The WOCN Society 40th Annual Conference (June 21-25th, 2008)
2262
Use of a 100% Na CMC dressing with Ionic Silver on IV infiltrate wounds in neonates
Melissa B. Waide, MSN, CPNP, CHKD, Pediatric Plastic Surgery Nurse Practitioner, 601 Chlidren's Lane, Norfolk, VA 23507
The management of open wounds caused from IV infiltrates in extremely premature infants poses a challenge since these patients have very fragile skin, are very sensitive to stimulation caused by frequent dressing changes and the increased risk for fungal infections associated with petroleum based products in patients weighing <1000 grams.1
While having an open wound leaves these vulnerable patients at risk to systemic infection, the goal for treatment is to keep the wound clean, covered and moist to promote granulation and rapid wound closure.
Previously these wounds have been treated with silver sulfadiazine or antibiotic ointment topically and/or covered with a dry gauze or non-adherent dressing. These methods required manipulation of these wounds twice a day for patients that can be very unstable with hands-on care. Some of these treatments are not recommended if the infants are under phototherapy or in a humidified environment.
Currently the Na CMC with Ionic Silver dressing is placed on any wound that has been caused by an IV infiltrate that may be necrotic or have superficial tissue loss. The dressing is moistened and covered with an occlusive dressing. Dressing changes are performed weekly or as needed if the dressing dries out. Typically within one week the superficial wounds are healed and the deeper wounds may require another 1 or 2 dressing changes until the area has re-epithelialized.
The Na CMC with Ionic Silver dressing has shown to be an effective dressing for healing wounds caused by IV infiltrates in extremely premature infants requiring fewer dressing changes and less noxious stimulation for the patient while providing antimicrobial coverage to prevent infection and maintain a clean, moist wound bed for granulation and re-epithelialization.
While having an open wound leaves these vulnerable patients at risk to systemic infection, the goal for treatment is to keep the wound clean, covered and moist to promote granulation and rapid wound closure.
Previously these wounds have been treated with silver sulfadiazine or antibiotic ointment topically and/or covered with a dry gauze or non-adherent dressing. These methods required manipulation of these wounds twice a day for patients that can be very unstable with hands-on care. Some of these treatments are not recommended if the infants are under phototherapy or in a humidified environment.
Currently the Na CMC with Ionic Silver dressing is placed on any wound that has been caused by an IV infiltrate that may be necrotic or have superficial tissue loss. The dressing is moistened and covered with an occlusive dressing. Dressing changes are performed weekly or as needed if the dressing dries out. Typically within one week the superficial wounds are healed and the deeper wounds may require another 1 or 2 dressing changes until the area has re-epithelialized.
The Na CMC with Ionic Silver dressing has shown to be an effective dressing for healing wounds caused by IV infiltrates in extremely premature infants requiring fewer dressing changes and less noxious stimulation for the patient while providing antimicrobial coverage to prevent infection and maintain a clean, moist wound bed for granulation and re-epithelialization.
1.Campbell JR, Zaccaria E, Baker CJ. Systemic candidiasis in extremely low birth weight infants receiving topical petrolatum ointment for skin care: a case-control study. Pediatrics 2000 May; 105;(5):1041-5.
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