Clinical Case Series - Wound: Managing Exudative Wounds While Protecting Peri-wound Skin and Promoting Patient Comfort Using Soft Silicone-Exudate Transfer Dressing (SSETD)**

Clinical Case Series: Wound

Problem:  Five patients with differing wounds suffered issues with exudates, maceration and pain. 

Patient A was admitted 5/07 with thoracic surgical wound. Exudates increased with activity, as did frequency of dressing changes and patient’s complaints of pain. 

Patient B was admitted 11/07 after multiple surgeries following near complete traumatic amputation of right leg.  Patient had dressing change-related pain, fragile newly-epithelialized skin and edema-related exudates.

Patient C was admitted 10/08 with left lower extremity ulcer complicated by generalized edema and cellulitis.  Had significant exudates, fragile peri-wound skin and dressing change-related pain.

Patient D was admitted 10/08 post-surgical repair of right ankle. The wound drained copious serosanguinous fluid.  Peri-wound skin was compromised by maceration, erythema and ecchymosis. 

Patient E was admitted 11/08 with non-healing surgical wounds to back. Wounds were highly exudative with macerated and fragile peri-wound skin.  The patient had dressing change-related pain.

Past Management:  Patient A was managed with a dry dressing. 

Patient B had multiple treatments, including negative pressure wound therapy and silver hydrofiber*. 

Patient C was managed with silver hydrofiber* and gauze overwhelmed by edema-related exudates volume.

Patient D was managed with 2% Chlorhexidine Gluconate 70% Isopropyl Alcohol*** pad over incision line with a gauze secondary dressing.

Patient E was managed with silver hydrofiber * often adhering to the wound.

Current Approach:  All patients had SSETD** initiated as primary or secondary dressing.

Patient Outcomes: All patients had improvements in peri-wound skin condition.  Patient B requested the “soft gentle dressing” when discharged. Patient D’s maceration resolved within twenty-four hours of SSFPWCL ** use.  All patients reported decreases in pain.  The nurses caring for patients A and C reported decreased use of pain medication and need for dressing changes.

Conclusion: SSETD ** is an excellent option for managing wound exudates while maintaining/improving peri-wound skin condition and managing pain.

*Aquacel Ag, ConvaTec

**Mepilex Transfer, Molnlycke

***Chloraprep, Enturia