to the body contour well.

PATIENT OUTCOME:  Within one month, the wound was closed.  Changing the dressing less frequently provided more comfort and decreased pain.  There were no clinical signs of infection.  Exudate was managed. Faster closure was achieved with fewer outpatient clinic visits and was more cost effective.  

CONCLUSION:  The absorbent silver barrier dressing was a successful method of choice for containing moderate exudate and providing a barrier to bacteria.    

Financial Assistance/Disclosure:  Smith & Nephew, Inc.